Chemo or Surgery: Deciding The Order For Ovarian Cancer Treatment
SHARE

Fact Checked

SurvivorNet Fact Checking and Medical Review Standards:  

The SurvivorNet News Team creates high quality medical information that complies with our industry leading standards for factual accuracy and sourcing from leading experts at academic medical institutions. Every news article is thoroughly fact-checked by our physician collaborators. We vet each piece of work for factual integrity, impartiality, and clearly label any professional conflicts.

All SurvivorNet articles adhere to the following standards:

  1. All studies and research papers cited are from reputable academic medical institutions or peer-reviewed journals.
  2. When we use data, statistics, or quotes these references link to the original source.
  3. All content related to new treatments, drugs, procedures, and so on must clearly describe availability, side effects, treatment target (such as triple negative breast cancer)
  4. All medical information on SurvivorNet is sourced from respected medical professionals with verified medical credentials and links are provided to these sources.
  5. We strive to give the reader relevant background information and include, clearly-sourced contextual health information in all articles. Readers are clearly alerted to any conflicts of interest from a medical source or the authors of a cited study.
/ Updated July 29th, 2020

Chemo or Surgery: Deciding The Order For Ovarian Cancer Treatment

Medical Source: Dr. Irina Dimitrova
Henry Ford Health System
×

First Treatment For Ovarian Cancer

  • Deciding whether to do surgery or chemo first is complex.
  • A patient's overall health and fitness are factors.
  • The goal of surgery is to remove all visible cancer. Doctors use tools such as imaging and a laparoscopy to help them decide if that is likely.
  • Chemo is given first if doctors determine that initial surgery would not be successful.
Doctors who are caring for ovarian cancer patients typically have two approaches to treatment. Both include a combination of chemotherapy and surgery, but the sequence of those treatments can vary.

The decision as to whether to treat with surgery initially or with chemotherapy initially is quite complex, says Dr. Irina Dimitrova, gynecologic oncologist at Henry Ford Health System, in Detroit. "The two most important factors that come into play are first, is the patient healthy enough to safely undergo a major surgical procedure?" Do they have any underlying conditions or disease that would impair their recovery? “The second factor is the disease itself. Will a surgeon be able to remove all visible disease? The goal of surgery is to remove all visible cancer, and if we determine that we are unable to do that, then the patient will probably get neoadjuvant chemotherapy, which means they'd get chemotherapy first."

Read More
Doctors use several tools to assess the extent of the cancer, including imaging studies and what's called a diagnostic laparoscopy a minimally invasive surgical procedure that allows them to examine the organs inside the abdomen. Using a slender camera, they investigate the extent of the cancer, and whether they're able to do what's called a debulking procedure, to remove all visible disease. According to the National Institutes of Health (NIH), oncologists have had particular success with debulking in ovarian cancer patients, as compared with other types of cancer.

If a patient isn't fit enough for surgery, or doctors aren't confident they can successfully remove the tumor, "then we treat them with chemotherapy first and monitor their response," says Dimitrova. Doctors usually give three or four cycles of chemotherapy, hoping to shrink down the cancer. “If they respond well to the chemo, and we get their health to a place where surgery is safe, we would then proceed with surgery” followed by additional chemotherapy treatment.

Dimitrova says she makes it a point to clear up any misconceptions her patients have about chemo. "There is definitely a belief among patients that chemotherapy is worse than the disease itself," she says. "What I hear most often is that the effects of chemotherapy are worse than the effect of cancer," especially the nausea and vomiting. "Patients believe that they’re going to be sick all the time." And while that might have been the case 20 years ago, "it is clearly not true nowadays." If patients are throwing up all day, then the doctors are not doing their job.

Learn more about SurvivorNet's rigorous medical review process.

Dr. Irina Dimitrova is a gynecologic oncologist with Henry Ford Health System. Read More

SN Local - Explore Ovarian Cancer expertise and community near you:

Treatment For Ovarian Cancer
NOW
PLAYING
Treatment After an Ovarian Cancer Diagnosis
NOW
PLAYING
COVID-19 Changes Ovarian Cancer Treatment Guidelines 'In Real Time'

My Health Questions

Powered by SurvivorNet

Rapid evidence support for real-world oncology decisions.

Not sure where to start? Try these prompts.

icon

What factors should be considered when deciding whether to start with chemotherapy or surgery for ovarian cancer treatment?

icon

How does diagnostic laparoscopy aid in the treatment decision for ovarian cancer patients?

icon

What misconceptions do patients often have about the side effects of chemotherapy compared to the effects of cancer?

Continue The Journey

Explore: Maintenance

Related Articles

28-Year-Old Woman Thought Her ‘Intermittent Heartburn’ Was From Unhealthy Eating Habits, But It Turned Out To Be Aggressive Stomach Cancer: ‘Long Story Short, I Survived”

Robotic Surgery Vs. Open Prostate Surgery

Renowned Fashion Designer Carmen Marc Valvo, Who Beat Colon Cancer 22 Years Ago, Pushed For Answers Prior To Getting Diagnosed: ‘The Disease Has Empowered Me To Make Sure People Are Aware’

28-Year-Old Mom Says Doctors Dismissed Her Stomach Pains As Acid Reflux. It Turned Out To Be Stage 4 Gastric Cancer

×

Introducing, the Journey Bar

Use this bar to access information about the steps in your cancer journey.

Please confirm you are a US based health care provider:

Yes, I am a health care Provider No, I am not a health care provider