Treatment Options for Ovarian Cancer: Surgery, Chemotherapy, and New Advances

Understanding the Goal

Ovarian cancer treatment aims to remove or destroy cancer cells, prevent recurrence, and help patients maintain quality of life. Because ovarian cancer is often discovered in later stages, its management usually requires a combination of therapies—surgery, chemotherapy, targeted therapy, and sometimes radiation or immunotherapy.

Each woman’s treatment plan is tailored based on several factors:

The type and stage of cancer
Whether she wishes to preserve fertility
Her overall health and genetic profile
The response of the cancer to initial treatments

The following sections outline every major treatment approach and how they work together to improve survival and well-being.

Surgery

Surgery is almost always the first line of treatment for ovarian cancer. It serves both diagnostic and therapeutic purposes—confirming the stage and removing as much cancer as possible.

Types of Surgical Procedures

Debulking (Cytoreductive) Surgery
This is the cornerstone of ovarian cancer management. The goal is to remove all visible tumors from the abdomen. Studies show that women with no visible residual disease after surgery live significantly longer.
Total Hysterectomy
Involves removing the uterus, both ovaries, and fallopian tubes. It’s the standard approach for post-menopausal women or advanced cases.
Fertility-Sparing Surgery
For early-stage cancers confined to one ovary, surgeons may remove only the affected ovary and fallopian tube, preserving the uterus and the other ovary for future pregnancy.
Omentectomy and Lymph Node Removal
The omentum (a fatty apron inside the abdomen) and nearby lymph nodes are removed to check if cancer has spread.
Second-Look Surgery
In selected cases, doctors perform a follow-up surgery after chemotherapy to check whether any cancer remains.

What to Expect After Surgery

Recovery can take several weeks. Pain, fatigue, and digestive changes are common but manageable with supportive care. Physical activity and balanced nutrition play a major role in regaining strength.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells that surgery can’t remove. It’s a vital part of ovarian cancer treatment, given either before or after surgery.

When Chemotherapy Is Given

Adjuvant therapy: After surgery, to destroy remaining microscopic cells.
Neoadjuvant therapy: Before surgery, to shrink tumors and make them easier to remove.
Maintenance therapy: To prevent recurrence after initial success.

Common Drug Combinations

The standard regimen includes platinum-based drugs such as:

Carboplatin or cisplatin, combined with
Paclitaxel (Taxol) or docetaxel (Taxotere)

These drugs are usually delivered intravenously every three weeks for several cycles.

Side Effects

Nausea and vomiting
Hair loss
Fatigue
Increased risk of infection
Numbness or tingling (neuropathy)

Most effects are temporary, and modern anti-nausea and growth-factor medications help patients tolerate treatment better.

Targeted Therapy

Targeted therapy focuses on specific molecular changes in cancer cells, making treatment more precise and often less toxic than traditional chemotherapy.

PARP Inhibitors

One of the biggest breakthroughs in ovarian cancer care, PARP inhibitors block the enzyme that helps cancer cells repair DNA damage. This causes the cells to die.

Common drugs include:

Olaparib (Lynparza)
Niraparib (Zejula)
Rucaparib (Rubraca)

They are especially effective in patients with BRCA1 or BRCA2 mutations or other defects in DNA-repair genes. PARP inhibitors are typically taken as oral pills and used as maintenance therapy after chemotherapy.

Anti-Angiogenic Therapy

Tumors need blood vessels to grow. Bevacizumab (Avastin) is an anti-angiogenic drug that cuts off this blood supply, starving the tumor. It’s given through an IV infusion, often alongside chemotherapy.

Advantages

Targets cancer-specific mechanisms
Can be combined with chemotherapy or used alone
May extend remission time in recurrent disease

Hormone Therapy

Hormone therapy is mainly used for low-grade or stromal ovarian cancers that depend on estrogen for growth.

How It Works

Drugs either block hormone receptors or reduce hormone production, depriving the cancer of its growth signal.

Common agents:

Tamoxifen (blocks estrogen receptors)
Letrozole and Anastrozole (lower estrogen levels)
Goserelin (suppresses ovarian hormone production)

Hormone therapy is generally milder, with fewer side effects than chemotherapy, and can be an option for older women or those unable to tolerate aggressive treatment.

Radiation Therapy

Radiation uses high-energy X-rays to destroy cancer cells. Although not a first-line treatment for ovarian cancer, it can help in specific situations:

To control localized recurrences
To relieve pain or bleeding
To treat residual disease that cannot be surgically removed

External beam radiation is most common and delivered over several sessions. Side effects include fatigue, mild nausea, and temporary skin irritation, but these typically subside after completion.

Immunotherapy

Immunotherapy is an exciting and rapidly developing area of ovarian cancer research. It aims to stimulate the immune system to recognize and attack cancer cells.

Current Immunotherapy Options

Checkpoint Inhibitors – Drugs such as pembrolizumab (Keytruda) block proteins (PD-1/PD-L1) that help cancer hide from the immune system.
Cancer Vaccines – Experimental vaccines are designed to train the immune system against ovarian cancer antigens.
Adoptive Cell Therapy – Involves using a patient’s modified immune cells to directly target tumor cells (still under clinical trial).

While immunotherapy hasn’t replaced chemotherapy, it holds promise for recurrent or chemotherapy-resistant ovarian cancers.

HIPEC (Heated Chemotherapy)

HIPEC, or Hyperthermic Intraperitoneal Chemotherapy, is a specialized technique used during surgery. After the visible tumors are removed, a heated chemotherapy solution is circulated throughout the abdomen for 60–90 minutes.

The heat enhances drug absorption and kills microscopic cancer cells left behind.

Benefits

Delivers high drug concentration directly to cancer sites.
May improve survival in advanced stages.
Reduces systemic toxicity compared with traditional IV chemotherapy.

HIPEC requires expertise and is available at specialized cancer centers, but it has shown encouraging results for stage III and IV patients.

Maintenance Therapy

Once the initial treatment is complete and the cancer is in remission, doctors may recommend maintenance therapy to prevent recurrence.

Options Include

PARP inhibitors for BRCA-mutated or HRD-positive cases
Bevacizumab to prevent new blood vessel formation
Low-dose chemotherapy in some patients

The duration usually ranges from 1–3 years, depending on the patient’s tolerance and risk profile.

Maintenance therapy has transformed ovarian cancer care, helping many women extend remission for years.

Recurrent Ovarian Cancer

Unfortunately, ovarian cancer tends to return in about 70% of advanced cases. When it does, doctors consider several factors—how long the remission lasted, previous treatments, and the patient’s condition.

Treatment Categories

Platinum-Sensitive Recurrence – Returns after more than 6 months; often treated again with platinum-based chemo.
Platinum-Resistant Recurrence – Returns within 6 months; requires non-platinum drugs like liposomal doxorubicin or topotecan.
Targeted or Immunotherapy – For tumors with specific mutations or resistance to standard treatments.

Palliative Treatments

Even when cure isn’t possible, therapy can extend life and improve comfort by controlling pain, bloating, and digestive issues.

Supportive and Complementary Care

Modern oncology focuses not only on survival but also on the quality of life. Supportive therapies help manage symptoms, reduce side effects, and support emotional health.

Common supportive strategies:

Pain management and anti-nausea medications
Nutritional counseling
Physical therapy to restore mobility
Psychological counseling and support groups
Complementary options like meditation, yoga, and acupuncture

These approaches empower patients to remain active and maintain emotional balance during treatment.

Clinical Trials

Clinical trials offer access to cutting-edge therapies before they become widely available. Many major advances in ovarian cancer treatment—like PARP inhibitors—originated in such studies.

Patients may qualify for trials investigating:

New combinations of chemotherapy and immunotherapy
Personalized vaccines
Novel targeted drugs for BRCA-negative patients

Participation is voluntary but can provide hope for those with advanced or recurrent disease. Patients should discuss eligibility with their oncologist or visit clinicaltrials.gov for current listings.

The Role of Genetic Testing

Genetic and molecular testing have revolutionized ovarian cancer treatment. By analyzing tumor DNA, doctors can select therapies most likely to succeed.

Common tests include:

BRCA1/BRCA2 mutation analysis
HRD (Homologous Recombination Deficiency) status
Next-generation sequencing panels

Women with inherited mutations may also encourage their family members to undergo testing for early prevention or risk-reducing surgery.

Lifestyle and Recovery

Treatment is only one part of the journey. Healing continues long after the hospital stay ends.

Tips for recovery:

Maintain a balanced diet rich in fruits, vegetables, and lean proteins.
Engage in light exercise like walking or yoga to improve circulation and reduce fatigue.
Prioritize sleep and stress management.
Seek professional help for depression or anxiety.

Adopting healthy habits strengthens the immune system and improves long-term outcomes.

Hope and Future Therapies

The landscape of ovarian cancer care is changing fast. Research now focuses on precision medicine, where treatment is guided by a tumor’s unique genetic makeup.

Emerging innovations include:

Bispecific antibodies that connect immune cells directly to tumor cells.
mRNA vaccines designed to prevent recurrence.
Artificial intelligence (AI) tools to detect cancer earlier through imaging or biomarkers.

These advances offer renewed hope that ovarian cancer may one day become a manageable chronic condition rather than a fatal disease.

Key Takeaways

Ovarian cancer treatment is multidisciplinary, involving surgery, chemotherapy, and targeted therapies.
PARP inhibitors and HIPEC have dramatically improved survival outcomes.
Genetic testing is essential to personalize treatment.
Recovery includes physical, emotional, and lifestyle support.
Ongoing research continues to make new, more effective therapies possible.