Ovarian Cancer Treatment
When you receive ovarian cancer treatment at MD Anderson, a multidisciplinary team of some of the nation’s foremost experts customizes your care. This team of specialists communicates and collaborates at every step. They customize your ovarian cancer treatment to be sure you receive the highest chance for successful treatment with the least impact on your body.
Our physicians have extensive experience in treating every type of ovarian cancer, including recurring and rare ovarian cancers. We offer the latest, most advanced therapies, including surgery, chemotherapy, hormonal therapies, targeted therapies and immunotherapies.
Surgery usually is the first step in treating ovarian cancer. It is crucial that your surgeon be experienced in this delicate procedure. Studies have shown that patients with ovarian cancer have better outcomes and better chances for survival when the largest amount possible of the tumor is removed.
The gynecologic oncology surgeons at MD Anderson are some of the most experienced in the nation. This gives them a level of expertise that is available at few other cancer centers.
Pioneering research
Our experts are constantly researching newer and more advanced ovarian cancer treatment, including working to understand it on the molecular and genetic level. In some cases, we can offer gene therapy and targeted therapies that are available at only a few places in the nation.
We are proud to house a prestigious federally-funded Ovarian Cancer SPORE (Specialized Program of Research Excellence) program. This means we can offer a wide variety of clinical trials for new therapies.
Ovarian cancer treatments
If you are diagnosed with ovarian cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:
- The exact type of ovarian cancer
- The stage of the cancer
- The size of the tumor after surgery (debulking)
- Your desire to have children
- Your age and overall health
Surgery, followed by chemotherapy, is a common treatment for ovarian cancer. One or more of the following therapies may be recommended to treat ovarian cancer or help relieve symptoms.
Ovarian cancer surgery
Surgery is the main treatment for ovarian cancer. Often, ovarian cancer surgery is done to remove or biopsy a mass to find out if it is cancer. Once cancer is confirmed, the surgeon stages the cancer based on how far it has spread from the ovaries. If the disease seems to be limited to one or both ovaries, the surgeon may immediately remove the ovarian cancer and will biopsy the pelvis and abdomen to find out if the cancer has spread.
It is often obvious during the surgery whether ovarian cancer has spread; if it has, the surgeon will remove as much of the tumor as possible. This may help other treatments work better. This is called debulking.
The ovaries, uterus, cervix, fallopian tubes and omentum (fatty tissue around these organs), and any other visible tumors in the pelvic and abdominal areas may be removed during debulking. The spleen, lymph nodes, liver or intestines also may be removed partially or completely. Sometimes debulking is not possible because the patient is not healthy enough or the tumor may be attached to other organs. In these cases, any tumor left will be treated with chemotherapy.
Chemotherapy for ovarian cancer
Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.
You may need chemotherapy after surgery to destroy ovarian cancer cells that are still in the body.
Learn more about chemotherapy.
Intraperitoneal chemotherapy (IP therapy) for ovarian cancer is a way to give chemotherapy drugs. It may be used if a small amount of tumor is left after debulking. Sometimes IP chemotherapy works better than regular chemotherapy. In IP treatment, concentrated chemotherapy is put into the abdominal cavity through a catheter (tiny tube) or implanted port. This allows it to come into contact with the cancer and the area of the body where the cancer is likely to spread. The drugs also get into the blood and travel through the body.
Radiation for ovarian cancer
Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Although radiation therapy rarely is used to treat ovarian cancer, it may help destroy any cancer cells that are left in the pelvic area.
Learn more about radiation therapy.
Ovarian cancer targeted therapy
Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.
MD Anderson is among just a few cancer centers in the nation that are able to offer targeted therapy for some types of ovarian cancer.
Learn more about targeted therapy.
Immunotherapy
The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system’s ability to eliminate cancer. There are many different types of immunotherapy and some are available only in clinical trials.
Learn more about immunotherapy
Our ovarian cancer clinical trials
MD Anderson leads the nation in innovative research into the causes, prevention, detection and treatment of ovarian cancer. In fact, we are one of the few cancer centers in the nation to house a prestigious federally-funded Ovarian Cancer SPORE (Specialized Program of Research Excellence) program. This means we can offer a variety of clinical trials of new treatments for ovarian cancer.
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If you need an oophorectomy as a part of your ovarian cancer treatment, you probably have some questions.
How much of your internal reproductive system will be removed? Will you still have menstrual periods or be able to conceive a child? How long will it take to recover?
We checked in with Jolyn Sharpe Taylor, M.D., a surgeon who specializes in gynecologic cancers, to find out what to expect.
What is an oophorectomy?
It’s the surgical removal of an ovary. If only one ovary is removed, it’s called a unilateral oophorectomy. If both are removed, it’s called a bilateral oophorectomy.
Is an ovary the only part of the female reproductive system that’s removed during an oophorectomy?
Yes, but it’s usually removed with the nearby fallopian tube. That procedure is called a salpingo-oopherectomy.
What types of cancer are treated with an oophorectomy?
An oophorectomy is most commonly used to treat ovarian cancer, but it can also be used to treat different types of cancer that have spread to the ovary.
Is an oophorectomy ever used for people who don’t have cancer?
Yes. Some hereditary conditions increase a woman’s chances of developing ovarian cancer. So, an oophorectomy is considered a type of risk-reduction surgery.
In fact, the Ovarian Cancer Research Alliance just issued a new guideline related to risk reduction. It calls for women who have finished childbearing and are undergoing abdominal surgery anyway to have their fallopian tubes removed at the same time. This is because many ovarian cancers are thought to begin in the fallopian tubes.
Menopausal patients undergoing a hysterectomy may also have an oophorectomy, as there’s no real benefit to retaining the ovaries if you’ve already stopped menstruating.
Is an oophorectomy considered major surgery?
That depends on why and how you’re having it done.
If the ovary is being removed because of a very large tumor, or as part of a debulking procedure to remove as much cancer as possible, then it’s considered major surgery.
But if the ovary can be removed through small incisions using minimally invasive techniques — especially as part of a risk-reduction procedure — then it’s not considered major surgery.
How long does it take to recover from an oophorectomy?
Your recovery depends on the type of surgical incision used and your general health.
With larger incisions, you can expect to be in the hospital for an average of three to five days. With minimally invasive techniques using small incisions, you can typically go home the same day.
It varies quite a bit, though. So, the best way to find out what you can expect is to ask your doctor.
Regardless of the type of surgery you have, you should not lift anything heavier than 10 pounds for six weeks, to prevent the development of a hernia.
What are the possible side effects of an oophorectomy?
Again, that depends on many factors, including:
- your age
- whether you’re already in menopause, and
- whether you’re having a unilateral or bilateral procedure.
If you’re already in menopause, side effects related to hormone levels should be minimal. This is because your ovaries have already shut down, so it won’t matter if one or both are removed.
If you haven’t entered menopause yet, you’ll need to meet with a reproductive endocrinologist before the procedure. They can discuss how it might affect you and your reproductive function.
Could I still conceive a child after an oophorectomy? Will I still have menstrual periods?
Again, that depends. If you only have one ovary removed and you still have one functioning ovary left and a uterus, then the answer to both questions is yes. But if both of your ovaries are removed and you’re still of child-bearing age, the answer is no, unless you’re using assisted reproductive techniques. A bilateral oophorectomy causes instant surgical menopause.
What’s the most important thing to know about oophorectomies?
Talk with your doctors, so you’ll understand exactly what the procedure means for you. If you’re not already in menopause, an oophorectomy could bring about many changes. If you are in menopause, you’ll likely see very little impact on your overall well-being.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
A hysterectomy is a common procedure used to treat gynecologic cancers, like ovarian cancer, cervical cancer and endometrial cancer, and other health conditions impacting the uterus. But there are still many myths surrounding this type of surgery. And, if you need a hysterectomy, you may have anxiety or questions about long-term side effects, including the impact on your fertility.
We spoke with gynecologist oncologist Jolyn Taylor, M.D., about what patients planning for a hysterectomy should expect.
What is a hysterectomy?
A hysterectomy is a surgery to remove a patient’s uterus. There are a few types of hysterectomies:
- Total hysterectomy: Removal of the uterus and cervix
- Supracervical hysterectomy: Removal of the uterus only
- Simple hysterectomy: Removal of the uterus and cervix, but not the tissue adjacent to the cervix (called parametria) or the upper vagina. This is the most common type of hysterectomy.
- Radical hysterectomy: Removal of the uterus, cervix, upper part of the vagina and supporting tissues adjacent to the cervix called the parametria
Removal of a fallopian tube is known as a salpingectomy. Removal of an ovary is known as an oophorectomy. Removal of both a fallopian tube and an ovary is a salpingo-oophorectomy. Some patients may have both fallopian tubes and/or both ovaries removed.
It is important to talk to your surgeon about whether your ovaries should be removed at the time of hysterectomy. This decision will be based on your age, the reason you are having the hysterectomy and other medical factors. All women, however, should have their fallopian tubes removed if they are undergoing hysterectomy. This has been shown to decrease the risk of ovarian cancer later, and fallopian tubes have no impact on ovarian or hormonal function.
Hysterectomies may be performed through either:
- open surgery, also called a laparotomy with one larger incision, or
- a minimally-invasive, laparoscopic or robotic hysterectomy performed through multiple smaller incisions
Patients should talk to their health care provider to see which type of procedure is right for them. Most cervical cancer patients should avoid a minimally invasive hysterectomy, as studies show this could increase the risk of recurrence.
Who needs a hysterectomy?
A hysterectomy is a part of the standard treatment for patients who have been diagnosed with cervical, endometrial or ovarian cancer. However, some women who wish to try to get pregnant in the future may have the option for conservative therapy that does not involve a hysterectomy. Some women may need a prophylactic hysterectomy to reduce their chances of developing cancer in the future if they have been diagnosed with some hereditary conditions.
Outside of cancer care, hysterectomies are performed to treat uterine fibroids, heavy vaginal bleeding, some uterine prolapse, endometriosis (when the tissue that lines the uterus grows outside of the uterus) or adenomyosis (when the tissue that lines the uterus grows inside the walls of the uterus where it doesn’t belong) that are unable to be controlled through non-surgical means.
Are there any risks?
Often, especially when used for cancer treatment, a hysterectomy is performed along with other procedures, so the risk is specific to each individual patient. It’s important that you talk to your doctor about your risks.
What should patients expect during a hysterectomy?
Patients receive general anesthesia before a hysterectomy. During the procedure, the surgeon will remove the uterus through an incision in the abdomen or the vagina. Surgery can last anywhere from one to three hours. It may take longer if the surgeon is doing additional procedures.
How long does it take to recover from a hysterectomy?
Historically, recovery from a hysterectomy was a difficult process, but thanks to efforts like MD Anderson’s Enhanced Recovery Program, patients who have a minimally invasive or open hysterectomy both recovery relatively rapidly. But the experience does vary depending on which type of procedure you have. Patients who have an open radical or simple hysterectomy can expect to be in the hospital one to four days. Patients who have a minimally invasive hysterectomy will be able to leave the hospital as early as the same day as the procedure.
Regardless of the type of hysterectomy, patients should expect to be up and walking around the same day as the surgery. Patients often experience discomfort at the incision site for about four weeks. Patients should refrain from any heavy lifting for six weeks and from being fully submerged in water, using tampons, having sex or placing anything in the vagina until their doctor says they’ve healed.
What type of long-term side effects should a patient expect?
Patients who have had a hysterectomy will not be able to become pregnant, so it’s best to consider the hysterectomy relative to your goals surrounding fertility. Outside of fertility, patients will not experience any long-term side effects. A common myth is that hysterectomies cause patients to experience early menopause, but this is not true as hormonal function comes from the ovaries.
Will a patient still have a period after a hysterectomy?
This is a really frequently asked question. No, a patient who has a hysterectomy will not menstruate. Despite this, a patient who has a hysterectomy will not go into menopause unless the ovaries are removed.
What advice do you have for a patient interested in preserving her fertility?
Any patient who has been told they need a hysterectomy can weigh need for hysterectomy with their reproductive goals with their care team or seek a second opinion. Cancer patients who need a hysterectomy but are interested in preserving their fertility should seek care at a center with an oncofertility program, like MD Anderson. Our oncofertility specialists don’t just treat people with gynecologic cancers. They treat anyone whose cancer may impact their fertility. They can help patients who are considering a hysterectomy weigh their options so they can make the best decision for themselves.
Does a hysterectomy affect sexual function?
No, a hysterectomy alone does not impact sexual function. Recovery from surgery and undergoing therapy for cancer, including possibly going into menopause, however, may impact sexual function. Some hormone therapies used to treat cancer may cause sexual side effects. Patients should share their side effects and concerns with their care team.
Overall, hysterectomies are a safe and effective option for treating several types of cancer, and many patients who have them continue to live normal lives after.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.