This page was reviewed under our medical and editorial policy by
Ruchi Garg, MD, Chair, Gynecologic Oncology, City of Hope Atlanta, Chicago and Phoenix
This page was reviewed on May 17, 2022.
Treatment for ovarian cancer typically depends on many factors, including the cancer type and stage, the potential side effects, the woman’s age and whether she’s planning to have children. Surgery is often the first treatment recommended for ovarian cancer, and may involve the removal of the ovaries and fallopian tubes, uterus, lymph nodes in the area, and surrounding organs and tissue including omentum and appendix. Chemotherapy is usually recommended after surgery for epithelial type ovarian cancers.
Cancer treatments generally fall into two categories.
There are many types of surgical procedures that may be used, depending on the cancer’s stage and original location. These include:
For patients with recurrent ovarian cancer, a treatment options are individualized and may include surgery followed by chemotherapy, or chemotherapy on its own.
Learn more about surgery for ovarian cancer
Chemotherapy drugs are used to kill cancer cells or prevent their growth. This treatment may be used to shrink large tumors and make surgery easier to perform, or to treat any cancer cells that remain following tumor removal. They’re administered orally, intravenously or directly into the abdomen by catheter, known as hyperthermic intraperitoneal chemotherapy (HIPEC).
PARP inhibitors are a form of targeted therapy used to treat ovarian cancer. Designed to block the enzyme named poly ADP-ribose polymerase (PARP) from identifying damaged DNA inside cancer cells, PARP inhibitors may stop cancer cells from repairing themselves. The U.S. Food and Drug Administration has approved certain PARP inhibitor drugs to treat ovarian cancer.
There are other ovarian cancer treatments that aren’t as common but still may be used in specific situations.
This treatment targets cancer cells in order to kill them or keep them from growing. Radiation therapy may be recommended in rare cases of ovarian cancers where the tumor is isolated to an area and can be targeted with the radiation beam when there are otherwise limited treatment options for the patient.
Hormone therapy is designed to deprive ovarian tumor cells of the hormones they need to grow, including estrogen. Hormone therapy for ovarian cancer may be used subsequent to chemotherapy and other therapies. A common regimen of hormone therapy for ovarian cancer patients involves a class of drugs to lower estrogen levels in the body. This type of treatment is more commonly used in rare ovarian stromal tumors.
Cancer research is ongoing, with many ongoing clinical trials for ovarian cancer therapies. Patients should ask their doctors about the most recent studies and the potential benefits and risks. At City of Hope, we have several ongoing trials available to offer a range of treatment options for our patients diagnosed with ovarian cancer.
Ovarian egg preservation or ovarian tissue preservation involves freezing ovarian tissue before cancer treatment so women may be able to have children later. Fertility preservation is a common concern for young women diagnosed with cancer, particularly those diagnosed with cancer affecting the reproductive system. In some cases, surgery to remove a tumor may require removal of the ovaries, fallopian tubes, cervix or uterus. Even without surgery, treatments such as chemotherapy and radiation therapy may damage these organs.
If fertility is a concern, we recommend discussing this with your provider prior to beginning any therapy.
Treatment for ovarian cancer typically starts with surgery to remove the tumors and check for cancer in the lymph nodes. The extent of the surgery will depend on the cancer’s stage. Additional treatment with chemotherapy and/or targeted therapy, such as PARP inhibitors or monoclonal antibodies, are also options that will depend on the stage of the cancer.
Stage 1 or early ovarian cancers are typically first treated with surgery, which may help determine whether the cancer cells have spread to the lymph nodes in the abdomen.
For some women, surgery may be the only treatment needed for stage 1 ovarian cancer. However, based on factors like genetics, the size of the primary tumor or the cancer’s characteristics, the patient may also benefit from chemotherapy. The cancer cells’ grade, or how they look under a microscope, can also guide the need for chemotherapy.
If surgery reveals that cancer has spread to the lymph nodes or other structures in the abdomen, doctors classify it as more advanced. For stages 2, 3 and 4 ovarian cancers, the care team may recommend other treatments along with surgery.
Depending on the tumor size, doctors may recommend chemotherapy or targeted therapy before surgery to shrink the tumor. This approach is called neoadjuvant therapy.
Surgery may be followed by chemotherapy (which may be given either through an IV or directly into the abdomen), targeted therapy or both.
More specifically:
Women concerned about their risk of ovarian cancer should speak with their doctor about whether preventive surgery may be an option. Candidates for preventive surgery may have a: