Treatment of Stage II Ovarian Cancer
Patients diagnosed with stage II ovarian cancer have cancer that is limited to the ovaries and other pelvic organs, but has not spread to the upper abdomen, lymph nodes, or sites outside the abdomen.
The following is a general overview of the treatment of stage II ovarian cancer. Circumstances unique to your situation and prognostic factors of your cancer may ultimately influence how these general treatment principles are applied. The information on this website is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.
Most new treatments are developed in clinical trials. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients.
Participation in a clinical trial may offer access to better treatments and advance the existing knowledge about treatment of this cancer. Clinical trials are available for most stages of cancer. If you are interested in participating in a clinical trial, you should discuss the risks and benefits of clinical trials with your physician. To ensure that you are receiving the optimal treatment of your cancer, it is important to stay informed and follow the cancer news to learn about new treatments and the results of clinical trials.
Current Treatment
The standard treatment for stage II ovarian cancer consists of both surgery and chemotherapy. Patients with stage II ovarian cancer may experience a range of outcomes following standard treatment. Patients with stage IIA disease experience cancer recurrence rates of 30 percent to 40 percent. However, 60 percent to 80 percent of patients with more advanced stage IIB disease may develop cancer recurrence. This is because patients with stage II ovarian cancer are often left with microscopic disease and currently available chemotherapy is unable to eradicate all of the remaining cancer.
Surgical Debulking
During debulking surgery, physicians attempt to remove as much of the ovarian cancer as possible. Debulking is believed to be beneficial because it reduces the number of cancer cells that ultimately need to be destroyed by chemotherapy and therefore decreases the likelihood of the cancer developing a resistance to chemotherapy.
Following surgical debulking, all patients with stage II ovarian cancer are offered additional treatment. This is because many patients with stage II disease have small amounts of cancer that have spread outside the ovary and were not removed by surgery. An effective treatment is needed to eliminate the remaining cancer to improve the survival time of women in this situation. Currently, this treatment is chemotherapy.
Chemotherapy for Stage II Ovarian Cancer
It is important to understand that many patients with ovarian cancer already have small amounts of cancer that were not removed with surgery or have spread away from the ovaries. These cancer cells cannot be detected with any of the currently available tests and are referred to as micrometastases. The presence of micrometastases causes cancer recurrence following treatment with surgery alone.
An effective treatment is needed to cleanse the body of micrometastases to improve a patient's duration of survival and potential for cure. Regardless of the timing or the necessity of performing interval debulking surgery, combination chemotherapy using one or more anticancer drugs is considered "standard" treatment for patients with stage II ovarian cancer.
Clinical trials have demonstrated that for patients with advanced stage ovarian cancer, treatment with combination chemotherapy regimens containing a platinum compound Platinol® (cisplatin) or (Paraplatin®) carboplatin prolongs the duration of survival and prevents more recurrences of cancer compared to treatment with surgery and nonplatinum compounds. Current first-line chemotherapy typically consists of a taxane (Taxol® [paclitaxel] or Taxotere® [docetaxel]) and a platinum compound administered every 3 weeks for six cycles.
Clinical Trial Participation
Because many patients still experience recurrence of their cancer following standard therapy, some patients and their doctors consider participation in clinical trials evaluating new treatment approaches as their initial option.
Before deciding to receive adjuvant chemotherapy treatment or to participate in a clinical trial, you should ensure you understand the answer to three questions:
- What is my prognosis (risk of cancer recurrence) without adjuvant chemotherapy treatment?
- How will my prognosis be improved with treatment?
- What are the risks of treatment?
This content was last modified on
July 23, 2007
.