How is stage 3 ovarian cancer treated?
In stage III of ovarian cancer, the disease is usually spread to the peritoneal cavity with deposits over the surface of other intra-abdominal organs. The patient may experience gross ascites (abdominal fluid). In this stage, the most effective way of treatment is the first chemotherapy then surgery. If the patient’s general condition is good, no ascites, limited peritoneal disease on CT scan, surgery followed by chemotherapy is also the option.
The treatment includes surgery with the procedures of staging and debulking. The surgeon identifies the stage of cancer first and debulks it, which provides for the removal of the uterus, fallopian tubes, ovaries and, the omentum, which is fatty tissue from the upper abdomen near the stomach and intestines. Surgery removes most of the tumor. If there are cancer cells on other organs like the liver or intestines, surgery removes that part of the organ. The goal of the surgery is to leave behind no visible tumor or no tumor bigger than 1cm as the smaller the remaining tumor, the better the outlook of the patient.
- where chemotherapy goes before surgery
Upfront surgery (Staging laparotomy and debulking)
- when the spread of disease is minimal and the patient’s general condition is good, it may be the right choice
After surgery, doctors allow patients to recover. Chemotherapy then starts, which goes on for about a year. Most of the chemo is through intravenous therapy. But there is also another option of intra-abdominal along with intravenous. Intra-abdominal (HIPEC or EPIC) is the usual option if surgery removes the whole tumor. It might not work if traces of cancer cells remain.
After surgery and chemo, oncologists perform a series of blood tests. The tests check for CA-125 and also to check if treatment is working. Doctors may also recommend a PET scan, a CT scan, or an MRI may help.
See more on treatment for ovarian cancer here.