Ovaries are part of the female reproductive system. They produce eggs and as well as the hormones estrogen and progesterone. Ovarian cancer is a fairly common form of cancer in women; affecting over 22,000 women in the United States each year. Roughly half of patients diagnosed with ovarian cancer are over the age of 60. While there are numerous types of ovarian cancer, the majority of cases originate in the epithelial cells that cover the ovaries. A second, less common type, called stromal ovarian cancer, originates in the germ cells that manufacture eggs.

The risk factors affecting ovarian cancer include family history, never having been pregnant and prolonged menopausal hormone therapy. Later stage symptoms may include bloating, pressure or pain in the abdomen, nausea and fatigue.

Surgery, chemotherapy, targeted therapy, hormone therapy and radiation therapy are all viable ovarian cancer treatment options. Which option is best for you depends primarily on the stage and location of your tumor or tumors. Other factors to take into consideration are your age and whether or not you intend to become pregnant in the future.

Surgery

Your Gynecologic Oncologist will recommend a laparotomy in order to further diagnose the location, type and stage of the cancer. At the same time, he or she may remove one or both ovaries, the fallopian tubes, uterus and omentum – the layer of padded tissue that covers your intestines. Lymph nodes and tissue samples from the abdomen and pelvis may also be taken for diagnostic purposes.

Chemotherapy

Two different forms of chemotherapy may be used as ovarian cancer treatment. Intraperitoneal chemotherapy delivers the drug directly to the tumor area via a thin tube inserted into the abdomen. With systemic chemotherapy, the drug is injected or taken orally and kills cancerous cells as it travels throughout the body via the bloodstream. In most cases, chemotherapy follows surgery. However some women have chemotherapy prior to a laparotomy. Typically two or more drugs are given every three to four weeks for three to six cycles.

Targeted Therapy

Targeted therapy uses drugs to interfere with cellular activity that the cancer depends on to survive and grow. Biotherapy has been effective in shrinking or slowing down the growth of advanced ovarian cancer.

Hormone Therapy

Certain drugs that lower estrogen levels in women have been found to be effective against stromal ovarian cancer. Drugs that affect gonadotropin-releasing hormone stop estrogen production in the ovaries. Aromatase inhibitors stop other hormones in post-menopausal women from turning into estrogen. Without estrogen the stromal ovarian cancer cells cannot grow.

Ovarian Cancer Radiation Therapy

Radiation is often prescribed in addition to surgery or in combination with chemotherapy. One of several highly sophisticated forms of External Beam Radiation Therapy or Internal Radiation Therapy may be recommended depending on the size and location of the tumor or tumors.

3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT)

3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT) are two forms of External Beam Radiation Therapy. During 3D-Conformal treatments, a device called a "multi-leaf collimator" will shape the individual radiation beams to “conform” to the shape of your tumor according to the data and instructions it receives from the system computer. IMRT uses thousands of radiation “beamlets” from many different angles to deliver a single dose of radiation. The intensity of the “beamlets” can change during the treatment session to modulate the dose, so that the tumor receives a very precise high dose of radiation, while minimizing damage to surrounding, normal tissue.

Before each session, a Radiation Therapist will carefully position you on the treatment table using a body immobilizer for precise body placement. Image guidance will be used to confirm the location of the tumor before the therapy begins. During your ovarian cancer treatment sessions, the radiation delivery system will revolve around you, delivering the radiation according to the plan set by your Radiation Oncologist. Each treatment session lasts from 10 to 30 minutes. Typically, you will be scheduled for five sessions a week for several weeks. These sessions of radiation therapy for ovarian cancer are pain-free and require no sedation so you can return to your normal activities right away.