If you’ve been diagnosed with ovarian cancer it can be a very scary and confusing time and you may have a number of questions about what happens next. The section will provide you with information about how ovarian cancer is treated, how to talk to your family and friends about your diagnosis, where to go for more support and advice specifically for younger women.
Treating ovarian cancer often involves surgery followed by chemotherapy. For some women chemotherapy is necessary before surgery. Each woman’s experience is different and your treatment pathway will depend on the type, stage and grade of ovarian cancer you have.
You will be treated by a specialist oncology team that will include a gynaecological oncologist and clinical nurse specialist. More information about your oncology team, and the types of questions you might want to think about asking them can be found in our guide to treating ovarian cancer.
Ovarian cancer surgery is carried out by gynaecological specialist. The aim of surgery is to remove as much of the cancer as possible. Depending on the stage of your cancer some, or all, of the following things may have to be removed during surgery:
- The affected ovary or ovaries and their fallopian tube
- The womb
- The lymph nodes and surrounding tissues
- The omentum (a fold of fatty tissue covering the intestines)
- Any cancer that has spread to the abdominal cavity
- The appendix
After your surgery you may have to stay in hospital for up to a week so you can be monitored by hospital staff. Once you have been discharged home your recovery time could be anywhere between 6 and 12 weeks depending on how invasive your surgery was, and how much time your muscles and tissues need to heal. During this time you will need to avoid things such as lifting, house work, and driving.
Long-term effects of surgery
If you had both of your ovaries removed during surgery this will immediately trigger the menopause.
If you have surgery to remove both ovaries and fallopian tubes, and your womb; you will no longer be able to get pregnant. If you were diagnosed before you were able to complete your family you should discuss the subject of ‘fertility sparing surgery’, which preserves the womb and an unaffected ovary, so that you might be able to become pregnant later on.
Ovarian cancer surgery may also affect your sex life. If you have both of your ovaries removed the levels of oestrogen will be reduced. This could lead to a reduction in the mucus that lubricates your vagina and a loss of fat tissue around your genital area, making your vagina shorter, less elastic and drier. Other changes that may occur include loss of libido, vaginal itching and pain or discomfort during sex.
Most women with ovarian cancer are offered chemotherapy. Chemotherapy is given to reduce any disease that remains after surgery, or to reduce the likelihood of the cancer returning.
Chemotherapy works by attacking cells that divide rapidly. If your cancer has been discovered at an early stage you may not require chemotherapy. However, most patients need to have some chemotherapy and this is usually started after surgery. In some cases, chemotherapy is given first and surgery is carried out afterwards.
Chemotherapy drugs are usually given by mouth or injected into a vein which enables them to enter the bloodstream in order to kill cancer cells. It’s usually given in cycles of treatment followed by a rest period that allows normal cells to recover from the effect of the drugs. A typical course of chemotherapy for ovarian cancer involves six cycles. Each cycle lasts three or four weeks.
When you’ve finished chemotherapy, you will have check-ups every three months, and then every six months if you’re still cancer free. If you are cancer free after ten years (or five years for early stage ovarian cancer), you’ll be considered to be in remission and you’ll no longer need regular check-ups.
Side effects of chemotherapy
Chemotherapy drugs are very powerful and they can affect some normal cells. The cells that are typically affected include hair follicles, the cells that line your stomach and intestines, red and white blood cells, and blood clotting agents.
Symptoms you might experience include nausea and vomiting, a loss of appetite, extreme tiredness, a sore mouth and, with certain types of chemotherapy, hair loss.
Side effects experienced will vary from person to person, and will depend on how much of a drug you are given and how long your treatment lasts. It may also just depend on how your body reacts generally to the treatment. If you experience side effects during your treatment be sure to discuss them with your clinical oncology team as they will be able help you manage them.
Treatments such as targeted therapy, hormone therapy and complimentary therapy may also be available. Many of these treatments are not commonly used, and can sometimes only be accessed by being part of a clinical trial. If you would like to explore other treatment options for ovarian cancer you should start by discussing this with your gynaecological oncologist.
More information about other treatments is available in our guide to treating ovarian cancer.
Advice for younger women
Risk of developing ovarian cancer increases with age, with 84 percent of cases diagnosed in women over the age of 50. However, ovarian cancer can affect women of all ages, and there are things that younger women may need to think about and consider if they have the disease. Our younger woman’s guide to ovarian cancer contains everything you need to know about having the disease at a younger age. Download it here.
Telling your family and friends
Telling your family and friends that you have ovarian cancer can be difficult and you may feel worried about how they will react. There’s no right or wrong way to let your family and friends know, but following these tips might help:
- Choose a quiet location – a comfortable, quiet and private place will help you to focus on what you’re saying.
- You don’t have to do it alone – you may find it easier to have someone with you while you tell other people, or you may prefer someone else to tell your friends and family for you.
- Little by little – introducing the subject gradually will give people time to prepare for what they’re about to hear. Telling people suddenly can sometimes cause more distress.
- Keep it brief – talking about key facts will help your friends and family process what they’re hearing.
Macmillan cancer support have a lot of further advice about how to talk to your friends and family about ovarian cancer here.