Chemotherapy

Chemotherapy means using a combination of drugs to kill cancer cells. Before surgery, it is used to reduce the size of the tumour so that it will be easier to remove. After surgery, it is used to destroy any remaining cancer cells. The most common drugs used to treat ovarian cancer are Paraplatin and Taxol; however, others are available if this initial combination does not prove successful.

How Chemotherapy Is Given

Chemotherapy is usually used systemically, which means that the drugs are taken intravenously, and circulate through your system. Recent evidence suggests improved survival in patients who receive IP (intraperitoneal) chemotherapy. This requires the use of a portocath, which is a small device that is placed under the skin of the abdominal wall, and is either inserted during your initial surgery or afterwards in the radiology department.

The chemotherapy drugs used to treat ovarian cancer are often given in cycles, once every three to four weeks. The treatment is usually repeated six times. In most cases, you can receive these drugs as a day patient or through home care treatments. When administered intravenously, the total treatment may take up to five hours.

More recently, the standard intravenous therapy has been used in combination with chemotherapy injected directly into the abdominal cavity, using a catheter placed during the initial surgery. The chemotherapy drugs target the cancer cells attached to the lining of your abdomen. This combination has been shown to improve the survival rate of women with advanced ovarian cancer.

Side Effects

Chemotherapy drugs are most destructive to rapidly growing cells like cancer cells; however, they cause side effects because they are toxic to all of the body's cells. But it is important to remember that not everyone experiences severe side effects from chemotherapy. The side effects will vary depending on the specific drugs being used, the dosage, and the length of time you are on the medication. Side effects may include:

• nausea and vomiting
• loss of appetite
• anemia (low iron)
• diarrhea or constipation
• fatigue
• headaches
• hair loss
• peripheral neuropathy (nerve damage that causes pain or numbness in the hands or feet)
• darkening of the skin and fingernails
• hearing loss

You are not likely to experience all of these symptoms. Talk to your caregivers about what you are experiencing. In most cases, they can give you medications to relieve your symptoms, if, for example, you are feeling nauseous. They can also tell you more about how long your symptoms are likely to last and how other women have coped. Women using chemotherapy may need to drink extra fluids to prevent kidney damage.

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