Chemotherapy for ovarian cancer

Chemotherapy uses anti cancer drugs to destroy cancer. The drugs circulate throughout the body in the bloodstream.

You might have chemotherapy after surgery, or both before and after. Doctors often use the drugs carboplatin and paclitaxel for ovarian cancer.

When do you have chemotherapy?

You might have chemotherapy on its own or combined with surgery. You might have it:

  • after surgery 
  • both before and after surgery 
  • on its own, without surgery

Who has chemotherapy?

Your treatment depends on several factors, including how far your cancer has spread (the stage) and what it looks like under the microscope (the grade).

You might have chemotherapy if your cancer is:

  • stage 1c or above
  • at an earlier stage (1a or 1b), but is high grade
  • has come back after you were first treated (recurrence)

How often do you have it?

You usually have chemotherapy once every 3 weeks. You usually have the chemotherapy drugs on day 1 followed by a rest period to allow you to recover from side effects.

Each 3 week period is called a cycle of treatment. You normally have about 6 cycles in all, but you may have more. 

It takes 3 to 4 hours to have each treatment in the outpatients department. On rare occasions you might have it over 24 hours, when you would stay in hospital overnight.

Types of chemotherapy

Doctors most commonly use the chemotherapy drug carboplatin to treat ovarian cancer. You might have it on its own or with another chemotherapy drug called paclitaxel (Taxol).

Your doctor might use other types of chemotherapy drugs if your cancer has come back.

How you have chemotherapy

Into your bloodstream

You might have chemotherapy into a vein (intravenously) through a drip into your arm. A nurse puts a small tube into one of your veins and connects the drip to it.

Or you may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through. It’s worked out based on your weight, height and general health.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • increased risk of getting an infection
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

When you go home

Chemotherapy for ovarian cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

If you have any questions about chemotherapy, you can talk to Cancer Research UK's information nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Monitoring treatment

Your doctor can find out how well your chemotherapy has worked using: 

  • CA125 blood tests
  • scans 

CA125 blood test

CA125 is a protein made by some ovarian cancer cells that circulates in the bloodstream. Doctors usually measure it before you start treatment. If you had high levels, your doctor will expect the level to fall as the chemotherapy destroys the cancer cells.

You might have CA125 blood tests before each chemotherapy treatment to see how well the treatment is working. Or you'll have the test once your whole course of chemotherapy has finished.

Not all women with ovarian cancer have raised CA125 levels. If you did not have raised CA125 when you were first diagnosed, your doctor can't use this blood test to monitor your treatment.

Scans

Doctors can also use scans, such as a CT scan, to see how well treatment has worked. You might have a scan after 3 or 6 cycles of chemotherapy.

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    JA Ledermann and others
    Annals of Oncology, 2013. Volume 24, Supplement 6.

  • Ovarian cancer: recognition and initial management
    National Institute of Health and Care Excellence (NICE), 2011

  • Management of epithelial ovarian cancer
    Scottish Intercollegiate Guidelines Network (SIGN), 2013

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    Blackwell, 2015

  • British gynaecological cancer Society (BGCS) Epithelial Ovarian / Fallopian Tube / Primary Peritoneal Cancer Guidelines: Recommendations for Practice
    C Fotopoulou and others
    European Journal of Obstetrics and Gynecology and Reproductive Biology, April 2017.  Vol. 213, p123–139

  • Cancer of the ovary, fallopian tube and peritoneum
    J Berek and others
    International Journal of Gynaecological Obstetrics 2018: Issue 143 Supplement 2 pages 59 - 78

Last reviewed: 
18 Jan 2022
Next review due: 
18 Jan 2025

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