What’s the Best Ovarian Cancer Treatment Path? That Depends on Several Factors

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The Best Initial Treatment for Your Specific Cancer

After a diagnosis of ovarian cancer, every woman’s treatment path will look a bit different
Most of the time, the first course of treatment a woman receives will be either chemotherapy or surgery
Surgery first is most common, but it’s important to keep in mind that not all women are eligible to receive surgery for ovarian cancer; poor overall health and other conditions can make the procedure risky

After a woman has been diagnosed with ovarian cancer, the initial treatment she receives will be dependent on a number of factors, but most often, it will include some combination of surgery and chemotherapy.

“Or sometimes we may look into hospice care if a patient doesn’t want to go through treatment and experience the side effects of treatment,” says Jessica Perreau, a nurse practitioner at Texas Oncology in San Antonio. As a nurse practitioner who works with ovarian cancer patients, Perreau often spends time talking with patients and their families to make sure a specific treatment plan aligns with their goals.

“We talk with the patient and their family and see what is in line with what they would like for their treatment,” Perreau explains.

Most of the time, the first step for ovarian cancer treatment ends up being surgery first, followed by chemotherapy. In some cases, however, a woman might not be eligible for surgery, in which case the decision would likely be to go straight to treatment with chemotherapy.

“If patients come in and they’re in a wheelchair and they have kidney failure… things like that that are already chronic diseases that they’re dealing with… sometimes we will just go straight to chemotherapy,” Perreau says, explaining, “we don’t want to make things worse in regard to their quality of life, especially if they don’t appear to be an ideal surgical candidate.”

What if Chemo Does Not Work?

Ovarian cancer can be particularly difficult to treat, and it unfortunately does return frequently after initial treatment. When it does return, it may be more aggressive and resistant to platinum-based chemotherapies.

For some women, a promising new treatment called Elahere (generic name mirvetuximab soravtansine) may be an option. Elahere was given emergency approval by the Food and Drug Administration (FDA) in 2023.

The drug is part antibody and part chemotherapy. It works by targeting the folate receptor alpha (FRÎ±) protein present on the tumor cell surface. Up to 80% of new and recurrent ovarian cancers may carry this protein (FRÎ± levels tend to be higher in more aggressive ovarian cancers).

Multiple phase III clinical trials have indicated that the drug showed effectiveness at suppressing cancer growth in at least one-third of patients.

The findings indicate that patients with ovarian cancer should speak to their doctors about testing for the FRÎ± protein and see if they are eligible for this ground-breaking new treatment.

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Jessica Perreau is a nurse practitioner at Texas Oncology in San Antonio. Read More