The extent and type of surgery is based on the patient's general health and the stage and type of the cancer.
- For epithelial ovarian cancer, the primary goals of surgery are staging (determining the degree to which the cancer has spread) and debulking (removing as much of the tumor as possible). Surgical options can include a hysterectomy - partial (removing only the uterus) and total (removing the uterus and the cervix), a unilateral salpingo-oophorectomy (removing only one ovary and one fallopian tube) or a bilateral salpingo-oophorectomy (removing both ovaries and both fallopian tubes).
- For germ cell tumors and stromal tumors, surgery - hysterectomy and unilateral or bilateral salpingo-oophorectomy - is done to remove the cancer, with additional debulking surgery if necessary.
- Other surgical procedures that may be included in the treatment plan include an omentectomy (removing the omentum, the tissue in the peritoneum that contains blood vessels, nerves, lymph vessels and lymph nodes) and a lymph node dissection or lymphadenectomy (removing all or part of a lymph node to examine for cancer cells).
Radiation therapy for ovarian cancer patients is used primarily to treat areas to which the cancer has spread, rather than as a form of treatment for the primary tumor. It can be administered either as external radiation therapy (from outside the body) or internal radiation therapy (a radioactive substance is placed in or near the tumor).
Chemotherapy uses specific drugs to slow or kill cancer cells. With systemic chemotherapy, the medication is injected into a vein or given orally for specific types of ovarian cancer. It can also be injected through a catheter directly into the abdominal cavity, called intraperitoneal chemotherapy or regional chemotherapy.
Targeted therapy is designed to identify and attack specific cancer cells without harming normal cells. Targeted therapies can also be used to activate cells to carry drugs, toxins or radioactive material directly to cancer cells.
Hormone therapy uses hormones or hormone-blocking drugs to treat ovarian stromal tumors. Hormone therapy can include luteinizing-hormone-releasing hormone (LHRH) agonists which stop estrogen production by the ovaries, tamoxifen which stops estrogen from stimulating cancer cell growth and aromatase inhibitors which block the aromatase enzyme from converting hormones into estrogen in post-menopausal women.
New treatment options continue to be studied in clinical trials, such as immunotherapy, which uses the patient's immune system to fight cancer, by boosting, directing or restoring the body's natural defenses against cancer.