What are the treatment options for (epithelial) ovarian cancer?

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Treatment options may include surgery, chemotherapy and sometimes radiotherapy. The treatment advised in each case depends on various factors such as the stage and grade of the cancer, and your general health. A specialist will be able to give the pros and cons, likely success rate, possible side-effects and other details about the various possible treatment options for your type and stage of cancer.

You should also discuss with your specialist the aims of treatment. For example:

In some cases, treatment aims to cure the cancer. (Doctors tend to use the word 'remission' rather than the word 'cured'. Remission means there is no sign of cancer following treatment. If you are 'in remission', you may be cured. However, in some cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
In some cases, treatment aims to ease symptoms. For example, if a cancer is advanced then you may require treatments such as painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer which may ease symptoms such as pain.

Surgery
An operation is advised in most cases. If the cancer is at a very early stage, (just confined to the ovary and not spread) then an operation to remove the affected ovary and associated fallopian tube may be all the treatment required. However, in many cases the cancer has grown into other nearby structures or has spread. Therefore, a more extensive operation is often needed. For example, the operation may involve removing the affected ovary, plus the uterus, the other ovary and also other affected areas in the lower abdomen.

During the operation the surgeon may take small biopsy samples from structures in the abdomen and from structures lining the abdomen such as the diaphragm or lymph glands (nodes). The samples are looked at under the microscope to see if any cancer cells have spread to these structures. This helps to give an accurate staging and helps to decide on further treatment.

Chemotherapy
Chemotherapy is a treatment of cancer by using anti-cancer drugs which kill cancer cells or stop them from multiplying. See leaflet called 'Chemotherapy with Cytotoxic Drugs' for details. Chemotherapy is commonly given after having an operation. This aims to kill any cancer cells that have been left behind following the operation.

Sometimes chemotherapy is given before surgery to reduce the size of the cancer. This may make surgery easier and more likely to be successful.

A second operation is sometimes advised after a course of chemotherapy. This aims to inspect inside the abdomen, assess how well chemotherapy has worked and to remove any cancer which could not have been removed in the first operation, but which will have shrunk following chemotherapy.

Radiotherapy
Radiotherapy is a treatment that uses high energy beams of radiation which are focussed on cancerous tissue. This kills cancer cells or stops cancer cells from multiplying. (See leaflet called 'Radiotherapy' for details.) Radiotherapy is not often used for ovarian cancer. It is sometimes used following surgery to kill cancer cells which may have been left behind after the operation. Radiotherapy may also be used to shrink secondary tumours that have developed in other parts of the body and are causing pain or other symptoms.