Chemotherapy for ovarian cancer

When do you have chemotherapy?

You might have chemotherapy:

• into your vein - the drugs circulate throughout your body in the bloodstream

• directly into your tummy (abdomen) during surgery - this is called hyperthermic intraperitoneal chemotherapy (HIPEC)

Your treatment depends on several factors. These include how far your cancer has spread (the stage) and what it looks like under the microscope (the grade).

When you have chemotherapy depends on your individual case. You might have chemotherapy on its own or combined with surgery. You might have it:

• after surgery 

• both before and after surgery 

• on its own, without surgery

How often do you have it?

You usually have chemotherapy once every 3 weeks. Each 3 week period is called a cycle of treatment. You usually have the chemotherapy drugs on day 1 followed by a rest period to allow you to recover.

You normally have about 6 cycles in all, but you may have more. 

It takes 3 to 4 hours to have each treatment in the outpatients department. On rare occasions you might have it over 24 hours, when you would stay in hospital overnight.

Types of chemotherapy

If you have epithelial ovarian cancer, you usually have the chemotherapy drug carboplatin. You might have it on its own or with another chemotherapy drug called paclitaxel.

Your doctor might use different chemotherapy drugs if:

• your cancer has come back

• you have a different type of ovarian cancer 

Read about the types of ovarian cancer

Targeted cancer drug treatment

Some people may have treatment with a targeted cancer drug. This will depend on your situation. You might have a targeted cancer drug:

• with chemotherapy

• on its own after chemotherapy

Find out about targeted cancer drugs

How you have chemotherapy

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Find out more about central lines

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

Before your first chemotherapy, your doctor will explain what drugs you need, how you have them, and what the side effects are. You’ll sign a consent form. This is a good time to ask any questions you might have.

Side effects of chemotherapy

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

Side effects depend on:

• which drugs you have

• how much of each drug you have

• how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements

• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Read about the safety of complementary and alternative therapies

When you go home

Chemotherapy for ovarian cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Monitoring treatment

Your doctor can find out how well your chemotherapy has worked using: 

• CA125 blood tests

• scans 

CA125 blood test

CA125 is a protein that circulates in the blood. It can be measured with a blood test. It might be raised in women with some types of ovarian cancer. You may hear doctors calling CA125 a type of tumour marker.

Doctors usually measure your CA125 level before you start treatment. If you had high levels, your doctor will expect the level to fall as the chemotherapy destroys the cancer cells.

You might have CA125 blood tests before each chemotherapy treatment to see how well the treatment is working. Or you'll have the test once your whole course of chemotherapy has finished.

Not all women with ovarian cancer have raised CA125 levels. If you did not have raised CA125 when you were first diagnosed, your doctor can't use this blood test to monitor your treatment.

Scans

Doctors can also use scans, such as a CT scan, to see how well treatment has worked. You might have a scan after 3 or 6 cycles of chemotherapy.