Treatment options for ovarian cancer

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The team might include a:

• surgeon specialising in cancer of the womb, ovaries, cervix and vagina (gynaecological oncologist)

• cancer specialists who treat cancer with drugs (medical oncologist) and radiotherapy (clinical oncologist)

• gynaecological cancer specialist nurse (also called a clinical nurse specialist or CNS)

• pathologist who examines any cancer or tissue the surgeon removes

• radiologist who looks at your scans and x-rays

• MDT coordinator who makes sure all your results are ready and appointments are booked

• research nurse who specialises in clinical trials, and supports people who take part in them

The treatment you have depends on:

• the type of cancer you have

• where your cancer is

• how far it has grown or spread (the stage)

• how abnormal the cells look under a microscope (the grade)

• whether the cancer has spread to another part of the body (this is called secondary cancer or metastases)

• your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you. They may suggest a treatment on its own, or a combination of treatments.

Find out about the stages of ovarian cancer

Treatment by stage

Stage 1 ovarian cancer

Surgery is the main treatment for stage 1 ovarian cancer. Your specialist surgeon (gynaecological oncologist) usually removes:

• your ovaries

• fallopian tubes

• womb (including the cervix)

The surgeon also examines the inside of your abdomen for signs of cancer.

For some low grade stage 1A cancers, it might be possible to only remove the affected ovary and fallopian tube. The unaffected ovary and your womb are not removed. This means you might be able to become pregnant and have a baby afterwards. 

After surgery, your doctor might suggest you have chemotherapy. This is called adjuvant chemotherapy and aims to lower the risk of your cancer coming back.

Stage 2, 3 and 4 ovarian cancers

Surgery and chemotherapy are the main treatments for stage 2, 3 and 4 cancers. Your specialist surgeon (gynaecological oncologist) removes:

• both ovaries

• fallopian tubes

• your womb (including the cervix)

They will also check where the cancer has spread to in your pelvis and if it is in your lymph nodes. Your gynaecological oncologist will aim to remove as much of the cancer as possible. 

This is called cytoreductive surgery. You may also hear it called debulking surgery.

When you have chemotherapy will depend on your individual case. You might have:

• chemotherapy after surgery – this is called adjuvant chemotherapy with cytoreductive surgery

• chemotherapy before and after surgery – this is called neoadjuvant chemotherapy with interval cytoreductive surgery

• chemotherapy into your abdomen during surgery – this is called hyperthermic intraperitoneal chemotherapy or HIPEC

You might not have surgery if you have very advanced cancer or you are not well enough. You might have chemotherapy on its own or combined with other treatments. 

Some women with stage 3 or 4 ovarian cancer have also targeted cancer drugs. You might have this with chemotherapy, or on it’s own after chemotherapy.