What type of chemotherapy or surgery has already been performed? In what location have the ovarian cancer cells reappeared?
In addition, it is often suggested that woman consider joining a clinical trial that is testing newer therapies to treat cancer.
Persistent ovarian cancer
If the ovarian cancer is considered persistent, further surgery to debulk more of the cancer may be attempted first. A decision will be made to either continue with the current chemotherapy the woman is taking, or a second-line chemotherapy will be used instead.(1)
Recurrent ovarian cancer
If the ovarian cancer is recurrent, then the length of time there was a remission is considered as well as what chemotherapy drug the woman originally had for first-line treatment.
Through the use of second-line chemotherapy, also called salvage chemotherapy, and/or use of drugs from a clinical trial may help prolong her life.
If the ovarian cancer returns in less than six months, the woman’s prognosis may be poor if she has already had the two of the most common treatments — taxane and platinum chemotherapy — and did not respond to them.(1)
If the ovarian cancer returns after six months of remission, the woman can have more surgery to debulk the tumor, receive radiation therapy and have platinum and taxane chemotherapy if she did not have them before. Texas Oncology states that they have a good chance of improving with the use of these drugs.
Otherwise there are a number of other second-line chemotherapy drugs that can be tried and found in studies to bring on a remission such as: Doxil®, Gemzar®, Hycamtin® or etoposide.(1)
In addition to the data gained from clinical trials, there has been progress using monoclonal antibodies, which bind to cancer cells and stimulate the immune system to attack and kill the cells.
High-dose chemotherapy, along with the use of stem cells that boost the body’s amount of red blood cells, can also be tried.
1) Recurrent Ovarian Cancer. Texasonlcology.com. Retrieved September 18, 2016.
2) Olivia W. Foley, BS et al. Recurrent Epithelial Ovarian Cancer: An Update on Treatment. Review Article | April 15, 2013 | Oncology Journal, Gynecologic Cancers, Ovarian Cancer.
3) Why has the cancer come back? Target Ovarian Cancer.org.uk. Retrieved September 18, 2016.