In case of ovarian cancer, depending on its type, its stages of development ... different treatments can be proposed. The surgical operation is the most important treatment regardless of the stage of cancer development. This intervention makes it possible to make an accurate assessment of the local and regional extension of cancer. The surgeon inspects the entire abdomen, the abdominal surface of the diaphragm, the surface of the liver, the colon, the rectum, the small intestine, the ovaries and the uterus, the bladder looking for metastases. This assessment of extension makes it possible to evaluate the stage of evolution of the cancer and conditions the treatment of the disease.
Surgery also allows of course to remove the tumor, and possible metastases (when the cancer is at an advanced stage), when their ablation is possible. The ovaries, the uterus and its appendages must usually be removed, as well as parts of the digestive tract, particularly the colon or small intestine, if metastases have invaded them.
It is possible under certain conditions to keep a healthy ovary and the uterus if the woman is young and she wants children.
After the surgery, a chemotherapy treatment is undertaken. These cures are usually quite tiring, but they are necessary to clean small tumors and cells that could not be removed by surgery. For some advanced stages of ovarian cancer, treatment may begin with chemotherapy sessions. We are talking about neoadjuvant chemotherapy. Also note that chemotherapy drugs are sometimes delivered directly into the peritoneum.
Generally 6 cycles of chemotherapy are planned, one cycle every 3 weeks. The drugs are administered by the venous route. It is most often a combination of carboplatin and paclitaxel. The treatment can be done in home hospitalization (HAD) if the infrastructure and the state of health of the patient allow it.
For some advanced stages of ovarian cancer, in addition to chemotherapy, an antiangiogenic drug may be given. It blocks the small vessels that normally feed the cancer. Without these vessels, the cancerous tissues die.
The medical supervision of the treated patient is done by medical examinations carried out very regularly during and after the treatments. A blood test of a marker, CA125, is performed regularly.
In case of recurrence, a second series of chemotherapy treatments may be performed, sometimes with new surgery and / or treatment with anti-angiogenic medication if it had not been previously prescribed. Monitoring is of course necessary after treatment.
As we have seen above, in the case of a BRCA mutated gene, certain ovarian serous epithelial cancers can be treated with a PARP inhibitor, in case of recurrence.