Chemotherapy for ovarian cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is given after surgery if all the cancer could not be removed at the operation, or if the surgeon feels that cancer cells may have remained behind. If the tumour is likely to be difficult to remove, chemotherapy may be given before surgery to shrink the cancer and make the operation easier and more effective. Chemotherapy is the main treatment if the cancer has spread to the liver or beyond the abdomen.

Chemotherapy drugs are usually given by infusion into a vein (intravenously), which may take several hours. Women described it as feeling cold, but painless. This is usually followed by a rest period of a few weeks, which allows the body to recover from unwanted effects of the treatment. Together, the treatment and rest period is known as a cycle of chemotherapy. The number of cycles depends on the type of cancer and how well it responds to the drugs. Generally six cycles of chemotherapy are given, over 4-5 months. Chemotherapy is often given as an out-patient treatment but it sometimes means spending a few days in hospital. The drug most commonly used to treat ovarian cancer in the first instance is carboplatin, either alone or in combination with paclitaxel (Taxol) but there are other chemotherapies used.

Some women we talked to were anxious because they didn’t know what chemotherapy would involve. A few felt discouraged because other people being treated looked very ill. Women described the process of being given the treatment, including extra drugs to minimise unwanted effects. A few had veins that were difficult to inject because they had already been used many times.

She knew little about chemotherapy before she had it

Age at interview 48

Gender Female

Age at diagnosis 48

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Describes the process of being given chemotherapy and other drugs to minimise unwanted effects

Age at interview 53

Gender Female

Age at diagnosis 52

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Her veins were difficult to find, making the chemotherapy injection difficult.

Age at interview 44

Gender Female

Age at diagnosis 41

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A woman who had been very fearful about chemotherapy reflected that, unpleasant as it was, the experience helped her to see kindness in other people.

Describes how chemotherapy frightened her and how it brought out the good in people.

Age at interview 55

Gender Female

Age at diagnosis 50

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Many women found the surroundings in the chemotherapy unit pleasant and comfortable and the nurses very knowledgeable and supportive. Some women read books or took someone with them to help pass the time. Several said that steroids made them hungry and were surprised how much they wanted to eat while they were having their treatment. Chatting to other patients was not always possible if they already had company or didn’t feel like talking, or because they were treated in individual rooms. Travelling to and from the hospital for chemotherapy could be a problem for those living a long distance away, or who felt very ill.

Describes how she passed the time during chemotherapy treatments.

Age at interview 51

Gender Female

Age at diagnosis 48

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Spent hours travelling to the hospital for chemotherapy while feeling ill.

Age at interview 62

Gender Female

Age at diagnosis 61

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Most women found their body responded in a similar way each time they were treated. This meant they could plan to avoid doing things on the days when they expected to feel ill, and to do things when they expected to feel well. Some found that the more treatments they had the worse they felt. Keeping a diary sometimes helped women to feel more in control. (See also ‘Unwanted effects of chemotherapy’.)

Her body’s reaction to chemotherapy followed a pattern.

Age at interview 65

Gender Female

Age at diagnosis 62

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One can plan ones life around chemotherapy treatments because the body reacts similarly after…

Age at interview 41

Gender Female

Age at diagnosis 40

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The more chemotherapy she had the more ill she felt.

Age at interview 80

Gender Female

Age at diagnosis 79

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Some women could continue working on their good days between treatments, whilst others needed long periods of time off work. Women who worked with children had to stop work because they had been told to avoid coughs, colds and children.

She could work on days when she felt well between chemotherapy treatments.

Age at interview 55

Gender Female

Age at diagnosis 50

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Blood tests were done between treatments to check whether the body had recovered enough to cope with the next one, and waiting for these test results could be nerve-racking. Sometimes treatments were postponed for a few days to allow people longer to recover. This could be inconvenient as well as worrying for women who had worked out their treatment schedules and fitted other plans around them. A few had the dosage reduced or fewer courses of chemotherapy than planned because their bodies were not coping well. Occasionally treatment must be abruptly stopped because the patient has a serious reaction to the drugs.

Explains her anxiety when waiting for results of blood tests before being allowed the next…

Age at interview 41

Gender Female

Age at diagnosis 38

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A chemotherapy treatment was postponed because blood tests showed she had not recovered enough…

Age at interview 43

Gender Female

Age at diagnosis 41

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Women whose cancer returns after initial treatment also receive chemotherapy. In addition to carboplatin and paclitaxel, other drugs that can be tried include liposomal doxorubicin (Caelyx), topotecan, cisplatin and etoposide, some given intravenously, some orally. One woman had five courses of four different chemotherapy drugs for her cancer.

Had five courses of four different chemotherapy drugs because her cancer kept returning.

Age at interview 61

Gender Female

Age at diagnosis 54

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Surgery for ovarian cancer

Surgery may be the first treatment for ovarian cancer, and is sometimes needed to make the diagnosis, or may follow a course of chemotherapy (aimed...