Ovarian Cancer

Ovarian cancer - treatment complications

For most people with ovarian cancer treatment goes according to plan, but for a minority something goes wrong, causing additional health problems. Such treatment complications are rare and the problems they cause may last longer than the more common  side effects of treatment, which are usually reversible. Women with complications often feel that they keep getting set back on their road to recovery, which can be upsetting and frustrating. 

After any abdominal surgery adhesions can form. These are growths of fibrous tissue, like scars, that stick tissue and organs together. Adhesions sometimes cause problems and one woman we interviewed developed acute pain and had to have an operation to remove adhesions that were blocking her bowel. Another woman had chronic diarrhoea after surgery because a valve had been removed which normally prevented bile salts from entering the bowel. Once recognised this was quickly controlled with medicine. 

She eventually needed an operation to remove adhesions that were blocking her bowel.

She eventually needed an operation to remove adhesions that were blocking her bowel.

Age at interview: 49
Sex: Female
Age at diagnosis: 48
SHOW TEXT VERSION
PRINT TRANSCRIPT
On the second of those combined cycles, my brother was here, and he took me in for the chemotherapy, and on the way in I started to get a stomach ache and when I was waiting to see the doctor I was really in a lot of pain and doubled up in pain. And a nurse came and took me to a bed in the chemo suite and got the doctor. And by which time I was really kind of writhing around in agony, I was in a lot of pain. And they gave me some morphine that didn't really help. 

But eventually after an x-ray they discovered that I had got a blockage in my bowel, some adhesions, forced by adhesions which if you ever have an operation in that part of your body you always have these adhesions hanging down and at any point they can loop round the bowel or they can cause problems with blockages. And I have had that before in my life. And it's very, very, very, very painful. 

So I had to be admitted to hospital and I had a bowel surgeon come to see me now and he decided that the best thing to do would be to wait for a few days and see if the blockage resolved itself. It wasn't life threatening at that point.  

But then eventually what he did, he decided to operate, and so I had my second operation within about 2 months, which was not very good at all.

Diarrhoea was caused by bile salts entering the bowel after a valve was removed from her bowel.

Diarrhoea was caused by bile salts entering the bowel after a valve was removed from her bowel.

Age at interview: 61
Sex: Female
Age at diagnosis: 54
SHOW TEXT VERSION
PRINT TRANSCRIPT
I had the usual feelings of nausea and loss of appetite and of course I was struggling with my bowel at the same time, which made it extremely difficult because I had permanent diarrhoea for about eleven weeks until my oncologist actually suddenly understood what had happened, and that some valve had been removed when they'd removed part of the bowel, which coped with bile salts from the liver. And the valve had been removed and so nothing was doing its job, and so the bile salts were reaching a part of the bowel that they shouldn't reach and causing huge inflammation, and as soon as he had researched that and discovered and gave me some medication for that, which I still take, it was solved like at a stroke, in a day.  

Sometimes extensive abdominal surgery leads to the development of a hernia, the protrusion of part of the intestines through an abnormal opening in the abdominal wall. A few women needed further operations to put this right. After her hysterectomy one woman had a deep vein thrombosis (DVT), which was successfully treated with medication. Another was found to be allergic to the morphine she received for post-operative pain.

Developed a hernia after her hysterectomy and needed another operation to put it right.

Developed a hernia after her hysterectomy and needed another operation to put it right.

Age at interview: 41
Sex: Female
Age at diagnosis: 38
SHOW TEXT VERSION
PRINT TRANSCRIPT
Now unfortunately with that operation I did end up with a massive hernia which wasn't diagnosed till a bit later, till I think in the January. And I remember coming out of hospital and thinking 'gosh I really am numb, I can't feel part of my abdomen, and as it turned out the reason why because it was intestine, you know, I couldn't get any, I can't think of the word, anyway at all, sensation there.  

So I then had to go on and have another operation a year later. But by that time so much of the intestine had spilled out behind the muscle wall, that it ended up quite complicated. And I mean I just looked so perverse, I really did, it was, you know, it was as though I could never leave the cancer behind, because I ended up with this comedy body as we used to call it, and still do a certain degree.  

So last Easter, not the Easter just gone, in 2002, I had what was hopefully the last operation to repair the muscles. But unfortunately because so much had spilt out it ended up quite complicated and I now have meshes in my abdomen.

Developed a deep vein thrombosis (DVT) after her hysterectomy.

Developed a deep vein thrombosis (DVT) after her hysterectomy.

Age at interview: 52
Sex: Female
Age at diagnosis: 50
SHOW TEXT VERSION
PRINT TRANSCRIPT
What it was, I came out of hospital, I think, on a Tuesday, because I had the operation on the previous Tuesday. My husband brought me home about two o'clock. I still had the silly white knee-length sock things on, and he was doing some dinner, and about to dish it up, and he put washing on, so I said to him, 'Oh, you'd better put these in the wash', because I'd been wearing them non-stop - putting them back on again, or having them put back on for me - so, 'About time these had a wash'. So he put them in the washing machine.

I finished my dinner, and I thought, 'My leg feels a bit funny'. It was my left leg. And it felt a bit sort of stiff in the calf area. And I just, as he was out in the kitchenette, just looked down, and it was swollen, like that, it was like I'd ' my leg had a football half way up in the calf, and the ankle was quite swollen as well. And I felt it, and it was very stiff, like there was a football there, as opposed to sort of squidgy. And so I panicked because I knew the symptoms, you know, or I'd been told to look out for DVTs and that, not thinking, for one minute, that I would get one, because I'd had the silly socks and the injections and so on.

But, I went out and showed him, and he said, 'No, that don't look right, does it'. So' it wasn't painful, it wasn't red and hot, but we went to the GP, who looked at it and felt it, and said, 'Yes, it definitely is'. He sent me to the local hospital, which only does minor injuries, so they gave me another bee sting injection, with the dosage that the hospital had been giving to me.  

The next day I had to go to the hospital and have a scan, an ultrasound scan again, and they found' she went straight to it actually, she used the scan on my left groin, and that's where the clot was, it had gone from my calf to my groin, so then they put me on the Warfarin, and I was on that for about eight months all told.  

Had an allergic reaction to the morphine she was given for post-operative pain.

Had an allergic reaction to the morphine she was given for post-operative pain.

Age at interview: 65
Sex: Female
Age at diagnosis: 59
SHOW TEXT VERSION
PRINT TRANSCRIPT
So, following morning I went down to theatre. Don't know much of what went on down there and when I came back it was quite a while before I came to. Very painful, I was on morphine and I had an absolutely disastrous night. I learned afterwards that I was allergic to morphine. Morphine, if you are not aware and nobody explained, that it stops you from breathing. It doesn't actually stop you from breathing but the sensation is that you can't breathe, and so I lay awake most of the night thinking 'I am going to die if I don't breathe'. And it wasn't until the following morning that I was told that it was due to the morphine. So after that they gave me a different type of painkiller.  

A few women had problems having needles put in their veins to take blood or to administer their chemotherapy. One had such sore arm veins from repeated use that blood was taken from her feet, which was painful; another was left with bad bruises on her hands after inexperienced doctors had tried to find a vein. One woman had a tooth damaged while a tube was put down her throat during anaesthesia.

Was left with bad bruising on her hands from having cannulae put in her veins for chemotherapy.

Was left with bad bruising on her hands from having cannulae put in her veins for chemotherapy.

Age at interview: 80
Sex: Female
Age at diagnosis: 79
SHOW TEXT VERSION
PRINT TRANSCRIPT
Perhaps one thing, I forget the name of, when you're getting your chemo you get this, I forget the name of the thing, put into your vein. But this is the one and only thing I would say to the well-trained doctors, make sure that the young doctors who are putting that into the vein, they should have far, far more experience, because my hands were in a dreadful mess. Now, I had, out of my 4 treatments, I had one excellent doctor who made a perfect job, and the other 4, 2 in particular they just butchered me. And I was going about with hands, I mean okay, from a cosmetic point of view I wasn't worried, but if you had seen my hands after the mess those 2 doctors made of my hands, you'd have thought I'd had 10 rounds with Mohammed Ali without my gloves on. They were, they were butchers. Now that's the one and only thing I would say, make sure that those young doctors that's doing that job can do it properly because that is a nasty experience.  

Patients are more susceptible to infections after chemotherapy because the immune system is weakened (see 'Chemotherapy'). Although low blood counts are common during chemotherapy, infections are rare. However, one woman developed a chest infection and another had her treatment stopped after four sessions because her immune system was too badly damaged. She then developed meningitis, an infection of the brain and spinal cord.

She developed meningitis after chemotherapy damaged her immune system.

She developed meningitis after chemotherapy damaged her immune system.

Age at interview: 47
Sex: Female
Age at diagnosis: 35
SHOW TEXT VERSION
PRINT TRANSCRIPT
Yes, I was told that it was advisable for me to stop at that point, particularly in view of the fact that it was a very early stage ovarian cancer.  

So for my, for my particular case it was felt that the risks were now becoming too great.

So it wasn't that you had a bad reaction to it or anything like that?

Not physically but internally obviously it was depleting my immune system and it wasn't swinging back. With the chemotherapy the cells drop off and then they start to recover and that's why they give you monthly treatments and they give you time for the immune system to recover. But it probably doesn't recover to the same level. It is expected to drop down, but with mine it dropped down and didn't recover and dropped down even further and didn't recover, and carried on to the point where it was becoming dangerous or certainly not advisable as a treatment for a stage 1 cancer.  

And then I got meningitis, but that's another story and that was because my immune system was depleted from the chemotherapy treatment.  

Some people have an extreme reaction to chemotherapy. Some women we talked to were so sick after their treatment that they needed to be admitted to hospital. One of these women explained how she discovered that it was how she was taking her morphine that caused the problem rather than the chemotherapy itself. One woman had abdominal pains after her chemotherapy and another had an allergic reaction to the anti-sickness medication. Very rarely the chemotherapy drugs themselves may cause anaphylactic (allergic) shock.

Was very sick after chemotherapy and needed to be hospitalised.

Was very sick after chemotherapy and needed to be hospitalised.

Age at interview: 66
Sex: Female
Age at diagnosis: 56
SHOW TEXT VERSION
PRINT TRANSCRIPT
And I went on to have one course of carboplatin. It was okay, I did alright, I was well when I went into it but I had a late reaction, and having had the treatment on Tuesday. On the Saturday I became so ill that I was passing out when I was being sick. I managed to phone a friend on my mobile and she said "Don't you worry I'll be there in twenty minutes," I couldn't get out of bed because I was passing out when I was sort of sick. 

And I have a neighbour who has become a very good friend and support who's a doctor, and she said "I'm going across to get him." Brought him, he gave me an injection and said "If this doesn't work in forty-five minutes come back and get me," and he said to me " I'm putting you, I'm phoning, I'm putting you back in the ward, I'm phoning for the ambulance, I'm telling them you're on your way, I hope you don't mind." So I said "Please feel free." So I went. And they were worried, he said "I'm glad they're going to see what happens when patients come back from the day hospital sometimes," as a GP no doubt he's seen some of, you know, these things happen. But then they can put more patients through and for most people it works very well. 

Was very sick after chemotherapy but found out that it was caused by the way she was taking her morphine.

Was very sick after chemotherapy but found out that it was caused by the way she was taking her morphine.

Age at interview: 61
Sex: Female
Age at diagnosis: 54
SHOW TEXT VERSION
PRINT TRANSCRIPT

So we had quite a horrible time at the beginning of the first treatment because I was on morphine and it was difficult to get the dose right and also I don't know whether I hadn't explained it, I don't really know, but I didn't feel that anybody had twigged that the morphine might be making me sick. Because I was very sick after the first chemo and my husband went back to the hospital three times for more anti-nausea tablets, and in the end the Sister said 'your wife really shouldn't be, she shouldn't really be still feeling this from the chemicals'. But nobody had said, put two and two together and decided that it was probably the morphine. 

So I thought we'd better see a pharmacist at the hospital, who really spotted the problem right away and explained that I had been taking these morphine tablets when I felt I needed them, which is not the way to do it at all apparently. You have to take them, if it says 'every four hours' every four hours, otherwise you keep feeling sick, because the effects wear off. Then you have another one to kill the pain and it causes you to feel sick. So I really was doing it myself. But everybody worked together so that when I had the second session of chemo it was all sorted, and it is.
 

Had an allergic reaction to the chemotherapy on her sixth treatment.

Had an allergic reaction to the chemotherapy on her sixth treatment.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
SHOW TEXT VERSION
PRINT TRANSCRIPT
So the treatment went on for five times with no problem at all. On the sixth time, they'd put the stuff through my system to clean it out, and they'd just started to give me the chemotherapy treatment, carboplatin I think it was, and the nurse was telling me... I'd said to her, sort of just conversationally, 'Do you have any people who have a real problem about having the treatment when you insert the drip and things?' and she said, she was telling me about somebody who'd had a problem with their heart. I think she said a heart attack, I can't remember. 

And as she started' As the carboplatin started to go into my body, I started to think, 'Oh, I can't breathe properly'. And I was literally pushing myself out to try and breathe. And she looked at me and suddenly moved very quickly, and I'd had some kind of anabolic reaction, some kind of reaction to the treatment. And so I had to have something pumped into me to counteract that treatment. And she said, 'I can't give you any more'. So on my sixth treatment, I didn't have a sixth treatment because, whether my body was actually rejecting the treatment, which is what the oncologist said had happened. 

Chemotherapy can affect kidney function, which is usually monitored before and during treatment. After her cancer had failed to respond to conventional chemotherapy, one woman had it treated (outside the UK) with peritoneal chemotherapy, where the drugs are injected directly into the abdomen. Because of an error in the way the treatment was administered her kidneys failed. She was later tried on a dose of intravenous chemotherapy but her immune system went into shock and she ended up spending two weeks in a coma in intensive care.

Had chemotherapy injected into her abdomen and her kidneys failed due to an error in the administration of the drugs.

Had chemotherapy injected into her abdomen and her kidneys failed due to an error in the administration of the drugs.

Age at interview: 46
Sex: Female
Age at diagnosis: 39
SHOW TEXT VERSION
PRINT TRANSCRIPT

I started my chemotherapy about a week after the surgery. I didn't come out of hospital, I stayed in until I was ready for my first chemo, which was Taxol and cisplatin. And I had 6 treatments of Taxol and cisplatin and it didn't clear it. I still had, my CA 125 was still a couple of hundred, so the oncologist wanted me to have peritoneal chemotherapy. So I had surgery to put a port into my abdomen and when they did that surgery they had a second look and said there was new growth there. So I had a wash of cisplatin, just cisplatin on its own into my abdominal cavity. Now, that did do the trick.  

I went into remission. Unfortunately it also killed off my kidneys completely so ever since then, that was in April '97 I've had end stage renal failure which has required haemodialysis 3 times a week.  
 

Was tried on chemotherapy after her kidneys failed but ended up in intensive care as a result.

Was tried on chemotherapy after her kidneys failed but ended up in intensive care as a result.

Age at interview: 46
Sex: Female
Age at diagnosis: 39
SHOW TEXT VERSION
PRINT TRANSCRIPT
Now unfortunately, nobody has ever tried, that we are aware of, has tried to have Taxol and one of the platinum drugs with end stage renal failure so we were stabbing in the dark. We didn't really know, it was a difficult balance getting enough in so that it would attack the tumours but also not so much that I couldn't get it dialysed out. There was also the problem of the time period because I have 2 days between dialyses; when was the right time to give it? So they did warn me that I was a guinea-pig and that they didn't really know what would happen but I had one treatment and it was catastrophic. Within a couple of days I was in the local hospital, my white blood count disappeared, my platelets disappeared, I ended up with pneumonia and septicaemia and I was rushed to intensive care and I was 2 weeks on life support in intensive care with my life hanging in the balance.  


 

Last reviewed June 2016
Last updated June 2016

 

Copyright © 2024 University of Oxford. All rights reserved.