Occasionally, cancers will be advanced at initial diagnosis and your gynecologic oncologist may feel that surgery is unlikely to be as effective as desired, or that immediate surgery will be too difficult for you to tolerate. In this situation, chemotherapy treatments can be given to shrink the tumor. Once there has been shrinkage and your physical condition is improving, surgery is performed usually followed by more chemotherapy.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for ovarian cancer is usually given intravenously (injected into a vein). You may be treated in the doctor’s office or the outpatient part of a hospital.
The drugs travel through the bloodstream to reach all parts of the body. This is why chemotherapy can be effective in treating ovarian cancer that has spread beyond the ovaries. However, the same drugs that kill cancer cells may also damage healthy cells. Chemotherapy is usually given in cycles. Periods of chemotherapy treatment are alternated with rest periods when no chemotherapy is given. Most women with ovarian cancer receive chemotherapy for about 6 months following their surgery.
There is another way to deliver chemotherapy, called intraperitoneal (IP) chemotherapy. With IP chemotherapy, the medications are injected directly into the abdominal cavity in hopes of delivering a large dose directly to the tumor location. Intraperitoneal chemotherapy is recommended for women with Stage III ovarian cancer in whom all of the tumor spots bigger than 1 centimeter were removed with surgery. Recent studies have shown that while IP chemotherapy has more short term toxicity, it is associated with a longer survival rate. It is important for you to talk with your team about the pros and cons of this approach.
Side Effects of Chemotherapy
Each person responds to chemotherapy differently. Some people may have very few side effects while others experience several. Most side effects are temporary. They include:
- Loss of appetite
- Mouth sores
- Increased chance of infection
- Bleeding or bruising easily
- Hair loss