The Ovarian Cancer and Chemotherapy Experience
- Chemotherapy regimens for ovarian cancer are very effective
- Ovarian cancer treatment protocols typically require six cycles
- Side effects of ovarian cancer treatment can be well managed
- The treatment experience is unique to the individual
“The nice thing about ovarian cancer is that our chemotherapy regimens are extremely effective,” says Dr. Stephanie Wethington, a gynecologic oncologist at Johns Hopkins University. “In general, they’re very well tolerated. We can manage the side effects, and the protocols work for the vast majority of patients.”
Read More- A platinum-based agent (usually cisplatin or carboplatin)
- A taxane, such as paclitaxel (Taxol®) or docetaxel (Taxotere®).
These drugs are usually delivered through an intravenous infusion every 3 to 4 weeks. “Typically, for ovarian cancer, patients will get three cycles. Then we’ll do repeat imaging and assessments followed by another three cycles of treatment,” Dr. Wethington says.
Ovarian cancer tends to shrink or even disappear with chemotherapy, but cancerous cells may begin to grow again over time. If the cancer recurs after six months, your doctor may use another platinum-containing regimen. If it recurs sooner, your doctor may choose to use a different drug combination.
Drugs used to treat ovarian cancer include:
- Albumin bound paclitaxel (nab-paclitaxel, Abraxane®)
- Capecitabine (Xeloda®)
- Cyclophosphamide (Cytoxan®)
- Etoposide (VP-16)
- Gemcitabine (Gemzar®)
- Ifosfamide (Ifex®)
- Irinotecan (CPT-11, Camptosar®)
- Liposomal doxorubicin (Doxil®)
- Melphalan
- Pemetrexed (Alimta®)
- Topotecan
- Vinorelbine (Navelbine®)
Managing Side Effects
Chemotherapy attacks all dividing cells, whether they’re cancerous or not. Unfortunately, those indiscriminate attacks are what lead to side effects. Healthy cells that rapidly divide, such as skin, hair, and gastrointestinal cells are at greatest risk of damage.
Common side effects of chemotherapy include:
- Changes in taste
- Fatigue
- Diarrhea and abdominal cramping
- Hair loss
- Loss of appetite
- Nausea and vomiting
- Mouth sores
- Neuropathy (numbness, tingling or pain in the hands and feet)
Doctors give chemotherapy in cycles with built-in rest periods to help minimize side effects and give the body time to repair itself. Today’s chemotherapy regimens are more tolerable than in the past, and the majority of side effects tend to resolve after you complete treatment.
“One of the great things that has happened in cancer treatment over the past 10 to 20 years, in addition to the discovery of PARP inhibitors and more chemo regimens for ovarian cancer, is our increasing ability to manage side effects for patients who are on chemotherapy,” Dr. Wethington says. “You should not be bed-bound for the 21 days following a chemotherapy infusion, but you can expect to have a few days where you feel more tired than usual.”
Navigating the Chemotherapy Experience
The chemotherapy experience is unique to each individual. Some women are able to continue working during treatment while others decide to take time off. The decision depends largely on the type of job you have and your support system.
“It’s an individual decision, but if you decide you want to continue working during treatment, the potential is there,” Dr. Wethington says. “We can work with you to devise a plan to make that happen.”
Whether you choose to continue working or not, it’s important to keep your doctor informed about how you’re tolerating treatment. Some doctors advise keeping a daily log. The reason: There are a number of medications available to help manage things like nausea, vomiting, and fatigue. Plus, if you’re experiencing debilitating side effects, your doctor may choose to modify your treatment regimen.
Doctors have more choices in chemotherapy than ever before, so they can adjust the regimen and the treatment schedule to accommodate your needs and lifestyle. Conversations with your health care team and careful planning can help you navigate the experience with the greatest ease.
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