Treatment

Standard of Care for Ovarian Cancer

Treatment for ovarian cancer aims primarily to remove or destroy the cancer, relieve symptoms, and extend survival while maintaining quality of life. Treatment is tailored based on the type, stage, grade of the cancer, and overall patient health, often combining surgery and chemotherapy with targeted therapies when appropriate.

1. Surgery (if the cancer is operable)

Goal: The primary goal is maximal cytoreductive surgery (also called debulking surgery) to remove all or most of the tumour because this improves response to further treatments.

  • Primary cytoreductive surgery: Usually the first step for most patients with advanced ovarian cancer if the surgeon believes complete or optimal tumour removal is achievable.

  • Interval debulking surgery: Sometimes chemotherapy is given first (neoadjuvant chemotherapy) to shrink tumours followed by surgery.

  • Fertility-sparing surgery: Occasionally considered for young patients with early-stage disease who wish to preserve fertility.

2. Chemotherapy

  • Goal: To destroy cancer cells, shrink tumours, and prevent recurrence.

  • Common agents:

    •  A combination of paclitaxel and carboplatin.

    • Pegylated liposomal doxorubicin hydrochloride (PLDH).

  • When it’s used:

    • Before surgery (neoadjuvant therapy) to shrink the tumour in patients not initially fit for surgery or with bulky disease.

    • After surgery (adjuvant therapy) to target any remaining microscopic disease.

    • To prolong remission and survival in advanced or recurrent cancer.

 

3. Radiation Therapy

  • Goal: To destroy ovarian cancer cells.

  • Used:

    • Rarely used to treat ovarian cancer but may be used to:

      • Shrink the tumour.

      • Minimise symptoms in advanced disease.

4. Palliative and Supportive Care

  • Goal:  To improve quality of life from diagnosis through end-of-life care. It is an essential part of comprehensive ovarian cancer care and can be provided alongside curative treatments or as the main approach when active cancer treatments are no longer effective or appropriate.

  • Includes: Pain relief, control of gastrointestinal symptoms (nausea, vomiting, constipation, and bowel obstruction), nutritional support, physical therapy, emotional support and management of treatment side effects.