Ovarian Cancer Treatment
When you receive ovarian cancer treatment at MD Anderson, a 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 rare ovarian cancers. We offer the latest, most-advanced therapies, including surgery, chemotherapy, hormonal therapies and targeted therapies.
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
We’re 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 are able to 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 stage of the cancer
- The size of the tumor after surgery (debulking)
- Your desire to have children
- Your age and overall health
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 times, 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 will biopsy the pelvis and abdomen to find out if the cancer has spread.
Debulking Ovarian Cancer
If it is obvious during the surgery that ovarian cancer has spread, the surgeon will remove as much of the tumor as possible. This may help other treatments work better.
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
You may need chemotherapy after surgery to destroy ovarian cancer cells that are still in the body.
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
Although radiation therapy rarely is used to treat ovarian cancer, it may help destroy any cancer cells that are left in the pelvic area. It also may be used if the cancer has come back after other treatments. In most cases, the main goal of radiation therapy is to control symptoms such as pain, not to treat the cancer.
Ovarian Cancer Targeted Therapy
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. These new drugs stop the growth of cancer cells by interfering with certain proteins and receptors or blood vessels that supply the tumor with what it needs to grow.
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 SPORE (Specialized Program of Research Excellence) program. This means we are able to offer a variety of clinical trials of new treatments for ovarian cancer.
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.
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