Chemotherapy for ovarian cancer
Chemotherapy uses anti cancer drugs to destroy cancer. The drugs circulate throughout the body in the bloodstream.
You might have chemotherapy after surgery, or both before and after. Doctors often use the drugs carboplatin and paclitaxel for ovarian cancer.
When do you have chemotherapy?
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
Who has chemotherapy?
Your treatment depends on several factors, including how far your cancer has spread (the stage) and what it looks like under the microscope (the grade).
You might have chemotherapy if your cancer is:
- stage 1c or above
- at an earlier stage (1a or 1b), but is high grade
- has come back after you were first treated (recurrence)
How often do you have it?
You usually have chemotherapy once every 3 weeks. You usually have the chemotherapy drugs on day 1 followed by a rest period to allow you to recover from side effects.
Each 3 week period is called a cycle of treatment. 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
Doctors most commonly use the chemotherapy drug carboplatin to treat ovarian cancer. You might have it on its own or with another chemotherapy drug called paclitaxel (Taxol).
Your doctor might use other types of chemotherapy drugs if your cancer has come back.
How you have chemotherapy
Into your bloodstream
You might have chemotherapy into a vein (intravenously) through a drip into your arm. A nurse puts a small tube into one of your veins and connects the drip to it.
Or you may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
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.
Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.
So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Before you have each treatment you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.
So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.
Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.
Depending on the type of treatment that you are having we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.
All chemotherapy is given over different time periods so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot so please be prepared to bring along some bits to keep you occupied, such as books and music.
So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.
So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse who will be able to answer them for you.
Before your next cycle of treatment you will come in and see the doctor in the clinic room, you’ll have a blood test and an examination to make sure you are fit and well for treatment you will then come back the following day or later on that week for treatment.
Before you start chemotherapy
You need to have blood tests to make sure it’s safe to start treatment. You usually have these the day before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. It’s worked out based on your weight, height and general health.
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.
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.
Your doctor can find out how well your chemotherapy has worked using:
- CA125 blood tests
CA125 blood test
CA125 is a protein made by some ovarian cancer cells that circulates in the bloodstream. Doctors usually measure it 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.
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.