Chemotherapy or “chemo” is the use of one drug or, usually, a combination of drugs to kill cancer cells throughout the body. Chemotherapy treats the whole body rather than just one part of it.
- Cancer cells divide rapidly to reproduce themselves and create more cancer cells. Chemotherapy kills cancer cells by stopping their ability to divide and reproduce.
- Chemotherapy drugs can stop or slow the growth and spread of cancer cells, and can shrink the size of the cancer tumor.
- Chemotherapy is often used as a treatment for ovarian cancer; either before or after surgery.
- Given before surgery, chemo reduces the size of the tumor, making it easier to remove.
- After surgery, chemo is used to destroy any remaining cancer cells.
- Chemotherapy can also help deal with cancer symptoms such as ascites, which is a build-up of fluid in the abdomen.
- When chemo drugs are given intravenously, they travel through the bloodstream to the cancer cells.
- When they are given intraperitoneally, the anti-cancer drugs are put directly into the abdomen. This concentrates the chemotherapy drug on the cancer cells on the abdominal lining. However, much of the drug still does get into the bloodstream from the abdomen.
- One common chemotherapy regimen uses a combination of drugs to produce the best possible response to treatment, i.e. a combination of platinum products such as cisplatin or carboplatin with Taxol (paclitaxel).
- Other chemotherapy agents, such as topotecan, may be used to prolong survival.
- Chemotherapy commonly produces side effects such as:
- Low blood counts
- Hair loss
- These effects may be reversed once chemotherapy ends, although it may take some time
- Most ovarian cancer patients will receive combination chemotherapy, but that does not necessarily mean that you will have twice the normal number of side effects.
How do I take Chemotherapy?
Intravenous (IV) chemotherapy is used when cancer nodules inside the abdomen are larger than 2cm, and/or have spread outside the abdomen and pelvis.
- Chemotherapy drugs are injected into one of your veins (given 'intravenously' or IV) so that they can circulate through your blood stream
- Chemo treatments are given every 3 to 4 weeks
- Treatments are usually repeated 6 times, and sometimes up to 12
- Drugs can be injected over about 3 hours or they may be given over 24 hours
By IP Therapy
'Intraperitoneal' chemotherapy or IP chemotherapy is used only if cancer cells are inside the abdominal cavity.
- The drugs are given straight into your abdomen through a plastic tube
- Any ovarian cancer cells that are attached to the lining of the abdomen receive a high concentration of the chemotherapy drugs
- The levels in your blood stream are generally lower than with chemotherapy that goes directly into the blood stream, as a result, you may have fewer side effects
- The same drugs that are given into the blood stream to treat cancer of the ovary can be used
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- Some chemotherapy treatments are given by oral tablet, which may pose a problem to people who have problems swallowing
- Your medical team will advise you about your options
Common Questions About Chemotherapy
Will chemotherapy cure my ovarian cancer?
Whether or not chemotherapy will cure your cancer depends on many factors such as:
- The stage and grade of your cancer
- The outcome of your surgery – if the surgeon was able to remove all the visible tumor
- Your age
- Your overall health
It is important to remember that many women go on to lead long, productive and healthy lives after treatment for ovarian cancer.
There is always hope for a cure.
I was diagnosed at an advanced stage. What is chemotherapy going to do for me?
- Chemotherapy can stop cancer from spreading and dramatically slow the growth of cancer cells. This can help put cancer into remission enabling you to prolong your life.
- Chemo can also relieve the symptoms caused by your cancer, which can improve your overall quality of life.
How do I know that the chemotherapy is working?
- Every individual responds differently to treatment.
- There is a tumor marker called CA 125 that is sensitive to ovarian cancer. A downward trend in CA 125 indicates a positive response to chemo, i.e. as the numbers decrease, your chemotherapy is working.
My doctor has successfully removed all visible traces of cancer by surgery. Why do I still need chemotherapy?
- Chemotherapy can prevent the cancer from recurring.
- Cancer cells are very small and small clumps of cells can spread to other parts of the body. Chemotherapy helps to kill the nearly invisible cancer cells that cannot be removed by surgery.
Have treatments for ovarian cancer changed?
- There are many new approaches to treating ovarian cancer, such as new drugs and combinations of drugs.
- Women living in Canada benefit not only from research performed in this country but worldwide.
- Scientists and doctors meet frequently at medical conferences all over the world to share information and discuss new approaches to treatment.
I may not live very long anyway so what’s the point?
- No one can predict what will happen in the future.
- You may respond positively to chemotherapy and go on to lead a completely normal life.
- Chemotherapy may extend your life and could potentially enable you to receive new treatments that may result in a cure.
- It is important to remember that increasingly ovarian cancer is being regarded as a chronic disease; it may recur but repeated cycles of chemotherapy can put the disease back into remission and you can return to a normal quality of life.
Will I get the best treatment in Canada?
- Canada's cancer centres, physicians and nurses have a worldwide reputation for outstanding care.
- There are well-established protocols and standards of care right across Canada.
- While you may have to travel within Canada for treatment, you can expect to receive widely-accepted treatment regimes for ovarian cancer.
Types of Chemotherapy Drugs
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