Consumer Health: Treating ovarian cancer

September is Ovarian Cancer Awareness Month, which makes this a good time to learn about treating ovarian cancer.

Ovarian cancer ranks fifth in cancer deaths among women in the U.S., according to the American Cancer Society. More than 21,000 new cases will be diagnosed in the U.S. this year, and nearly 14,000 women will die of the disease.

Early stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that often are mistaken for more common benign conditions.

Signs and symptoms of ovarian cancer can include:

• Abdominal bloating or swelling.
• Quickly feeling full when eating.
• Weight loss.
• Discomfort in the pelvic area.
• Changes in bowel habits, such as constipation.
• A frequent need to urinate.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, it's more difficult to treat and frequently is fatal. Early stage ovarian cancer, where the disease is confined to the ovary, is more likely to be treated successfully.

If you've been diagnosed with ovarian cancer, your treatment will be based on the stage of your cancer. The stages of ovarian cancer are indicated using numerals ranging from 1 to 4, with the lowest stage indicating that the cancer is confined to the ovaries. By stage 4, the cancer has spread to distant areas of the body.

Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.

Surgeries to treat ovarian cancer include:

• Surgery to remove one ovary
  For early stage cancer that hasn't spread beyond one ovary, surgery may involve removing the affected ovary and its fallopian tube. This procedure may preserve your ability to have children.
• Surgery to remove both ovaries
  If cancer is present in both ovaries, but there are no signs of additional cancer, your surgeon may remove both ovaries and both fallopian tubes. This procedure leaves your uterus intact, so you may still be able to become pregnant using your own frozen embryos or eggs, or with eggs from a donor.
• Surgery to remove both ovaries and the uterus
  If your cancer is more extensive or if you don't wish to preserve your ability to have children, your surgeon will remove the ovaries, fallopian tubes, uterus, nearby lymph nodes and a fold of fatty abdominal tissue called the omentum.
• Surgery for advanced cancer
  If your cancer is advanced, your health care provider may recommend chemotherapy followed by surgery to remove as much of the cancer as possible.

Chemotherapy is a drug treatment that uses chemicals to kill fast-growing cells in the body, including cancer cells. Chemotherapy drugs can be injected into a vein or taken by mouth. Sometimes the drugs are injected directly into the abdomen, a procedure called intraperitoneal chemotherapy. Chemotherapy often is used after surgery to kill any remaining cancer cells. It also can be used before surgery.

Targeted therapy uses medications that target the specific vulnerabilities present within your cancer cells. Targeted therapy drugs usually are reserved for treating ovarian cancer that returns after initial treatment or cancers that resist other treatments. Your health care provider may test your cancer cells to determine which targeted therapy is most likely to affect your cancer.

Connect with others talking about living with ovarian cancer in the Gynecologic Cancers support group on Mayo Clinic Connect, an online patient community moderated by Mayo Clinic.