Treatments for stromal ovarian cancer

The following are treatment options for the stages of stromal ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is the main treatment and usually the only treatment for stage 1 stromal ovarian cancer. The types of surgery are:

• removing the uterus, both ovaries and both fallopian tubes (total hysterectomy and bilateral salpingo-oophorectomy)

• removal of the ovary with cancer and the fallopian tube on the same side (unilateral salpingo-oophorectomy) may be offered to those who want to get pregnant in the future

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.

Chemotherapy with a combination of drugs that includes carboplatin or cisplatin may be offered after surgery if you have a high risk of the tumour coming back (recurrence). Tumours that have a high risk of recurrence include those that are large, high grade or have broken open (ruptured).

The following are treatment options for stages 2, 3 and 4 stromal ovarian cancer.

Surgery is the main treatment for stages 2, 3, and 4 stromal ovarian cancer. The types of surgery are:

• total hysterectomy and bilateral salpingo-oophorectomy

• unilateral salpingo-oophorectomy may be offered if you want to get pregnant in the future

• surgical debulking (removing as much of the cancer as possible)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.

Chemotherapy may be offered after surgery for stages 2, 3 and 4 stromal ovarian cancer. The types of combination chemotherapy include:

• carboplatin and paclitaxel

• PEB (or BEP), which is a combination of cisplatin, etoposide (Vepesid) and bleomycin

• PVB, which is a combination of cisplatin, vinblastine and bleomycin

Hormone therapy may be offered after surgery for stages 2, 3 and 4 stromal ovarian cancer. Hormonal therapy is often offered to those who cannot tolerate chemotherapy because of the side effects or other health issues. The types of hormonal therapy include:

• tamoxifen

• letrozole (Femara)

• anastrozole (Arimidex)

• leuprolide (Lupron, Lupron Depot, Eligard)

• goserelin (Zoladex)

Recurrent stromal ovarian cancer means that the cancer has come back after it has been treated.

Surgery to debulk the tumour may be offered for recurrent stromal ovarian cancer.

Chemotherapy may be offered for recurrent stromal ovarian cancer. The types of chemotherapy are the same as those used for stages 2, 3 and 4.

Hormonal therapy may be offered for recurrent stromal ovarian cancer. The types of hormonal therapy are the same as those used for stages 2, 3 and 4.

Radiation therapy is also sometimes used for recurrences that are only found in small areas in the pelvis.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don't work anymore, they're not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can't have or don't want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.