Chemotherapy for Ovarian Cancer: What to Expect

Chemotherapy is considered a part of what’s called “standard of care” for ovarian cancer. And while the specific chemotherapy experience — including timing, length, and dose — may differ from patient to patient, most women with ovarian cancer will receive a combination of the two chemotherapy drugs carboplatin and paclitaxel (Taxol). Doctors often refer to the combination as Carbo/taxol for short.

“In our practice, patients usually come into the clinic sometime in the morning, probably 8:30 am or so, and they’re here for about four to five hours,” says Dr. Manojkumar Bupathi, medical oncologist at Rocky Mountain Cancer Center and Sarah Cannon Research Institute. Before the infusion, doctors will run a series of labs to make sure that a patient’s white blood cell count is high enough to receive chemotherapy. “We ensure all their blood work is okay, that their liver enzymes are fine, their kidneys are fine. They get their pre-medications first, and then [we’ll] start their IV chemotherapy, either the carboplatin or the Taxol, it really doesn’t matter which is first.

“Then they get their second drug, and assuming that they have no [adverse] reactions, once they’re done with their treatment, they get to go home.”

Chemotherapy medications can be given in a number of different ways. Typically, they’re administered into an IV, or via a medical port—a small device implanted under the skin just below the clavicle bone. A port tends to be easier on both patients and nurses, who don’t have to start a new IV for each new infusion.

A common treatment regimen for ovarian cancer is for patients to receive their medications one day every three weeks. Those three weeks, or 21 days, are called a cycle. Patients receive one infusion of chemotherapy, then go for 21 days without anything, and then start again with the next cycle.

Typically, if patients have surgery up front, they’ll have at least six cycles of their chemotherapy medications after surgery. If doctors decide that chemotherapy should be given first (usually to shrink the cancer) they generally give about three to four cycles of chemo prior to a patient’s surgery, and then, similarly, another three to four cycles of the same chemotherapy after surgery has been completed.

Chemotherapy Side Effects

Often, women are really scared when they come in for their first chemotherapy session — they’ve all heard horror stories about these drugs. However, unlike a few decades ago, these days, “the carboplatin/paclitaxel combination is generally fairly well-tolerated,” one oncologist reassured SurvivorNet. “It can be something that’s not as terrible an experience as they might have [anticipated], or had family members go through. Usually it’s very tolerable, very manageable, and something the patients can get through.”

The most common chemotherapy side effects are fatigue, nausea, and hair loss. Chemo may also cause bone marrow suppression, which concerns doctors because it can decrease patients’ ability to fight off infections. Most patients are advised to social-distance, especially around anyone with signs of illness, and to be proactive about contacting their oncologist if they have a fever, signs of infection, or simply don’t feel well.

Neutropenia is a condition associated with a low white blood cell count. Cancer chemotherapy is the most common cause.

“Using something called GM-CSF, [we’re] basically stimulating the bone marrow to allow white cells predominantly to come back to over 1000, so patients can continue with their treatment.” One of the main reasons why treatment gets delayed is that patients’ blood counts are not where they need to be, Bupathi says. “If someone is neutropenic, their ability to fight an infection is not there. If you give them chemotherapy that can be myelosuppressive, then their risk of infection goes up. And that’s really what you’re trying to minimize when you’re using drugs like this.”

Learn more about SurvivorNet's rigorous medical review process.