When you’re fighting ovarian cancer, chemo is one of the most powerful weapons in your arsenal. Because ovarian cancer is particularly responsive to chemotherapy, most gynecologic oncologists will almost always build chemo into a woman’s treatment regimen at some point—or multiple points—during her course of care.
Types of Chemo DrugsREAD MORE
For ovarian cancer, the most common chemo drug is a platinum-based agent, such as carboplatin, cisplatin, or oxaliplatin.
“Platinum seems to be by far the most effective agent ever discovered to kill ovarian cancer cells,” says Dr. Beth Karlan, gynecologic oncologist at UCLA Medical Center.
Typically, patients with ovarian cancer will receive another chemo drug called a taxane in combination with their platinum-based drug, too. The taxane drug used most often in the U.S. is called paclitaxel (often known by its brand names, Taxol and Abraxane.)
Because this combination of chemo drugs has proved effective in clinical research time and again, it has become the standard-of-care for ovarian cancer chemotherapy. But while most patients can expect to receive this combination, the dose of the drugs and the frequency with which they’re administered is usually personalized.
“That’s going to depend on the specifics of your tumor and your situation pre- and post-surgery,” Dr. Karlan says.
Chemo Dose, Frequency, and Methods
For some patients with stage 1 ovarian cancer, for instance, chemo may be given every three weeks, three times total. For patients with more advanced ovarian cancers, this treatment may increase, to six cycles of chemo, again every three weeks.
There is also a dose-dense chemotherapy option for ovarian cancer, during which patients—usually those with stage 3 or 4 ovarian cancer—continue receiving the platinum-based part of their chemotherapy every three weeks, but the taxane dose becomes more frequent, given every week instead.
The physical method of administering these drugs may vary, too. While many patients will receive their chemo drugs through an IV, others may get “belly bath” chemo, which is administered through a catheter, usually directly after surgery.
Belly bath chemo—called “intraperitoneal chemotherapy”—is a particularly good option for patients whose ovarian cancer has spread within the abdominal cavity.
How Will I Feel During Chemo?
During the course of many ovarian cancer chemotherapy regimens, Dr. Karlan says, most women are able to work and to go about most of their daily activities. But side effects do tend to worsen with each cycle.
“I say ‘most’ because they are going to be more tired,” she says. “Nobody’s ‘typical daily activity’ includes coming to a hospital for chemotherapy.”
That feeling of fatigue is one of the most common side effects associated with chemotherapy; any patient undergoing chemo should expect to feel more tired than they’re used to.
And because chemo drugs work by killing cells, patients may experience other side effects, too, such as nausea, hair loss, anemia, increased risk of infection, more frequent bleeding and bruising, and neuropathy, which is a tingling or loss of feeling, which usually begins in the fingers or toes. Hair loss is associated specifically with a drug called taxanes, and it happens to all patients on the drug.
Though there are a number of drugs and treatments available that may help with these side effects—particularly in the case of nausea, for which anti-nausea drugs are highly effective—the best way to manage these side effects is always going to be adequate preparation.
Engaging in frequent and transparent conversations with your oncologist about the severity of your side effects is also critical, because in some cases, it may be possible to adjust your chemo dose or change your treatment frequency.
“Most women are able to maintain their lifestyle, go out, enjoy life, whether they’re working or whether they’re driving carpool, and go on and live their lives, until they get through treatment, at which time, they really can resume just about all their activities,” Dr. Karlan says.