Ovarian cancer has been shown to respond well to chemotherapy (doctors call it an especially “chemo-sensitive” cancer), which is why women diagnosed with ovarian cancer will usually receive chemo at some point during the course of their treatment. Though every treatment plan is differentand should be personalized for your specific type and stage of cancerchemo drugs are often given before or after ovarian cancer surgery at three-week intervals. The treatment is administered either intravenously (through an IV) or through a catheter.
Doctors have been using a combination of a platinum-based chemo drug like cisplatin or carboplatin and a taxane drug like paclitaxel (known by its brand name, Taxol) to treat ovarian cancer for years. Usually, women receive a combination of both chemo drugs every three weeks. This regimen is the “standard-of-care” for ovarian cancer, a designation that draws on years of positive clinical trial results.
Read MoreBut there are important considerations to take into account with dose-dense chemo.
"It's not the panacea," Dr. Boyd says. With the dose-dense option, common side effects associated with chemotherapy can worsen. This is true for neuropathy, for instance, which is a tingling, numbness, or nerve pain that often starts in the fingers and toes. For some patients, medications like glutamine and small doses of B6 can help with neuropathy, but the drugs aren’t always as effective as doctors would like. If neuropathy or other side effects become particularly debilitating during chemo, it may be necessary to adjust the chemo dose.
"This is something we have to be thoughtful about when prescribing dose-dense chemotherapy," Dr. Boyd says.
It's also important to consider the quality of life implications of dose-dense chemo. "We're asking patients to come in to get their chemotherapy far more often," she says. "If you live far away from where you get your chemotherapy, that can be a pretty significant burden."
Dr. Boyd also points out that the eye-opening, dramatic results from the initial dose-dense chemo trial (which took place in Japan) were not replicated when oncologists tried to repeat the clinical trial with a similar drug in the United States. This doesn’t discount the potential overall-survival impact, but it’s certainly something to bear in mind.
"It's a complicated decision-making process that we go through," Dr. Boyd says. That decision-making process should involve ongoing, transparent conversations between you and your gynecologic oncologist. No two cancers are the same, and ultimately, the best treatment planwhether it’s standard-of-care chemo, dose-dense chemo, or another option altogetherwill be the treatment plan that works best for you. Treatment plans can change throughout the course of treatment, too, and chemo dose adjustments are normal, if not expected. If your side effects become too much for your body to handle during dose-dense chemo, you may return to the less-frequent option. Changes like these are common, and shouldn’t be a cause for worry.
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