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Chemotherapy for Ovarian Cancer

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

a group of people in a hospital receiving chemotherapy for ovarian cancer

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.

six food containers arranged in a circle on a white background

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.

Learn more

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.