Treatment overview

The main treatments for ovarian cancer are surgery and chemotherapy. Occasionally other treatments are used, such as radiotherapy or targeted (biological) therapies.

Decisions about the best treatment for you are made by a team of experts called a multidisciplinary team. The treatment plan they advise is based on:

  • the type of ovarian cancer you have
  • its stage and grade
  • where it is
  • your general health
  • your personal preferences.

Your cancer doctor and nurse can help you if you need to make decisions about treatment. They will also make sure your preferences are taken into account.

Early ovarian cancer

Women with borderline tumours or women with certain stage 1 ovarian cancers can often be cured with surgery.

Because they are not a true cancer, borderline ovarian tumours are treated with an operation alone. Occasionally, cells from these tumours spread and grow somewhere else, such as on the peritoneum. These are called ‘non-invasive implants’. They don’t usually cause problems and often don’t need to be treated. Instead the doctor may monitor them at regular check-ups.

The organisation Ovacome has more detailed information about borderline ovarian tumours. Call their support line on 0845 371 0554 or visit their website.

If you have early-stage ovarian cancer (not a borderline tumour), in certain situations your doctor may recommend chemotherapy after surgery. This is to reduce the risk of the cancer coming back. It includes stage 1 cancers that are:

  • high-grade
  • clear cell cancer
  • stage 1c.

It’s not common for ovarian cancer to be diagnosed at stage 1.

Ovarian cancer stages 2–4

You usually have a combination of surgery and chemotherapy or chemotherapy on its own. The aim of treatment may be to cure the cancer or to keep it under control for as long as possible. Your cancer doctor and specialist nurse can explain more about this.

You have surgery to remove as much of the cancer as possible. Doctors sometimes call this debulking. After this you have chemotherapy, either to:

  • treat cancer cells that cannot be seen during surgery – they can only be seen under a microscope
  • shrink any remaining cancer that couldn’t be removed during the operation.

If an operation isn’t likely to remove most or all of the cancer, you may be given some chemotherapy first. This is done to shrink the cancer so that surgery is more successful. After the operation, you have some more chemotherapy.

Sometimes chemotherapy is the main treatment. This is usually when an operation isn’t possible because of where the cancer is or if you aren’t well enough for a major operation. The aim is to shrink the cancer, help to control it and relieve symptoms.

When ovarian cancer is not at an early stage it’s more likely to come back (recurrence). If this happens it can usually be treated again with more chemotherapy and sometimes more surgery. Some women have several courses of chemotherapy, when they need it. This keeps the cancer under control for many years.

Newer treatments are also being developed. Your cancer doctor may talk to you about taking part in research, such as in a clinical trial.

Sometimes, if the cancer is very advanced, women may decide not to have or continue with cancer treatments. Your cancer doctor and nurse will support you and prescribe drugs and treatments to control and reduce your symptoms. This is known as supportive care (palliative care). You may see a specialist palliative care doctor or nurse for expert help with your symptoms.

We have more information to help support you if the cancer is advanced.

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Staging and grading ovarian cancer

The stage and grade of ovarian cancer, fallopian tube cancer and primary peritoneal cancer describes its size, whether it has spread and how quickly it may grow.