Pre-Surgical Treatment
- Neoadjuvant chemotherapy can be used to shrink disease before surgery
- In the COVID-19 era, it's possible your doctor may recommend chemo before surgery in an effort to manage your risk for exposure
- Doctors may use Bevacizumab in combination with chemotherapy to reduce the burden of disease
- If neoadjuvant chemotherapy is effective, there will be clinical evidence that the cancer has regressed and women's overall health will improve
When patients receive chemotherapy prior to surgery, it’s called neoadjuvant chemotherapy. “The intent of neoadjuvant chemotherapy is to control disease, to shrink the tumor,” says Dr. Ramez Eskander, a gynecologic oncologist at the University of California, San Diego. So, for example, if you have evidence of disease in several areas of the liver, doctors are not going to remove the liver to get rid of the tumor. Instead, they’ll use neoadjuvant chemotherapy to coax those diseased areas in the liver to die off.
Read MoreThese drugs are delivered through an IV infusion every 3 to 4 weeks. Typically, ovarian cancer patients get three cycles. Then doctors do repeat imaging and assessments followed by another three cycles of treatment. But every patient experience is unique. Some patients only need two cycles. Others need more than three. The number of cycles required depends on several factors, including:
- The patient’s health
- The stage of disease
- Where the cancer is located
- How patients respond to treatment
Success…and Side Effects
The chances of complications following surgery depend on a number of factors, including your age, extent of disease, and whether you have unrelated health conditions. Delivering chemotherapy before surgery reduces the risk of complications by 25 to 30 percent.
But the chemotherapy drugs are powerful anti-cancer treatments and often cause side effects. Though symptoms can vary from person to person, it's a good idea to know what to expect, and to be prepared. The most common side effects from chemotherapy are:
- Fatigue
- Hair loss
- Gastrointestinal issues like nausea and constipation
- Neuropathy
While hair loss is almost inevitable for women receiving paclitaxel as chemotherapy, other side effects can be managed. Doctors have a number of drugs that can be given before, during, and after chemotherapy to minimize or prevent nausea. Drugs can help with constipation or, though it occurs more rarely, diarrhea. And women vary widely in how much fatigue they experience. Some women are able to return to work or daily activities at least part-time, almost immediately. Others require more time to recover between infusions. Lifestyle changes such as better sleep hygiene and physical activity can help boost energy.
Your doctor can discuss the options with you and help you decide whether surgery or chemotherapy first is the best way to attack your cancer. And whichever option you choose, your medical team will help you manage any complications or side effects that arise.
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