Don’t Mess With ‘Matlock’ Actress Kathy Bates. At 77, Winning Cases and Beating The Bad Guys

Bates described to People that battling ovarian cancer was anything but “happy.”

Dr. Beth Karlan, a renowned gynecologic oncologist at UCLA Medical Center in Santa Monica, California, explains that there are different kinds of ovarian cancer that affect women in different decades of life. She adds that the most common type of ovarian cancer occurs around the time of the menopause.

She explains further to SurvivorNet how the cancer actually emerges.

“We have two ovaries, one on either side of the uterus, and the fallopian tube is what typically picks up the egg and brings it to the uterus so that it can be fertilized by sperm to become a baby, a fetus,” Dr. Karlan said.

“It’s actually thought that the common ovarian cancers that we think about actually begin in the cells on the fallopian tube, and that as the fallopian tube brushes over the ovary, these cells that become cancers stick to the ovary. Then that’s the place they grow and what we’ve called ovarian cancer,” Dr. Karlan continued.

Researchers have identified more than 30 types of ovarian cancer, but three are the most common:

• Epithelial tumors: Representing about 90% of cases, these form on the ovary’s outer layer. While many are benign, malignant forms can spread quickly before detection.
• Stromal tumors: Rare growths that arise in the connective tissue, producing estrogen and progesterone.
• Germ cell tumors: Found in egg-producing cells, these typically affect younger women and often impact only one ovary. Encouragingly, most germ cell cancers are highly curable.

Reflecting on her diagnosis in an interview with SurvivorNet, Bates admitted it “knocked the stuffing out of me.” Fortunately, doctors caught it just before it spread. She underwent surgery and chemotherapy while simultaneously working on the 2004 film “Little Black Book,” a feat she described as a grueling experience.

 

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Chemotherapy’s side effects went beyond nausea and fatigue; Bates recalled the difficulty of coming off steroids: “It was like detoxing. I was shaking, I couldn’t talk, and I remember I had to go do a voiceover, and it was just so, so difficult.”

The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.

• A feeling of bloating or fullness
• Pain in the pelvis or abdomen
• Nausea
• Vomiting
• Changes in bowel habits

WATCH: Spotting Ovarian Cancer Symptoms

Several genetic changes or mutations exist that are associated with ovarian cancer. The BRCA set of genes, BRCA 1 and 2, is among the most common.

The BRCA1 and BRCA2 gene mutations typically help regulate cell growth, but when mutated, they fail to control unchecked tissue expansion, increasing the risk of breast, ovarian, and other cancers.

WATCH: Understanding the BRCA Mutation

Nearly ten years later, she faced a second blow: stage 2 breast cancer. She underwent a double mastectomy and the removal of 19 lymph nodes, a procedure that left her with chronic pain and lymphedema, a lifelong swelling condition that often follows lymph node removal.

Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, explains that early-stage breast cancer typically means a small tumor confined to the breast with no lymph node involvement. For most women diagnosed with stage 1 disease, the first step is surgery to remove the cancer. If a lumpectomy – only the tumor and some of the surrounding tissue is removed – is performed, radiation therapy is usually recommended afterward.

Dr. Comen notes that there are exceptions. “In some cases, depending on a woman’s age, she may not need radiation.” “And depending on the tumor’s size, family history, or other factors, some patients choose a more aggressive approach. Even with early-stage breast cancer, a woman may elect to have a mastectomy to remove the entire breast.”

After surgery, a pathologist examines the tissue under a microscope to help determine what additional treatment, if any, is needed.

Treatment recommendations depend on several factors — the cancer’s stage, whether it has spread, a patient’s overall health, and the tumor’s specific biology. A care plan may include one or more of the following:

• Surgery
• Chemotherapy
• Radiation therapy
• Hormone therapy

As Dr. Comen emphasizes, “Even women with early-stage breast cancer often need some form of therapy after surgery to help prevent the cancer from coming back.”

Speaking on the Los Angeles Times’ The Envelope podcast, she revealed that the pain from breast cancer far surpassed her ovarian cancer experience.

Treatment required a double mastectomy (removal of both breasts) and the removal of 19 lymph nodes, leaving her with lasting physical challenges. She chose not to undergo reconstruction, explaining, “At the age I was, I thought, you know, I really don’t wanna go through that.”

A double mastectomy is a procedure that removes both breasts. Some women choose this procedure to reduce their risk of cancer, especially if they have a family history of cancer or possess the BRCA1 and BRCA2 gene mutation, which also increases their risk for breast and ovarian cancer.

WATCH: Dr. Elisa Port explains what happens during a double mastectomy.

Making the decision to undergo a mastectomy can be an emotional experience for many women facing breast cancer. While the surgery itself may take only a few hours, the mental adjustment can be difficult.

“A double mastectomy typically takes about two hours for the cancer part of the operation, the removal of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”

Dr. Port added that most women opt to have some sort of reconstruction. The length of these surgeries can vary greatly. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.

WATCH: Regaining your sense of self after reconstruction.

The surgery also led to lymphedema, a chronic swelling condition that often follows lymph node removal. Bates admitted the toll was crushing: “I was bitter, I was depressed. I thought my career was over. I thought, ‘There’s no way, I’m done, everything is done.’”

Through it all, Bates has remained a force — on screen and in life — proving to others battling cancer that resilience is powerful and can shine through whatever you’re faced with.

Additional Early-Stage Breast Cancer Treatment Options

We’ve discussed breast cancer surgery options, which include a mastectomy, a double mastectomy, a lumpectomy, and breast reconstruction. But let’s dig deeper into additional therapies early-stage breast cancer patients may face, including chemotherapy and radiation.

Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.

Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle.

“Neuropathy is probably one of the most challenging side effects,” says Dr. Urban. Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:

• Weakness in the hands or feet
• Stabbing or burning pain in the hands or feet
• Difficulty gripping, such as when holding a fork
• Difficulty with fine motor skills, such as writing or buttoning a shirt

Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.

“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Urban. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”

Hair loss is another side effect of chemotherapy.

WATCH: Coping with hair loss.

“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.

Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.

It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.

Most patients can expect regrowth four to six weeks after treatment. However, it is possible that when your hair grows back, you may notice some changes in its color and texture.

RELATED: How are chemotherapy side effects managed for ovarian cancer treatment?

Tips for Navigating Chemo Side Effects

When dealing with fatigue, doctors don’t have an arsenal of weapons to combat fatigue in terms of prescription medications. However, you can do several things to help minimize the hit and restore your energy.

• Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer, who have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
• Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
• Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.

Treating Neuropathy Symptoms

Doctors have several strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to make sure it doesn’t get worse. Before each chemotherapy infusion, the attending oncologist will assess whether the symptoms have progressed. If the symptoms worsen, they may adjust the dose or delay treatment. They may also try switching to another chemotherapy drug.

How to Get a Handle on Nausea

Most of these anti-nausea medications last for more than eight hours. One of the infusions commonly used reduces the degree of nausea for up to three days.

Complementary approaches may also be helpful. A few favorites:

• Ginger: Studies consistently show that ginger helps alleviate chemotherapy-induced nausea. The powerful herb appears to have an anti-spasmodic effect on the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
• Pressure bracelets: at your local pharmacy, these bracelets provide consistent pressure on a particular acupressure point on the wrist to reduce nausea.
• Deep breathing: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.

WATCH: Managing chemo side effects.

Coping with Hair Loss

If losing your hair is a concern for you before cancer treatment, know you have options like wigs, hats, wraps, and scarves, among other things.

Another option that can minimize hair loss is cryotherapy, “just a fancy way for saying cold therapy,” says Dr. Renata Urban, gynecologic oncologist at the University of Washington in Seattle.

Cryotherapy involves wearing cold caps or special cooling caps before, during, and after each chemotherapy treatment.

Radiation Therapy During Early-Stage Breast Cancer Treatment

Radiation therapy—using high-energy rays to destroy cancer cells—is a common follow-up to breast cancer surgery, especially for patients who choose a lumpectomy over a mastectomy. Its goal: reduce the risk of recurrence by targeting any lingering cancer cells in the breast or surrounding tissue.

While effective, radiation can come with side effects, both immediate and delayed. Common symptoms include:

• Fatigue
• Swelling
• Scar tissue
• Shortness of breath

RELATED: Cancer Patients With Dark Skin At Increased Risk of Painful Radiation Side Effects, New Research Says

One of the more serious concerns involves the heart, which can unintentionally absorb radiation due to its proximity to the breast.

“When the radiation is delivered, unfortunately, the heart happens to be somewhere very near to where they have their breast cancer, and it becomes an innocent bystander absorbing some of the radiation,” explained Dr. Jean-Bernard Durand to SurvivorNet.

This exposure can lead to complications such as fatigue, shortness of breath, and even heart failure—sometimes surfacing decades after treatment.

“We make it a point to see them on a regular basis so that we can catch these things very early and treat them,” Dr. Durand added.

Even advanced techniques like proton therapy, which aim to minimize damage to healthy tissue, aren’t immune to side effects. Fatigue remains a common complaint, and the risk of long-term injury still exists.

“Radiation is a form of energy… and when we give radiation, it has the ability to scatter,” Dr. Durand said. “Even though we may target one particular area, that scattering of energy can cause injury to the local surrounding structures, including the heart.”

Over time, this injury can lead to the development of scar tissue within the heart muscle, its electrical system, and blood supply.

“We believe it is what causes all the injury, that ultimately leads to the symptoms,” he explained.

For survivors, this underscores the importance of ongoing monitoring and open conversations with care teams.
Radiation treatment continues to evolve, with ongoing debates among experts about how to reduce side effects while optimizing outcomes. Dr. Shah outlined three key areas of discussion:

• Whole vs. Partial Breast Radiation: Shortening treatment duration and minimizing side effects are promising, though long-term data are still emerging.
• Identifying Patients Who May Not Need Radiation: Some individuals may not benefit from radiation, and omitting it could reduce unnecessary risks.
• Technique Optimization: Advancements in delivery methods aim to improve effectiveness while limiting harm to healthy tissue.

“I think the first debate that we have is whole breast radiation versus partial breast radiation and the idea of reducing duration of treatment and reducing side effects for patients, albeit with less than 10 years’ worth of long-term data,” Dr. Shah explained to SurvivorNet.

When to Screen for Breast Cancer

The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.

The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.

WATCH: When you’re getting a mammogram, ask about dense breasts.

Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.

Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.

Genetic Testing and Ovarian Cancer

Genetic testing—analyzing a patient’s DNA or biopsy tissue—can reveal critical insights about cancer: how it forms, how it behaves, and how best to treat it.

“There are certain cancer-causing genes that can be passed down from generation to generation,” explains Dr. Derrick Haslem, the director of medical oncology at Intermountain Healthcare in Salt Lake City.

As researchers uncover more about these inherited mutations, they’re not only pinpointing who might be most at risk—they’re also refining how cancers are detected and treated.

When it comes to ovarian cancer, this information is especially vital.

WATCH: What genetic testing reveals about your cancer?

“There are a lot of mutations that put people at a higher risk for ovarian cancer,” says Dr. Haslem. That’s why your medical team asks about your family history—because genetic red flags can run in families. “If you have a family history of ovarian cancer or breast cancer, that’s a really important thing to bring up with your healthcare provider.”

Mutations in the BRCA1 and BRCA2 genes are among the most common genetic links to ovarian cancer. Another factor, homologous recombination deficiency (HRD), can occur in women with BRCA mutations and further disrupts the cells’ ability to repair their DNA.

If you do have a strong family history, your doctor may recommend testing for BRCA mutations or other inherited syndromes like Lynch syndrome, which can also increase risk for ovarian, colorectal, and breast cancers.

Sometimes, testing positive for a high-risk mutation may lead to conversations about preventive steps. “If you were tested and you had that gene, then somebody might talk to you about prophylactic surgery to remove the ovaries and fallopian tubes,” says Dr. Haslem. This kind of preventive surgery can significantly reduce future cancer risk in those genetically predisposed.

Beyond risk assessment, genetic findings also guide treatment. “Certain chemotherapies and targeted therapies are much more effective in those types of cases,” Dr. Haslem adds. For example, PARP inhibitors—designed to block DNA repair in cancer cells—have shown strong results in patients with BRCA mutations and HRD.

Ultimately, genetic testing isn’t just about knowing your risk—it’s a tool that helps tailor treatment and potentially saves lives.

Ovarian Cancer Recurrence and Treatments to Help

Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in the Gland Surgery medical journal. With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.

Ovarian cancer is sub-categorized into two groups.

• Platinum-Sensitive Ovarian Cancer: Your cancer does not return for more than six months after treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
• Platinum-Resistant Ovarian Cancer: Your cancer returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.

“The mechanism that causes platinum resistance will cause someone to be resistant to other chemotherapies, as well. That’s why we’re looking for what we call targeted therapies – precision medicine,” Dr. Noelle Cloven from Texas Oncology-Fort Worth Cancer Center explained.

RELATED: Recurrent Ovarian Cancer Treatment: Is Your Disease “Platinum-Sensitive”?

Targeted therapies or precision medicine specifically target the proteins controlling cancer cells’ growth, division, and spread.

Maintenance Therapy for Ovarian Cancer

Maintenance therapy plays a critical role in helping ovarian cancer patients stay in remission after completing their initial treatment, which often includes surgery and chemotherapy.

“Maintenance therapy is continued treatment after the patient finishes their initial treatment,” explains Dr. Alpa Nick, a gynecologic oncologist with Tennessee Oncology in Nashville.

WATCH: PARP inhibitors are now options as part of ovarian cancer treatment for a growing number of women.

One common form of maintenance therapy is a daily oral medication known as a PARP inhibitor, which works by preventing cancer cells from repairing their DNA.

“The biggest question is: How do you choose between bevacizumab (brand name, Avastin) or a PARP inhibitor for maintenance therapy?” Dr. Nick says.

Both are effective options, but they take very different approaches. While PARP inhibitors target cancer cells’ internal repair systems, Avastin works externally by blocking new blood vessel growth, essentially starving tumors of the needed nourishment.

Genetic testing is key to determining which treatment is most effective. “When patients have their surgery, we can test their tumor to decide if their tumor has a homologous recombination deficiency (HRD),” says Dr. Nick. If HRD is present, patients are more likely to benefit from PARP inhibitors.

Some women may be candidates for a combination approach. The Food and Drug Administration (FDA) has approved Avastin in combination with olaparib (brand name Lynparza) for women with HRD-positive tumors who respond to platinum-based chemotherapy.

This pairing increased progression-free survival in clinical trials from 17 to 37 months. “A patient really has to make a decision upfront, or near the beginning of their treatment, that they want bevacizumab maintenance treatment because they’ll have it with their primary chemotherapy,” adds Dr. Nick.

American Society of Clinical Oncology (ASCO) guidelines now recommend that PARP inhibitors be offered to women newly diagnosed with stage III or IV ovarian cancer, regardless of their genetic status, if they’ve responded well to chemotherapy.

Meanwhile, another breakthrough therapy is offering new hope for patients with platinum-resistant ovarian cancer: Elahere (mirvetuximab). This targeted treatment is designed for women who test positive for high levels of folate receptor-alpha (FRα), a molecular marker found on some ovarian cancer cells.

“What that means is that the antibody part of the drug conjugate binds to the folate receptor on the tumor cells, and then that gets taken up into the tumor cell,” says Dr. Lyons.

“And then the drug that is conjugated with is the part that actually kills the tumor cells, by affecting the tumor cells’ ability to divide.” Often described as “biological missiles,” these antibody-drug conjugates are ushering in a new age of precision therapy.

Ovarian Cancer Recurrence

When cancer returns, it is referred to as recurrence. It often occurs because some cancer cells are left behind after treatment. Those cells grow over time and are eventually detected in follow-up scans received by patients in remission.

Ovarian cancer patients faced with a recurrence will likely need to restart chemotherapy or consider another surgical procedure.

WATCH: Ovarian cancer recurrence.

The type of treatment recommended for recurrence can depend on several factors:

• The period within which the cancer recurred
• The kind of chemotherapy the woman underwent in the past
• Side effects that came as a result of past treatments
• The length of time between the last treatment the woman underwent and the recurrence
• The specific mutations and molecular features of your cancer

If a woman’s time between remission and recurrence is more than six months, then the ovarian cancer is categorized as “platinum-sensitive” (that is, responsive to a platinum-based chemotherapy treatment), and that patient will be treated with chemotherapy and another platinum-based drug.

If the recurrence time happens less than six months into remission, the ovarian cancer is classified as “platinum-resistant.” At that point, women are usually treated with another type of chemotherapy and encouraged to enter a clinical trial. Alternatively, women might be platinum-refractory, which refers to a disease that grows while the patient is on chemotherapy and has a particularly poor prognosis.

Determining the probability that a woman’s cancer will recur depends on the stage at which they were initially diagnosed. According to most data:

• Women with stage 1 ovarian cancer have a 10 percent chance of recurrence.
• Women in stage 2 have a 30 percent chance of recurrence.
• Women in stage 3 have a 70 to 90 percent chance of recurrence.
• Women in stage 4 have a 90 to 95 percent chance of recurrence.

WATCH: Clinical trials can be life-saving.

Clinical trials are an option for women facing ovarian cancer with a high probability of recurrence. If you fall into this category, ask your doctor about possible clinical trial eligibility. Clinical trials help doctors better understand cancer and discover more effective treatment methods. They also allow patients to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), which can potentially be life-changing.

Questions for Your Doctor

If you have been diagnosed with ovarian cancer and need guidance to further educate yourself on the disease and treatment, consider these questions for your doctor.

• What type of ovarian cancer do I have?
• What stage is my cancer in?
• Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
• What initial treatment options do you recommend?
• What are the possible side effects of the recommended treatment, and how can they be coped with?
• Will insurance help cover my recommended treatment?

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