Chemotherapy for Ovarian Cancer

Chemotherapy for Ovarian Cancer

Chemotherapy for Ovarian Cancer
Chemotherapy (chemo) is the use of drugs to treat cancer. Most often, chemo is a systemic treatment
− the drugs are given in a way that lets them enter the bloodstream and reach all areas
of the body. Systemic chemo can be useful for cancers that
have metastasized (spread). Most of the time, systemic chemo uses drugs
that are injected into a vein (IV) or given by mouth. For some cases of ovarian cancer, chemotherapy
may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy. Drugs given this way are also absorbed into
the bloodstream, so IP chemotherapy is also a type of systemic chemo. This is discussed in more detail later in
this section. –Chemotherapy for epithelial ovarian cancer
Chemo for ovarian cancer is most often a combination of 2 or more drugs, given IV every 3- to 4-weeks. Giving combinations of drugs rather than just
one drug alone seems to be more effective in the initial treatment of ovarian cancer. The standard approach is the combination of
a platinum compound, such as cisplatin or carboplatin, and a taxane, such as paclitaxel
(Taxol®) or docetaxel (Taxotere®). For IV chemotherapy, most doctors favor carboplatin
over cisplatin because it has fewer side effects and is just as effective. The typical course of chemo for epithelial
ovarian cancer involves 3 to 6 cycles. A cycle is a schedule of regular doses of
a drug, followed by a rest period. Different drugs have varying cycles; your
doctor will let you know what schedule planned for your chemo. Epithelial ovarian cancer often shrinks or
even seems to go away with chemo, but the cancer cells may eventually begin to grow
again. Epithelial ovarian cancer often shrinks or
even seems to go away with chemo, but the cancer cells may eventually begin to grow
again. If the first chemo seemed to work well and
the cancer stayed away for a long time (at least 6 to 12 months)
it can be treated with additional cycles of the same chemotherapy used the first time. In some cases, different drugs may be used. Some of the other chemo drugs that are helpful
in treating ovarian cancer include (in alphabetical order):
Albumin bound paclitaxel – Altretamine (Hexalen®) – Capecitabine (Xeloda®) – Cyclophosphamide
(Cytoxan®) Etoposide (VP-16) – Gemcitabine (Gemzar®)
– Ifosfamide (Ifex®) – Irinotecan (CPT-11, Camptosar®) – Liposomal doxorubicin (Doxil®)
Melphalan – Pemetrexed (Alimta®) – Topotecan – Vinorelbine (Navelbine®)
The different drug combinations used to treat germ cell tumors are described later on in
the section Treatment for Germ Cell Tumors of the Ovary. Chemotherapy drugs kill cancer cells but also
damage some normal cells. Therefore, your doctor will be careful to
avoid or minimize side effects, which depend on the type of drugs, the amount taken, and
the length of treatment. Chemotherapy can damage the blood-producing
cells of the bone marrow, so patients may have low blood cell counts. This can result in:
Increased chance of infection (caused by a shortage of white blood cells) – Bleeding
or bruising after minor cuts or injuries (caused by a shortage of blood platelets) – Fatigue
(caused by low red blood cell counts) Most side effects disappear once treatment
is stopped. Hair will grow back after treatment ends,
although it may look different. There are remedies for many of the temporary
side effects of chemotherapy. For example, drugs can be given to prevent
and treat nausea and vomiting. For more information about chemotherapy and
its side effects Some chemo drugs may have long-term or even
permanent side effects. For example, cisplatin can cause kidney damage. To help prevent this, doctors give lots of
IV fluid before and after this drug is given. Both cisplatin and the taxanes can cause nerve
damage (called neuropathy). This can lead to problems with numbness, tingling,
or even pain in the hands and feet. Cisplatin can also damage the nerves to the
ear, which can lead to hearing loss (called ototoxicity). Other drugs can have other side effects, so
ask your doctor what side effects to expect from the drugs that you will receive. Most side effects improve once treatment is
stopped, but some can last a long time and may never go away completely. Chemo can also cause early menopause and infertility
(inability to become pregnant), which may be permanent. This is rarely an issue in the treatment of
epithelial ovarian cancer, since most women have both ovaries removed as a part of treatment. Rarely, some chemo drugs can permanently damage
bone marrow. This can later cause a bone marrow cancer
such as myelodysplastic syndrome or even acute myeloid leukemia. This is called a secondary malignancy. Your health care team knows which drugs can
cause this problem and will discuss this possibility with you. Their positive effects against ovarian cancer
offset the small chance that any of these drugs will cause another cancer. links

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