Ovarian Cancer Treatment: Surgery or Chemotherapy First?
SHARE

Medically Reviewed
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
6) Readers are clearly alerted to any conflicts of interest from a medical source or the authors of a cited study.
/ Updated September 16th, 2022

Ovarian Cancer Treatment: Surgery or Chemotherapy First?

Medically Reviewed: Dr. Whitfield Growdon Written by: Dr. Jose Alejandro Rauh-Hain
MD Anderson Cancer Center
×

The various paths forward through ovarian cancer treatment can be confusing for women and often lead to difficult decisions for oncologists.

Doctors have two main approaches to treatment when they are working with ovarian cancer patients. As Dr. Jose Alejandro Rauh-Hain, a gynecologic oncologist on staff at the University of Texas MD Anderson Cancer Center, tells SurvivorNet, both of these methods of treatment offer patients a combination of chemotherapy and surgery. "At the end of the day, both groups get chemotherapy and surgery. It's just the sequence of how we do it."

Read More
If a doctor is confident that he or she can remove the ovarian tumor completely without initial cycles of chemotherapy, this doctor will go ahead with a surgical procedure. "If we think we can do that, we do what we call a debulking procedure, or cytoreductive surgery," Dr. Rauh-Hain explains. "That's usually through an open incision."

The cytoreduction is designed to remove as much of the cancerous tissue as possible, although the procedure often does not entirely remove the tumor. As a result, the group that receives surgery first still goes through chemotherapy following the operation to ensure that the cancerous tissue is fully treated. This process is known as adjuvant chemotherapy, a process to treat microscopic disease that cannot be seen with the eye that the clinician knows persists in the body after an optimal surgical cytoreduction.

The other group is made up of women on whom doctors are not confident they can perform successful surgical tumor removal. This group receives chemotherapy before surgery. "We usually give three or four cycles of chemotherapy first, hoping that we are going to shrink down the cancer. And once the cancer is smaller, then we proceed with surgery," Dr. Rauh-Hain says. Following the surgery, this group usually receives a final chemotherapeutic treatment as further assurance that the cancerous tissue is gone.

This necessary combination of both treatments is related in part to the particular virulence of ovarian tumors. The cancer is particularly difficult to detect, so the average woman has a sizable tumor by the time she is diagnosed. As a result, both chemotherapy and debulking are needed to remove the majority of malignancies. According to the NIH, oncologists have had particular success with debulking in ovarian cancer patients, as compared with other types of cancer. The goal of a debulking procedure is to reduce the size of tumors as much as possible. If less than 1 cm of the tumor is left, that’s considered a successful surgery. From this size, chemotherapy can often further shrink the tumor to a point where there will be virtually no cancerous tissue left in the woman's abdomen. It’s important that ovarian cancer patients get to a skilled tertiary cancer center for surgery.

Learn more about SurvivorNet's rigorous medical review process.

Dr. Rauh-Hain is a Gynecologic Oncologist on staff at the University of Texas MD Anderson Cancer Center. Read More

Ovarian Cancer Initial Treatment

Deciding the first course of care for ovarian cancer is a crucial conversation between a woman and her gynecologic oncologist. Following a detailed diagnosis of the type of ovarian cancer, doctors typically recommend an aggressive combination of surgery and chemotherapy. Which treatment comes first depends on the stage and grade of the cancer.

NOW
PLAYING
Making an Initial Plan Should Be About Treatment -- But Also Your Needs, Goals & Fears
NOW
PLAYING
What's the Best Ovarian Cancer Treatment Path? That Depends on Several Factors
NOW
PLAYING
Ovarian Cancer: The Robotic Surgery Experience
NOW
PLAYING
The Standard of Care for Initial Treatment of Ovarian Cancer
NOW
PLAYING
How Serious is My Illness? "Staging" Ovarian Cancer
NOW
PLAYING
PARP Inhibitors: Why is Genetic Testing Important?

Patient Pathfinder:

Clinical Trial Finder

Are you looking for other treatment options?
Right now there are ... ovarian cancer trials in the U.S. within 100 miles of

Enter your zip code and travel distance to explore trials in your area...

Continue The Journey

Explore: Maintenance

Related Articles

For Woman, 44, Eraser-Sized Growth in Belly Button Turns Out To Be Ovarian Cancer Thanks To Caring Dermatologist

Why Model Elle Macpherson’s Breast Cancer Treatment Decision Is Not Necessarily So Controversial; The Serious Study of Overtreatment

Famous Stand-Up Comedian, 63, Admits ‘Fear Never Ends, But I Keep Going’ As She Embarks On New Treatment For Ovarian Cancer

Later Stage

Wife of Country Music Singer Coffey Anderson, 46, Plays ‘Shut-up Prank’ on Famous Husband Which ‘Had Her Rollin’ – Focusing on the Positive Amid Advanced 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