Ovarian Cancer: Treatment, Prevention & Awareness

By Dr. Priya Thakur Dubey, MBBS, DNB (OB GYN), DGO, MRCOG-1

World Ovarian Cancer Day, observed on May 8th, raises awareness, promotes early detection, and supports those affected. The 2025 theme, “No Woman Left Behind,” underscores equitable care and timely diagnosis. Part 2 discusses treatment, prevention, and awareness.

Once ovarian cancer is diagnosed, the next crucial step is determining the most effective treatment approach. Treatment usually involves a combination of approaches, tailored to the individual’s situation (such as the type of ovarian cancer and how far it has spread). Here are the main treatment options: 

● Surgery: Debulking usually means removing the ovaries and fallopian tubes (an operation called salpingo-oophorectomy), and often the uterus as well (hysterectomy), especially if the cancer is likely to have spread there. During the surgery, the surgeon will also remove any visible tumors in the pelvic/abdominal area and may take samples (biopsies) from various areas to check for microscopic spread. In early-stage cases, surgery might be the only treatment needed. Removing tumor bulk can help other treatments work better in more advanced cases. Surgery provides a definitive diagnosis (by examining the tissues under a microscope) and helps stage the cancer. This is why an accurate diagnosis often can’t be made until surgery is done. It’s recommended that a gynecologic oncologist (a specialist in female reproductive cancers) perform the surgery for the best outcomes.

● Chemotherapy: After surgery, most women with ovarian cancer will receive chemotherapy. The standard chemotherapy for ovarian cancer includes a combination of drugs, usually a platinum-based drug (like carboplatin or cisplatin) and a taxane (like paclitaxel). Chemotherapy for ovarian cancer is generally given in cycles over several months. It can cause side effects (fatigue, nausea, hair loss, etc.), but it significantly improves survival rates, especially in advanced stages, by attacking residual disease.

● Targeted Drug Therapy: In recent years, newer targeted therapies have been developed that hone in on specific characteristics of cancer cells. Unlike traditional chemo, which affects all fast-growing cells, targeted drugs aim for particular weaknesses in the cancer. For example, a class of drugs called PARP inhibitors (such as olaparib) focuses on cancer cells’ DNA repair machinery—they are particularly effective in cancers with BRCA mutations by causing those cancer cells to die (cancerblog.mayoclinic.org). These targeted drugs are often used as maintenance therapy after initial treatment to prevent or delay recurrence, especially in patients with certain genetic profiles. Another targeted approach involves monoclonal antibodies, which are lab-engineered molecules that attach to specific proteins on cancer cells. Bevacizumab (brand name Avastin) is one such drug that targets the tumor’s blood supply (used in some ovarian cancer cases to starve the tumor of nutrients) (cancerblog.mayoclinic.org). More recently, an antibody-drug conjugate called mirvetuximab soravtansine was approved for certain ovarian cancers—it’s like a “smart bomb” that delivers chemo directly to cancer cells bearing a folate receptor target (cancerblog.mayoclinic.org). Targeted therapies can be given alone or in combination with chemotherapy, depending on the scenario. They have opened new avenues, especially for recurrent ovarian cancer where traditional chemo may not work as well.

● Immunotherapy: The role of immunotherapy in ovarian cancer is still being explored. Unlike cancers such as melanoma or lung cancer, ovarian tumors haven’t shown dramatic responses to the currently available immune checkpoint inhibitor drugs (like PD-1/PD-L1 inhibitors) in most cases. However, researchers are testing various immunotherapy strategies. One promising area is cancer vaccines. For instance, scientists at Mayo Clinic are developing a vaccine to help the immune system recognize and fight ovarian cancer cells, aiming to prevent the cancer from returning after initial treatment (cancerblog.mayoclinic.org). This experimental vaccine uses a patient’s immune cells to train the body to attack tumor cells. While not standard care yet, it illustrates the cutting-edge efforts underway. Additionally, some patients might receive immunotherapy drugs as part of clinical trials or compassionate use, and ongoing trials are combining immunotherapy with other treatments to see if it can boost effectiveness.

● Hormone Therapy and Radiation: These treatments are not mainstays for the common type of ovarian cancer (epithelial ovarian cancer). Hormone therapy might be used for rarer ovarian tumors like stromal tumors (e.g., granulosa cell tumors), which can be hormone-sensitive (mayoclinic.org). In such cases, medications that block hormones (like estrogen) can help slow the cancer’s growth. Radiation therapy is generally not a primary treatment for ovarian cancer because the disease usually spreads diffusely in the abdomen, which is hard to target with radiation. However, radiation might be used in a limited way to treat localized painful areas or specific metastases (for instance, a spot of cancer causing pain that can be targeted with radiation for relief).

It’s heartening to note that treatment outcomes for ovarian cancer have been improving. The arsenal of therapies has expanded beyond just surgery and chemotherapy. As one Mayo Clinic oncologist put it, “Surgery and chemotherapy are no longer the only options” (cancerblog.mayoclinic.org)—new targeted treatments are helping more patients survive and thrive. The overall ovarian cancer death rate has been falling over the past few decades, thanks in part to better treatments (cancer.org). Doctors now often personalize treatment plans based on the tumor’s genetic makeup and the patient’s condition. This might mean combining approaches or using maintenance therapies to keep the cancer at bay after initial treatment.

Each patient’s case is unique, and the medical team will discuss the best approach for her. It can be a tough journey—ovarian cancer treatment is intensive—but many women get through it and go on to live cancer-free or with their disease well-controlled.

To understand the impact of ovarian cancer, consider a real-life scenario (a composite of common experiences). Jyoti is a 54-year-old mother of two. A few months ago, she began noticing that her stomach seemed bloated, and she often felt full after only a few bites of her meals. She initially wrote it off as weight gain or indigestion. Next came an ache in her lower abdomen that nagged her on and off. She ignored these signs for a while. It wasn’t until she also started feeling a constant urge to urinate that she visited her gynecologist, who listened carefully.

The doctor performed a pelvic exam and felt a fullness in Jyoti’s abdomen. An ultrasound and a CA-125 blood test were ordered. The ultrasound showed a suspicious ovarian mass, and the blood test showed an elevated CA-125 level. She was referred to a gynecologic oncologist, who explained that these findings were concerning for ovarian cancer.

Understandably, she underwent surgery, during which the surgeon indeed found ovarian cancer that had spread within her abdomen (it was Stage III ovarian cancer). The surgical team removed the tumors they could see. After recovering from surgery, she faced six cycles of chemotherapy. It was not easy—she experienced fatigue, nausea, and hair loss—but she persevered with the support of her family.

Fast forward to today: Jyoti has finished treatment. Her scans show no visible cancer, and she’s now on a PARP inhibitor pill as maintenance therapy to reduce the chance of recurrence (since her tumor was found to have a BRCA mutation). She is regaining her strength and hair, remaining cautiously optimistic. Looking back, Jyoti wishes she had recognized her symptoms earlier. “I had no idea these mild symptoms could be cancer,” she says. “I’m so glad I went to the doctor when I did. It’s scary to think what would have happened if I kept ignoring it.” Her journey highlights that even though ovarian cancer is serious, early detection and advances in treatment can lead to positive outcomes.

After reading about the challenges of ovarian cancer, you might be wondering: “Is there anything I can do to prevent it?” The reality is that there is no sure way to prevent ovarian cancer. This cancer can happen even in women with no known risk factors. However, researchers have identified several actions and life events that are associated with a lower risk of ovarian cancer. Think of these as protective factors—they don’t guarantee prevention, but they can tilt the odds in your favor:

● Birth Control Pills: Using oral contraceptive pills (combination estrogen-progestin) for a sustained period (for example, 5 or more years) is linked to a significantly lower risk of ovarian cancer (cdc.gov). Studies have shown that the protective effect can last for many years after a woman stops taking the pills. Of course, taking any medication has risks and benefits (the pill can have side effects and isn’t right for everyone), so this is a personal decision to discuss with a doctor. But epidemiologically, this is one of the strongest protective factors known.

● Pregnancy and Breastfeeding: Having one or more full-term pregnancies, especially having the first child at a younger age, is associated with reduced ovarian cancer risk (cdc.gov). Breastfeeding for a cumulative total of a year or more may also modestly lower risk (cdc.gov). The theory is that these factors reduce the number of ovulations in a woman’s lifetime (each pregnancy and breastfeeding period gives the ovaries a break), and fewer ovulations might mean less chance for something to go wrong in the ovarian cells.

● Surgical Prevention (for High-Risk Women): For women who are known to be at high genetic risk (like BRCA mutation carriers or those with a strong family history), preventive surgery is an option. This could be removal of the ovaries and fallopian tubes (prophylactic salpingo-oophorectomy) once childbearing is complete, or at least removal of the fallopian tubes (some ovarian cancers actually start in the tubes). These surgeries have been shown to dramatically reduce the risk of developing ovarian cancer (cdc.gov). In fact, for BRCA mutation carriers, preventive ovary removal by around age 40 is a standard recommendation to greatly lower cancer risk. Another surgical procedure that lowers risk is tubal ligation (having your “tubes tied”) (cdc.gov) or hysterectomy (removal of the uterus) if done for other reasons—these have been associated with reduced ovarian cancer risk as well, though they aren’t done solely to prevent ovarian cancer except in high-risk cases.

● Healthy Lifestyle: While lifestyle factors aren’t as linked to ovarian cancer as they are for some other cancers, general health measures are always beneficial. Keeping a healthy weight and avoiding obesity might help lower risk (mayoclinic.org) (and will certainly improve overall health). If you don’t need hormone replacement therapy after menopause, avoiding prolonged use of postmenopausal hormones could eliminate that risk factor (cdc.gov). And of course, not smoking (or quitting if you do) is advised for many reasons, even if its link to ovarian cancer is not major.

Perhaps the most important “preventive” strategy is not a medical intervention at all, but education and awareness. Knowing the risk factors and symptoms of ovarian cancer means you can take action early if needed. If you have a family history of ovarian or breast cancer, consider talking to your healthcare provider about genetic counseling (mayoclinic.org). A genetic counselor can help assess your risk and discuss whether genetic testing for mutations like BRCA might be appropriate for you. If you are found to carry a risk-raising gene, you can then make informed decisions about preventive measures.

For all women, being aware of your own body’s normal state is key. No one knows your body better than you do. If something seems off and persists—whether it’s bloating, pain, or an unusual pattern—don’t hesitate to get it checked. Early action is a form of prevention too, in the sense that it can prevent later-stage disease by catching it sooner.

Finally, support and spread awareness campaigns. September is Ovarian Cancer Awareness Month (often symbolized by the color teal). Organizations like the American Cancer Society, Ovarian Cancer Research Alliance, and others provide resources for education. By knowing and sharing information, we help more women recognize the signs and seek care in time.

Ovarian cancer has long been a formidable foe, often called the “silent” or “whispering” disease because its early signs are easy to miss. But as we’ve seen, it doesn’t have to be silent if we know what to listen for. Early diagnosis is difficult but not impossible—staying alert to symptoms and seeking medical advice when something seems wrong is our best defense in the absence of a routine screening test. We’ve also learned that certain women carry higher risks, and for them especially, proactive steps like genetic counseling or preventive surgery can be game-changers.

The journey through ovarian cancer—from suspicion to diagnosis to treatment—can be overwhelming. Yet, there is reason for hope. Medical science is making strides: surgeries are more precise, new drugs are extending remissions, and researchers are continually finding better ways to attack the disease. Many women, like the patient in our anecdote, go through the hardest fight of their lives and come out on the other side, cancer-free or managing it like a chronic condition. Their stories inspire us and remind us that we are not alone—there’s a whole community of survivors, advocates, and healthcare professionals working to improve outcomes.

In summary, if you remember a few key points from this article, let them be these: know the subtle symptoms and don’t ignore them, understand your risk factors and discuss them with your doctor, and be aware that treatments are improving every year, offering more hope than ever before. Ovarian cancer is challenging, but with early detection, proper treatment, and preventive awareness, lives can be saved. By staying informed and spreading knowledge, we empower ourselves and others to face ovarian cancer with clarity and courage.

Dr. Priya is currently working in Symbiosis Medical College for Women, Pune. She pursued her MBBS from Sanjay Gandhi Memorial Hospital and DGO (Diploma in Obstetrics and Gynecology) from Sultania Zanana Hospital, Bhopal. DNB (OBGY) from Noble hospital, Pune. She is a member of International Society of Ultrasound in Obstetrics Gynecology (ISUOG). UK certified fellow in fetal medicine. She is certified in perinatal mental health from NIMHANS.

References:

1. World Health Organization (WHO)
World Health Organization. “Cancer.” Accessed May 7, 2025. https://www.who.int/health-topics/cancer.

2. National Comprehensive Cancer Network (NCCN)
National Comprehensive Cancer Network. “Home.” Accessed May 7, 2025. https://www.nccn.org/.

3. American Cancer Society
American Cancer Society. “Home.” Accessed May 7, 2025. https://www.cancer.org/.

4. Surveillance, Epidemiology, and End Results Program (SEER)
National Cancer Institute. “SEER: Surveillance, Epidemiology, and End Results Program.” Accessed May 7, 2025. https://seer.cancer.gov/.

_MSM/DP