Treatment depends on the type of ovarian cancer, the stage of cancer, and the general health of the patient. The main treatments for ovarian cancer include surgery, chemotherapy, and/or anti-cancer drugs.
Surgery is almost always part of ovarian cancer treatment, but the type of surgery depends on the size and location of the cancer. Surgery is done to make a final diagnosis of ovarian cancer, to see if the cancer has spread, and to remove as much of the cancer as possible.
The most common types of surgery are:
- Bilateral salpingo-oophorectomy: the surgical removal of both the ovaries and fallopian tubes
- Unilateral salpingo-oophorectomy: the surgical removal of one of the ovaries and fallopian tubes
- Omentectomy: the surgical removal of the omentum (the tissue that lines the organs in the abdomen) in the instance that the ovarian cancer has spread to this area of the body
- Lymphadenectomy: the surgical removal of the lymph nodes (or oval-shaped organs of the immune system) in the instance that the cancer has spread through the lymph system
If ovarian cancer is found in organs outside the pelvis, such as in the lymph nodes or liver, the cancer is usually treated with chemotherapy in addition to surgery. Because of the high risk of spread, almost all women with HGSC will receive chemotherapy as part of their treatment - even when the cancer is diagnosed at an early stage. Chemotherapy is a drug treatment that kills cancer cells. Ovarian cancer is most often treated with a combination of two drugs, called carboplatin and paclitaxel (Taxol). At first, chemotherapy works very well and most of the ovarian cancer disappears. Unfortunately, advanced stage ovarian cancer usually comes back within two years in a resistant form which means chemotherapy may no longer work.
There is a great deal of clinical research being carried out to look for better treatments for ovarian cancer. One new treatment is for ovarian cancer patients who have mutations in the BRCA1 or BRCA2 genes, using drugs called poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors work by blocking the repair mechanisms in ovarian cancer cells. When this happens, the cancer cell DNA cannot be repaired and the tumour cells die. While more research is needed, the use of PARP inhibitors in clinical trials has had promising results for women with resistant forms of ovarian cancer that have returned after chemotherapy treatment.