Ovarian cancer in younger patients
If you are diagnosed with ovarian cancer and would still like to have children, our doctors will discuss your best options to preserve your fertility. If the cancer is at an early stage (stage I or II), one ovary (unilateral oophorectomy) and one fallopian
tube (unilateral salpingectomy) may be removed (when possible) to preserve reproductive functions. In later stages where the cancer has spread, broader surgery may be necessary. At any stage, we suggest discussing your fertility options and concerns
with the dedicated
fertility and reproductive specialists at DF/BWCC. For example, you may consider egg harvesting or embryo (egg)
freezing until treatment concludes.
Surgery takes place in the operating suites at Brigham and Women's Hospital, whose gynecology program is widely recognized as one of the best in the country. Post-surgical care and other inpatient care are provided by the DF/BWCC team either at Brigham
and Women's Hospital or at Dana-Farber's Inpatient Hospital located within Brigham and Women's Hospital.
Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and
fallopian tube are removed; or (b) the uterus plus both (bilateral) ovaries and fallopian tubes are removed. In a radical hysterectomy, the uterus, cervix, both ovaries, both fallopian tubes, and nearby tissue are removed. These procedures are
done using a low transverse incision or a vertical incision.
After surgery, your surgical samples are carefully examined by pathology experts in the Women's and Perinatal Pathology Division. Their evaluation will be shared with all members of the gynecologic oncology program, including your treatment team, in a
weekly tumor board meeting where further treatment (if necessary) and management of your tumor will be decided.
post-operative guidelines for gynecologic surgery.
Learn about strategies and tips for
recovering from your hysterectomy.
Medical oncologists at DF/BWCC offer the most effective therapies possible, while helping you maintain your quality of life during treatment. Chemotherapy (drugs that eliminate cancer cells or stop them from dividing) is provided at Dana-Farber's Yawkey Center for Cancer Care, one of the most advanced outpatient cancer centers in the country — designed by patients, for patients.
Chemotherapy for ovarian cancer may be administered at any stage, but it is usually given at the later stages of the disease. In general, chemotherapy drugs are administered after surgery to eliminate remaining cancer cells, or to keep them from returning.
However, there are times when chemotherapy will be given before surgery to make the tumor easier to remove.
Throughout your treatment, your medical oncologist will work closely with your team of nurses, nutritionists, and social workers to minimize the toxicities and side effects of chemotherapy, maintain your quality of life, and optimize your results. We
encourage you to be actively involved in the decision-making process when it comes to choices about chemotherapy treatment.
Intraperitoneal (IP) chemotherapy
Dana-Farber/Brigham and Women’s Cancer Center offers an advanced treatment for ovarian cancer that has already spread within the abdominal cavity. While the combination of intravenous chemotherapy and surgery is the best treatment approach for many patients,
studies have suggested that certain patients may benefit from receiving intraperitoneal (IP) chemotherapy after their initial surgery. IP chemotherapy delivers chemotherapy directly to cancer cells in the abdomen, so it is well-suited to the treatment
of ovarian cancer.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
In addition to traditional IP chemotherapy, DF/BWCC offers hyperthermic intraperitoneal chemotherapy (HIPEC). In contrast to standard IP chemotherapy that is given after surgery, HIPEC involves a single use of heated chemotherapy in the abdomen, which
is given at the time of surgery. Heating the chemotherapy improves absorption and directly destroys cancer cells. At the completion of the surgery, the chemotherapy is removed from the abdomen. Recent studies have shown that adding HIPEC to select
patients’ treatment improves survival significantly and doesn’t increase side effects or complications. HIPEC is for select patients with advanced stage ovarian cancer and we encourage patients to discuss treatment options with their cancer team.
Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to eliminate cancer cells or stop cancer growth. Radiation therapy for ovarian cancer is given by our experienced team of radiation oncologists. They are
pioneers in the field, regularly setting standards nationwide for treatment and safety.
Radiation therapy is used to treat select cases of ovarian cancer. While most ovarian cancer patients are not treated with radiation therapy, it may be used for patients with certain types of ovarian cancer, those who have isolated and/or minimal recurrence,
or to control symptoms such as pain. In rare or recurrent cases, these radiation treatments may be performed:
- 3D imaging radiation therapy called intensity-modulated radiation therapy (IMRT). IMRT uses computer images to find and target the cancerous tumor. Radiation is externally delivered and aimed at the tumor, firing thin radiation beams from different
angles. This reduces the damage to the surrounding healthy tissue.
interstitial brachytherapy, radioactive material is directly implanted in or near the tumor via a tiny needle, wire, or other device. Our radiation oncologists at DF/BWCC are
among a limited few in the nation to deliver this type of radiation with image-guided techniques. Occasionally, cylinder brachytherapy, a type of radiation therapy delivered to the vagina, will be performed on patients after surgery.
Revolutionary imaging therapies
For rare cases of ovarian cancer that require complex imaging treatment, you will be cared for in an innovative operating and research environment developed at Brigham and Women's Hospital (BWH) in 2011. Called the
Advanced Multimodality Image Guided Operating (AMIGO) Suite, our team of surgeons, interventional radiologists, imaging physicists, computer scientists,
biomedical engineers, nurses, and technologists use the latest imaging tools to develop and deliver the safest, state-of-the-art therapies. The AMIGO suite is unique, as it combines PET/CT, MRI, and OR technologies in one operating room. BWH is
one of the few hospitals in the United States to operate an AMIGO suite.
Clinical trials for ovarian cancer
DF/BWCC offers one of the largest and most active clinical trial programs available, including clinical trials for patients with ovarian cancer. The clinical
trials conducted at DF/BWCC have had a meaningful impact on the type of care administered worldwide.
Clinical trials are available for nearly every stage of ovarian cancer. For women with advanced or recurrent cases of ovarian cancer, taking part in a clinical trial may be the best treatment option. If you qualify for a clinical trial, your doctor will
carefully discuss all options and the best time to begin a trial.
Clinical trials are part of the cancer research process; they are regulated research studies to determine if new cancer treatments are effective, or better than a current plan. Not only can trials have meaningful anti-cancer benefits, but they can lead
to new discoveries and improve cancer care.
Clinical trials may include biologic therapies, or treatments that use the patient's immune system to fight the cancer. Trials can also include targeted therapies that attack specific vulnerabilities in cancer cells.
Find out more about
clinical trials at DF/BWCC. Detailed information about clinical trials is available from the
NCI website. For nationally run clinical trials, please visit
Read about research findings on how PARP inhibitor drugs are used to treat some ovarian cancers and how fast-growing organoid models of ovarian cancer could aid rapid drug treatment selection.
Questions to ask your doctor about clinical trials
If your doctor suggests a clinical trial as part of your cancer treatment, you may have questions before you get started. Review some
commonly asked questions about clinical trials and discuss them with your doctor.