Ovarian cancer treatment
A diagnosis of ovarian cancer can feel life-altering. At Advocate Cancer Institute, we support you with a full range of treatments to help you fight the condition with confidence.
Our multidisciplinary team includes gynecologists, gynecologic oncologists, radiation oncologists, reconstructive urologists, pathologists, genetics counselors, nurses and more – all dedicated to providing compassionate care to patients with ovarian cancer. We’ll work closely with you to create the best possible ovarian cancer treatment plan, including a full range of cancer support services to meet your needs.
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Ovarian cancer stages
If you have an ovarian cancer diagnosis, your ovarian cancer doctor will determine what stage your cancer is during a process called staging. A pathologist will examine and evaluate a biopsied tissue sample and determine the size of the tumor, and whether it has spread from the original site (metastasis). This will determine your ovarian cancer care plan.
Definitions of ovarian cancer stages
Ovarian cancer stages are defined by where your cancer is located and if it has spread to nearby or distant lymph nodes, fluids or organs. The lower the stage number, the less the cancer has grown or spread, and the higher your chances of successful cancer treatment.
In stage 1 ovarian cancer, the cancer is in the ovary or fallopian tubes and has not spread to lymph nodes or to any organs.
Stage 1A: Cancer is in one ovary.
Stage 1B: Cancer is in both ovaries or the fallopian tubes.
Stage 1C: Cancer is in one or both ovaries and fallopian tubes and one of the below is also occurring:
- Stage 1C1: Cancer is present on the surface of one or both ovaries.
- Stage 1C2: The tissue surrounding the tumor has ruptured before surgery.
- Stage 1C3: Cancer has spread to the fluids of the pelvis or abdomen.
Treatment: If there is a tumor present, your provider will likely recommend surgery to remove it. Additional treatment may not be needed for this stage of ovarian cancer, but chemotherapy or additional treatments may be recommended for those with 1B or 1C.
In stage 2 ovarian cancer, the cancer has spread from the ovaries to other nearby pelvic organs or the lining of your abdomen. It has not spread to lymph nodes or distant organs.
Stage 2A: Cancer is also in the uterus or fallopian tubes.
Stage 2B: Cancer is also in nearby pelvic organs like the bladder or rectum.
Treatment: In most cases, surgery to remove the tumor or reduce the size of the cancer is recommended for this ovarian cancer stage, but it depends on the type of tumor. Surgeries could include a total hysterectomy (removal of the whole uterus) or hysterectomy with salpingo-oophorectomy (removal of one or both ovaries, and the fallopian tubes, along with the uterus). Chemotherapy is also recommended.
In stage 3 ovarian cancer, the cancer has spread to nearby organs or lymph nodes, but not to distant sites beyond the abdomen and pelvis.
Stage 3A: Cancer cells are in the pelvis and have spread to lymph nodes outside or behind the peritoneum (membrane lining the cavity of the abdomen).
Stage 3B: Cancer smaller than 2cm has spread to the peritoneum and possibly the lymph nodes beyond the peritoneum.
Stage 3C: Cancer larger than 2cm has spread to the peritoneum and possibly to the lymph nodes in the abdomen or the outside of the liver or spleen.
Treatment: The ovarian cancer care plan for stage 3 cancer usually includes surgery to remove as much of the tumor as possible, along with more robust chemotherapy treatments to shrink and kill tumor cells. Monitoring through ovarian cancer palliative care – specialized care to relieve the symptoms, stress and pain of serious illnesses – will be required for follow-up treatment and recurrence.
In stage 4 ovarian cancer, cancer has spread to distant organs and tissues, like the liver, bones and lungs. Stage 4 cancer is considered metastatic ovarian cancer, the most advanced stage of the cancer.
Stage 4A: Cancer has spread to the fluid between the lungs and chest wall.
Stage 4B: Cancer has spread to the organs outside of the abdomen, such as the spleen, liver and lymph nodes in the groin-area.
Treatment: Stage 4 cancer can be cured and is treated like stage 3, with further monitoring. Chemotherapy will be needed before and after surgery and a targeted treatment drug may also be prescribed.
Ovarian cancer care plan
Treatment of ovarian cancer depends on a variety of factors, including the grade and stage of cancer, as well as your overall health and personal preferences. Our goal is to keep you feeling well throughout treatment without any major changes to your usual routine.
Hysterectomy
Surgical removal of the reproductive organs (hysterectomy) is often recommended for ovarian cancer care plans. Types of hysterectomy we perform include:
- Total hysterectomy: Removal of the whole uterus, including the cervix, but not the fallopian tubes or ovaries.
- Hysterectomy with salpingo-oophorectomy: Removal of one or both ovaries, and the fallopian tubes, along with the uterus.
- Radical hysterectomy: Removal of the uterus, cervix, and the top part of the vagina; pelvic lymph nodes may also be removed.
- Supracervical hysterectomy: Removal of the uterus while leaving the cervix whole.
- Abdominal hysterectomy: The reproductive organs are removed via an incision in the abdomen, either vertically from the navel down or horizontally along the top of the pubic hairline.
- Vaginal hysterectomy: The uterus is removed through the vaginal opening. You will not need an incision which means there is no visible scarring.
- Laparoscope-assisted vaginal hysterectomy: The uterus is removed in sections through a laparoscope tube inserted through tiny incisions in the abdomen or through the vagina. This results in minimal visible scarring and faster recovery.
It’s important to note that removing your ovaries or uterus will affect your ability to have children. If preserving your fertility is important to you, let your doctor know so they can discuss various options with you.
Chemotherapy, hormone therapy & radiation therapy
Chemotherapy is another treatment for ovarian cancer. The chemotherapy medication may be injected or it may be taken orally. Chemotherapy destroys cancer cells.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative way of using chemotherapy during surgery. After your surgeon removes all visible tumors, a heated chemotherapy agent is placed in the area for an hour or more so it can treat cancer cells that are too small to be visible. The chemo drug is then drained and the incision is closed.
Hormone therapy and radiation therapy are also used to treat ovarian cancer. Hormone therapy uses hormones or hormone-blocking medications to slow or block the growth of cancer cells.
Radiation therapy is recommended only occasionally for ovarian cancer care plans.
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