Ovarian Cancer
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.
Her veins were difficult to find, making the chemotherapy injection difficult.
Her veins were difficult to find, making the chemotherapy injection difficult.
Intravenous yes. I think that's quite traumatic. In, you know, for some people I had a problem them finding a vein, always was a problem and I think that's a problem for a lot of people. And so you're almost relieved when they get the cannula in and start getting the chemotherapy in because you think 'thank goodness that bit's over'. Because, you know, physically at the time that's the worst bit, you don't actually feel the effects of the drugs going in you at that time and, obviously it's all flushed through with saline and they put lots of other bits and bobs in as well as the chemotherapy! So that's physically probably the worst thing is the having the drip put in.
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.
Describes how chemotherapy frightened her and how it brought out the good in people.
And the thing that I had to hang onto, because that would have been quite a destructive thought really, was that it is attacking the bad bits. It's attacking the bad bits. The good bits have got a chance to get good again.
But the nurses on the wards were superb. They were so kind and I mean there were people on the wards hanging on to life, virtually hanging on there. But it wasn't a depressing ward, it wasn't a ward where you' There was a lightness about the ward, people were very kind towards each other. Even though it was kind of' I don't know, that's, they're the kind of sad things that make me look back and, it was almost bringing out the good in people.
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.
Describes how she passed the time during chemotherapy treatments.
It was comfortable but yes, people didn't really talk. Most of them had people with them and they didn't really chat. I got chatting to one man that was in there a couple of times, but I used to just doze off in the chair and read a book and do some crosswords and things like that, and just sort of sit there and think, 'hhmmm, boring'.
Spent hours travelling to the hospital for chemotherapy while feeling ill.
Spent hours travelling to the hospital for chemotherapy while feeling ill.
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.
Her body's reaction to chemotherapy followed a pattern.
One can plan one's life around chemotherapy treatments because the body reacts similarly after each treatment.
One can plan one's life around chemotherapy treatments because the body reacts similarly after each treatment.
I mean that's the good thing, if you like, about cancer and the treatment of chemotherapy is that everything has a time limit. You know exactly when you're having your treatment, you know you might feel poorly for three or four days afterwards but you know after that you'll feel fine, so you can plan your life to work round it. The same as avoiding busy places when your blood count is low, you know, don't go shopping on a Saturday afternoon, but you can go at a quieter time.
The more chemotherapy she had the more ill she felt.
The more chemotherapy she had the more ill she felt.
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.
She could work on days when she felt well between chemotherapy treatments.
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 chemotherapy treatment.
Explains her anxiety when waiting for results of blood tests before being allowed the next chemotherapy treatment.
I'd say the hardest bit of the chemotherapy was the waiting with each session because at this particular hospital, I don't know if it was the same at all hospitals, but you had to turn up and you had to be declared fit by the doctor before they would prepare the chemotherapy. So the wait was a bit unnerving, you know, you'd think 'well I'll steel myself, this is something I've got to go through' but that hour's wait before the chemotherapy drugs came over was often, you know, just a bit unnerving. The urge to run off was great I have to say. But they were great in the chemotherapy suite so it wasn't too bad.
A chemotherapy treatment was postponed because blood tests showed she had not recovered enough to cope with it.
A chemotherapy treatment was postponed because blood tests showed she had not recovered enough to cope with it.
In the meantime I was due to go back in every 3 weeks to have chemotherapy. When my first 3 weeks came up I had my bloods tested at the local surgery on the Monday ready to go to hospital on the Wednesday. But the first session I wasn't allowed to go because the platelets in my blood hadn't risen high enough. So I was quite disappointed in this because I thought I was a failure, couldn't have my treatment, really wanted just to get through the 7, or the 6 treatments. However the next week my blood was up so they took me in the following week.
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.
Had five courses of four different chemotherapy drugs because her cancer kept returning.
This is my fifth, yes.
And different drugs every time or have you alternated?
I had carboplatin, cisplatin, Taxol, and then last time I had Caelyx and I'm having that again this time. When I had it I understood again from the oncologist that you couldn't have more than a maximum of X number of mls of this drug, but whether again this is research that's changed things in a short time, because things do don't they. It's wonderful really how things improve. He's quite confident now that I will be able to have another six, obviously we'll monitor it as we go along, but another six doses of Caelyx.
And I didn't lose my hair with Caelyx, and I was treated at home on that occasion which was, I didn't know you could have chemotherapy at home, well that was quite interesting, and I think that was the drug that's caused me personally the fewest number of unpleasant side effects. Although I understand its, it has an effect on your heart and not everybody can take it because the risk to the heart is greater than the benefits, you know, to the cancer.
Last reviewed June 2016.
Last updated June 2016.
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