Making Treatment Decisions after an Ovarian Cancer Cancer Diagnosis

Dr. Allan James (“A.J.”) White, a gynecologic oncologist at the START Center for Cancer in San Antonio, Texas, explains that making these decisions and weighing all the factors is part of “the art of medicine.”

For women who are diagnosed with early-stage, localized ovarian cancer (meaning the cancer has not yet spread beyond the ovaries), doctors may suggest a minimally-invasive robotic surgery to remove the ovaries and uterus.

“We can send the patient home either the same day if we do the surgery early in the morning or the day after,” Dr. White says of these surgeries, emphasizing that the procedure is relatively short and simple.

For women who have been diagnosed with a more advanced stage of ovarian cancer, however, a more complicated procedure may be necessary. “With the more advanced cancers, the best treatment is to do radical removal of all the cancers we can detect with our open eye then give a postoperative chemotherapy,” Dr. White explains. By “postoperative chemotherapy,” he means chemotherapy administered after the surgery in an effort to target any cancer cells that were not removable during the procedure.

For other women, yet another option might be available, which is what Dr. White calls a “sandwich technique” (though the technical term for it is “neoadjuvant chemotherapy”). With neoadjuvant chemotherapy, a woman receives several courses of chemotherapy before surgery, in an effort to shrink down the cancer to a point where it more feasible to operate on. Then, after the surgery, the woman might go through another few courses of chemotherapy, again, to kill any remaining cancer cells that were missed during surgery.

“We have to do the best we can with the information we have,” Dr. White says, adding that not all cancer centers do things identically, and that treatment decisions vary from patient to patient.

Learn more about SurvivorNet's rigorous medical review process.

---