Most women with ovarian cancer will need chemotherapy (chemo). Chemotherapy is anti-cancer drugs (cytotoxics). The aim of the treatment is to either destroy the cells or slow down or stop the growth of the cells while causing the least possible damage to normal cells.
If your ovarian cancer has started to grow outside the ovary, research shows that having chemotherapy after surgery can improve your survival and reduce the risk of the cancer coming back. Some women may have chemotherapy before surgery to help shrink the cancer. Your medical oncologist will talk to you about how chemotherapy may benefit your own situation.
If your cancer comes back (recurs) after your initial treatment, your oncologist may suggest using chemotherapy again, possibly with different drugs.
As well as destroying cancer cells, chemotherapy can also damage healthy cells in your body. This can cause a range of side effects. Side effects depend on the particular drugs used, but also vary from woman to woman and from one chemotherapy cycle to the next.
The Cancer Council has an excellent booklet on chemotherapy (www.cancer.org.au or call 13 11 20 for a free copy).
Biological therapies are a newer type of cancer treatment. They work by changing the way the cells in our body work. They can interfere with the signals or blood supply that make cancers grow or block the DNA repair in cancer cells.
Biological therapies used to treat ovarian cancer include bevacizumab (Avastin®) and olaparib (Lynparza®) to treat patients with BRCA-related ovarian cancer.
Bevacizumab works by stopping the blood supply to the cancer by preventing new blood vessels developing. These drugs are called ‘angiogenesis inhibitors’. Olaparib is a ‘PARP-1 inhibitor’. PARP is a protein in our body that helps damaged cells to mend themselves. Olaparib stops PARP working. Cancer cells with altered BRCA genes depend on PARP to keep their DNA functioning. Taking olaparib stops PARP from mending the DNA cell damage, which means cancer cells don’t survive.
Several new experimental treatments are being investigated to treat women with ovarian cancer, including immunotherapy.
We are excited to announce some recent advancements in the treatment of ovarian cancer. Olaparib also called by its brand name Lynparza, is a type of biological therapy drug called a PARP-1 inhibitor. It is a treatment for ovarian cancer in women who have a change in a gene called BRCA (1 or 2).
The use of Olaparib has been well established in recurrent disease, but not as maintenance therapy in newly diagnosed women. The recent SOLO-1 trial was the first trial of Olaparib maintenance therapy after platinum-based (carboplatin/cisplatin) chemotherapy in newly diagnosed advanced ovarian cancer (stage 3 and 4 disease) with a BRCA mutation. It showed that two year maintenance therapy with Olaparib led to a substantial, unprecedented improvement in progression-free survival (PFS), with a 70% lower risk of disease progression or death with Olaparib than with placebo. Maintenance therapy with Olaparib extends progression free survival by estimated 3 years in advanced ovarian cancer.
A Global Compassionate Access Program for the drug Olaparib has recently commenced.
To be eligible to receive the drug on the compassionate access program a woman must have:
- Newly diagnosed, Stage three or four high-grade serous or endometrioid ovarian, primary peritoneal or fallopian tube cancer
- Germline or somatic BRCA mutation
- In clinical response or partial response after platinum-based chemotherapy
There are other eligibility criteria that also must be met so Ovarian Cancer Australia recommends that women speak to their treatment team regarding the program and their eligibility.
Radiotherapy is treatment with special x-rays aimed at the specific site of the cancer. The x-ray damages the DNA or genetic code in the cancer cells and this damage kills the cancer cells when they try to grow.
Radiotherapy is occasionally used as a treatment option for ovarian cancer. It can help remove any cancer cells left after surgery, to reduce the risk of the cancer coming back. It may also be used in advanced ovarian cancer to reduce the size of the cancer and help to relieve symptoms such as pain. If cancer comes back, it may occasionally be in an area that is suitable for radiotherapy – such as a lymph node.
There may be short-term or long-term side effects of radiotherapy. Your healthcare team will discuss these side effects with you.
The Cancer Council has an excellent booklet on radiotherapy (www.cancer.org.au or call 13 11 20 for a free copy).