what are the treatment options?

When thinking about your treatment, your doctors will take into account:

• the type of ovarian cancer you have
• whether there are signs the cancer has spread, and if so where to
• your age and general state of health
• your wishes.

Your doctors will tell you about the risks, benefits and side effects of the treatments being offered, and how they may affect your life afterwards.

You will then need to agree to the treatment before it can start. This is called giving your consent. Don’t be afraid to ask questions if there is anything you don’t understand.

The treatments you may be offered are:

Surgery
This means an operation to remove the cancer.

The most usual type of operation for ovarian cancer is a laparotomy.

Your surgeon may not be able to predict exactly how much surgery you will need. S/he may need to make these decisions during the operation. S/he will talk with you in advance about what might happen, so that you are prepared and can give your consent.

The surgeon will usually take out both of the ovaries, the uterus (womb) the fallopian tubes and a sheet of fatty tissue called the omentum. This means that you will not be able to have children and your menopause will begin, if it hasn’t already. Some women then have hormone replacement therapy (HRT) to counter some of the effects of the menopause, such as hot flushes.

If there is cancer on the bowel, the surgeon may have to cut out a piece of the bowel, and re-join the two ends. Some women need to have a colostomy. This means that your bowel will open onto the surface of the abdomen and you will need to wear a colostomy bag to collect your stools. In some cases the colostomy can be reversed later on, so that your bowel gets back to normal.

Rarely, if the cancer has grown into the bladder, the surgeon may need to take out some of the bladder, too.

Chemotherapy
Many women have chemotherapy after their surgery. Chemotherapy uses special drugs to kill cancer cells. The aim is to try to kill any cancer cells left behind after the operation. Sometimes chemotherapy is used before surgery to shrink the tumour, this is called neo-adjuvant therapy. Surgery is sometimes done after chemotherapy if it is felt that this is appropriate or may not be done at all dependant on the reponse to chemotherapy, your wishes and the decision of the multidisiplinary team.

The treatment usually involves Platinum compounds, and may involve other drugs.

They are usually injected into a vein, and you have several treatments over a period of a few weeks or months.

Ovarian cancer responds well to chemotherapy, although it may come back at some stage in the future. If it does, the doctor may try some different drugs to try to shrink the cancer, or s/he may discuss other treatment options with you.

Treatments to relieve symptoms
Ovarian cancer can’t always be cured… but treatment can shrink the cancer, make you feel better and prolong life.

If cancer has caused fluid to build up in the abdomen or around the lung, the doctor can help you to feel better by draining off the fluid through a tube. The fluid will build up again over time, and so the treatment may need to be repeated.