Chemotherapy for ovarian cancer uses drugs designed to destroy cancer cells or stop their growth. The type of chemotherapy given depends on the type of ovarian cancer. Usually, two different types of drugs are given together, but there are many combinations of drugs.
Chemotherapy may be used to:
- Kill cancer cells that may be left after surgery (“adjuvant” chemotherapy – chemotherapy given after surgery)
- Shrink ovarian tumors before surgery or radiation therapy to make the treatment easier (also called “neoadjuvant” chemotherapy – chemotherapy given before surgery or radiation)
- Kill cancer cells that have spread (metastasized) to other parts of the body
What types of chemotherapy are used for ovarian cancer?
Several types of chemotherapy are commonly used to treat ovarian cancer when newly diagnosed. Understanding the specific types of ovarian cancer can help patients and caregivers make informed decisions about treatment options. The two most common types of chemotherapy given when newly diagnosed are:
- Platinum-Based Chemotherapy
- Platinum-based chemotherapy is a type of cancer treatment that uses drugs containing the metal platinum (cisplatin and carboplatin). These drugs are commonly used in chemotherapy regimens for various cancers, including ovarian cancer. They work by interfering with the DNA in cancer cells, stopping them from dividing and ultimately causing them to die.
- Taxanes
- Taxanes (paclitaxel Taxol®) are a class of chemotherapy drugs that work by disrupting the process of cell division, which is crucial for cancer cell growth.
There are many other drugs that may be used to treat ovarian cancer. Visit ACS to learn more about these different chemotherapy drug options.
Informative Video - How is chemotherapy used to treat ovarian cancer?
Sarah Taylor, MD, an expert in cancer and women’s health from the University of Pittsburgh, discusses when and how chemotherapy is used to treat ovarian cancer and why it can be so effective. She also discusses chemotherapy that is done during surgery and how chemotherapy can help keep cancer from returning after treatment.
Chemotherapy for different ovarian cancer types
There are many types of ovarian cancer (subtypes), each responding differently to chemotherapy. Understanding your specific type of ovarian cancer is important for selecting the most effective chemotherapy treatment plan.
- Chemotherapy for epithelial ovarian cancer:
- Chemotherapy for epithelial ovarian cancer is usually given over 3 to 6 cycles. A cycle is a period of treatment followed by rest to allow your body to recover. Chemotherapy for epithelial ovarian cancer usually combines two drugs: a platinum drug (cisplatin – trade name Platinol and carboplatin- trade name Paraplatin) compound and a taxane (paclitaxel – trade name Taxol).
- Chemotherapy for germ cell tumors:
- Chemotherapy for germ cell tumors usually involves a combination called “BEP” (bleomycin, etoposide, and cisplatin). You may receive other drug combinations if the cancer isn’t responding to treatment or has come back. To learn about additional treatment for germ cell tumors, visit the ACS to learn more.
- Chemotherapy for stromal tumors:
- Stromal tumors aren’t usually treated with chemotherapy. When they are, treatment usually combines carboplatin and paclitaxel or PEB (cisplatin/Platinol, etoposide, and bleomycin).
How is chemotherapy given?
The way chemotherapy is given can greatly impact its effectiveness and the patient’s experience. In some cases, a combination of methods may be used. Chemotherapy is usually given in the following ways:
- Intravenous (IV) Chemotherapy: Most chemotherapy is given intravenously – injected into a vein either in the arm or chest via a needle or port.
- Advantage: Allows the drugs to quickly enter the bloodstream and circulate throughout the body, targeting cancer cells in various locations.
- Oral chemotherapy: Taken by mouth in pill or capsule form.
- Advantage: Convenient with ease of administration by the patient at home without the need for frequent hospital visits.
- Intraperitoneal (IP) Chemotherapy: Injected into the abdomen by a thin tube (catheter)
- Advantage: Delivers high concentrations of chemotherapy directly into the site of the cancer, potentially increasing effectiveness against tumors in the abdomen.
- Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Circulated through the peritoneal cavity at the time of surgery.
- Advantage: Delivers high concentrations of heated chemotherapy directly to the cancer site, reducing systemic exposure and reducing potential side effects.
Dosage and frequency may be daily, weekly, or monthly, depending on the type of ovarian cancer and chemotherapy. The duration depends on what research has shown to be the most effective for the particular type of cancer.
What are the side effects of chemotherapy for ovarian cancer?
Chemotherapy can lead to a range of physical, emotional, and psychological side effects. While it is effective at killing cancer cells, it can also damage healthy cells, which may weaken the body and cause a variety of symptoms. It’s crucial to inform your healthcare team about any side effects you experience so they can prescribe the appropriate medications and help manage them. In this section, we will explore some of the most common side effects associated with ovarian cancer treatments and discuss ways to manage them effectively.
Anxiety and depression
Anxiety can happen to anyone, but women facing recurrent ovarian cancer may get anxious more easily than others. Anxiety and fear are common and normal feelings when coping with a life-threatening illness. Some signs of anxiety:
- Feeling uneasy and tense
- Feeling of restlessness, uncertainty, and dread
- Sweating a lot
- Having a rapid heart rate or feeling your heart pounding in your chest
- Having a knot in your stomach
- Shakiness or have difficulty falling asleep
Some ways to cope with anxiety and depression include:
- Breathing exercises or meditation
- Getting a massage
- Listening to relaxation music
- Taking a drive or spending time in nature
- Watching a funny movie or TV show
- Playing with your dog or cat (or any pet)
- Taking a class
- Crafting (knitting, painting, etc.)
- Exercising or gentle stretching
- Taking up a new hobby
Brain fog (chemobrain)
It’s possible that memory problems, difficulties with concentration or “fogginess” may occur while undergoing chemotherapy or other treatments. It’s important to talk to your doctor since there may be ways to manage or treat these symptoms. Other factors may also play a role, such as insomnia, fatigue, depression, stress and anxiety.
Constipation
During treatment, it may be difficult to pass a stool (constipation). These changes can be caused by cancer treatment, changes in diet, pain medication and inactivity. If constipation is severe or lasts more than a few days, talk to your doctor. It may help to:
- Eat high fiber foods
- Move around as much as possible
- Add a fiber laxative to your diet
- Talk to a doctor before using suppositories (laxatives other than fiber, stool softeners or enemas)
Diarrhea
Diarrhea is loose, watery stools (bowel movements). Diarrhea can be dangerous because the body may not absorb enough water and nutrients and can cause you to become dehydrated or malnourished. Chemotherapy and other cancer treatments can cause diarrhea or make it worse. If it’s severe or lasts more than a few days, talk to your doctor. It may help to:
- Drink plenty of fluids
- Avoid insoluble fiber (whole grains and bran, nuts and some vegetables)
- Add soluble food (some fruit, including apples and berries, potatoes, lentils, peas, barley, oats and oat bran)
- Eat small meals and often
- Use reduced-lactose products
- Avoid caffeine
Fatigue
Fatigue is an extremely common problem for those going through treatment. You may experience fatigue much differently than healthy individuals do. Those in treatment describe fatigue as a chronic, unpleasant, distressing, life-and-activity limiting tiredness throughout the day that is not relieved by sleep and rest, while healthy peopleview fatigue as a normal, even pleasant part of daily life.
- Allow ample time to sleep
- Identify ways that necessary activities can be done using less energy (e.g., sitting while showering or preparing food)
- Schedule tasks that take the most energy at times of the day when you have the most energy
- Set priorities, eliminate non-essential activities, and delegate tasks to others when possible
- Talk to your doctor about exercise and routines that might help
Anemia
Anemia is the result of a decrease in oxygen transported to the cells throughout the body. This can make you feel tired. Anemia occurs when chemotherapy decreases the ability of the bone marrow to make red blood cells, lowering the amount of red blood cells to carry oxygen throughout the body. Tell your doctor if you are feeling extra tired or have other signs of fatigue or anemia. Here are some tips that may help:
- Eat well and stay hydrated
- Take time to rest and recover
- Talk to your doctor about including iron-rich foods or supplements
Hair loss
For many women, losing their hair (alopecia) is one of the most devastating side effects since it’s so visible and linked to a person’s identity and style. Chemotherapy can cause hair loss all over the body, including the eyebrows, eyelashes, arms and legs. Fortunately, the hair almost always grows back following treatment. To manage the stress from hair loss:
- Cut your hair to prepare for hair loss
- Consider wearing a wig
- Treat hair gently and use a mild shampoo
- Try hats and scarves
Infection
Many chemotherapy drugs can reduce the number of white blood cells, increasing the chance of infection. During treatment, even minor infections can become a problem. Some signs of infection include fever, chills, diarrhea, pain and redness at surgical sites, or bloody or cloudy urine. Tell your doctor if you think you may have an infection. To prevent infection:
- Avoid cuts and scrapes
- Wash hands often
- Avoid crowds
- Trim nails carefully
- Take a warm bath or shower daily
- Stay away from sick people
- Drink plenty of fluids
Infertility
After completing ovarian cancer treatment, some women maintain their fertility while others do not. If only one ovary was removed, it may still be possible to become pregnant. Some ovarian cancer treatments may cause infertility, including:
- Surgery to remove both ovaries
- Chemotherapy that changes your menstrual cycle
- Radiation directed at the pelvic area that damages ovaries
There are options for those who want a family, including in vitro fertilization (IVF) with a donor egg, surrogacy and adoption.
It’s important to discuss your fertility preferences and options with your medical team so your treatment can be planned accordingly. If you have undergone treatment for ovarian cancer and wish to have children, we suggest that you see a reproductive endocrinologist – a doctor who specializes in infertility treatment.
Mouth and throat problems
Chemotherapy can affect the healthy lining of your mouth, throat and tongue, causing difficulty in swallowing. In addition, the tissue inside the mouth can become irritated and dry, leading to a loss of appetite, mouth sores and infections. It may help to:
- Keep your mouth moist
- Rinse your mouth frequently
- Avoid irritating foods and drinks
Nausea and vomiting
Cancer treatment can cause nausea and vomiting. This can be prevented with certain medications. Be sure to discuss this with your doctor prior to treatment. Not every person experiences nausea and vomiting, but for those who do, the level of discomfort varies from person to person, drug to drug. It can last from hours, to a day or sometimes longer. Here are some tips that may help:
- Take an anti-nausea medicine
- Relax before treatments
- Avoid greasy, high-fat foods
- Eat and drink slowly
- Rest after eating
- Stay hydrated
Nerve and muscle problems
Chemotherapy can affect muscles and nerves, causing tingling, burning or numbness in the hands and feet (peripheral neuropathy). It can also cause loss of balance and clumsiness. It may help to:
- Wear sturdy, non-slip shoes
- Be careful when bathing
- Grab items slowly
- Soak hands and feet
- Move carefully
Pain
Pain is a common side effect of cancer and can be caused by a tumor pressing on nerves, bones or organs. It can also be caused by cancer treatments. Talk to your doctor if you are uncomfortable. It may help to:
- Track your pain levels daily and report trends to your doctor
- Stay on schedule with medication; don’t wait until pain gets worse
- Try complementary therapies
- Meet with a palliative care or pain specialist
Sexual side effects
It’s not unusual to lose a desire for sex or are not as interested in it as usual during your treatment. This is understandable, given the emotional and physical stress. Treatment side effects such as nausea, fatigue and pain, along with changes in the body’s appearance (e.g., hair and weight loss) can also reduce libido. Common problems include menopause symptoms, sexual problems and infertility.
Though a patient may be disinterested in sex and feel tempted to withdraw, they should communicate with their partner, address each other’s fears and stay connected. In time, by being tolerant of oneself and only doing what feels comfortable, and as health improves, a patient can look forward to feeling sexual again. It may help to:
- Communicate needs and limits with your partner and address feelings of fear
- Explore non-sexual intimacy, such as hugging, cuddling, kissing and holding hands as satisfying additions or alternatives to sex
- Rest and plan before and after sexual activity, and plan sexual activity during times of heightened energy levels
- Use water-soluble lubricants to help with vaginal dryness caused by hormonal changes
- Contact a counselor or therapist to help with emotional issues and sexual problems associated with cancer treatment and recovery
Skin irritation
Chemotherapy and other treatments can cause rashes, itching and peeling skin, and increase sensitivity to the sun. Cracked and irritated skin can be more prone to infection, so it’s important to take care of your skin during treatment:
- Apply sunscreen and lip balm
- Use skin products that are doctor recommended (soaps, lotions, moisturizers, powders)
- Let skin breathe
- Stay clean and dry
Informative Video - Brain Fog - Signs, Symptoms, and Coping Techniques
Dr. Chanel Davidoff, a cancer rehabilitation specialist, explores how cancer treatments can lead to brain fog or chemo brain and offers strategies for managing symptoms, improving focus, and discussing concerns with your doctor to enhance quality of life.
Nutrition during chemotherapy for ovarian cancer
One of the most important things you can do for yourself as you undergo treatment for recurrent ovarian cancer is to eat healthy. During the course of your treatment, your doctor may refer you to a nutritionist. This specialist can help design a good nutrition plan that you can easily follow. It is recommended that this plan consists of 5 fruits and vegetables a day. (Note: Fresh fruits and vegetables should be avoided if you are neutropenic.) It is also suggested that you eat chicken and fish and avoid red meat when you can.
To optimize your health and well-being during chemotherapy, you should include:
- Lean proteins: Chicken, turkey, fish, eggs, tofu, beans, and legumes
- Whole grains: Brown rice, quinoa, whole wheat bread, oatmeal, and barley
- Fruits and vegetables: Berries, oranges, apples, leafy greens, carrots, and bell peppers
- Healthy fats: Avocado, nuts, seeds, olive oil, and fatty fish like salmon
- Dairy or dairy alternatives: Greek yogurt, cottage cheese, milk, or fortified plant-based milks like almond or soy milk
- If you feel nauseated, eat plain carbohydrate foods, such as toast, pretzels, crackers, oatmeal, noodles or white rice
- Eat smaller, more frequent meals: Eat smaller portions more often throughout the day. If you have a decreased appetite, keep your favorite foods on hand to help you eat more.
- Snack between meals: Have a high-protein diet supplement or milkshake to add calories and nutrients.
- Plan meals: Decide your menus in advance and freeze extra meals to simplify your cooking schedule. If you often feel tired, buy foods that need little or no work to prepare.
- Make eating enjoyable: Dine with family or friends, play music, or set a tranquil mood with candles.
Watch our video playlist on nutrition for additional information.
Helpful Service: Free Meal Delivery
If you or a loved one is in active treatment for ovarian cancer, our free meal delivery service is designed to support patients with nutritious meals that can help provide the essential nutrients needed during treatment while reducing the financial burden when facing treatment.
Questions to ask your doctor
Starting chemotherapy for ovarian cancer can be overwhelming, but being well-informed can help you feel more confident and prepared. Here are some essential questions to ask your doctor that can help you understand your treatment plan and what to expect.
- What type of chemotherapy will I receive?
- How will the chemotherapy be administered?
- What is the schedule for my chemotherapy treatments?
- What is the goal of this chemotherapy treatment?
- What are the common side effects of the chemotherapy drugs I will be receiving?
- How can I manage these side effects?
- Are there any long-term side effects I should be aware of?
- What should I do if I experience severe side effects?
- How will chemotherapy affect my daily routine?
- Can I continue to work during chemotherapy?
- Are there any dietary restrictions or recommendations?
- How will we know if the chemotherapy is working?
- What other treatments will I need in conjunction with chemotherapy?
- Are there any clinical trials available for my type of ovarian cancer?
- What support services are available to me?
Ovarian cancer treatment resources
To find more information about ovarian cancer treatment and side effects, visit these helpful resources:
- American Cancer Society – Treatment Ovarian Cancer
- National Comprehensive Cancer Network – Ovarian Cancer Treatment Guidelines
- National Ovarian Cancer Coalition – Resource Guide for Those Newly Diagnosed
- National Ovarian Cancer Coalition – Resource Guide for Women With Recurrent Disease
- You and Ovarian Cancer – Animated Patient Guide
Medically reviewed and updated | August, 2024
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