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Ovarian, Fallopian Tube, and Peritoneal Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find basic information about this group of diseases and the parts of the body they may affect. This is the first page of Cancer.Net’s Guide to Ovarian, Fallopian Tube, and Peritoneal Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

About the ovaries

The ovaries are part of a woman’s reproductive system. Every woman has 2 ovaries, with 1 located on each side of the uterus. They are almond-shaped and about 1.5 inches long. These glands contain germ cells, also called eggs. Ovaries are the primary source of estrogen and progesterone. These hormones influence breast growth, body shape, body hair, and regulate the menstrual cycle and pregnancy. During menopause, the ovaries stop releasing eggs and producing certain hormones.

About the fallopian tubes

The fallopian tubes are part of a woman’s reproductive system. They are small ducts that connect a woman’s ovaries to her uterus. Typically, every woman has 2 fallopian tubes, with 1 located on each side of the uterus. During a woman’s monthly ovulation, usually an egg is released from 1 ovary and travels through a fallopian tube to the uterus.

About the peritoneum

The peritoneum is a tissue that lines the abdomen and most of the organs in the abdomen. The tissue covers the uterus, bladder, rectum, and the ovaries and fallopian tubes. A liquid called peritoneal fluid covers the tissue’s surface. This liquid helps the organs move within the abdomen and prevents them from sticking together.

About ovarian, fallopian tube, and peritoneal cancers

The term “ovarian cancer”' is often used to describe cancers that begin in the cells in the ovary,  fallopian tube, or peritoneum. The cancers are closely related and are treated the same way. In this guide, this group of diseases is referred to as “ovarian/fallopian tube cancer” because peritoneal cancer is relatively rare. When the term “ovarian cancer” is used, it includes both fallopian tube and peritoneal cancers, because it may be unclear where the cancer started.

These types of cancer begin when healthy cells in these areas change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

An ovarian cyst forms on the surface of the ovary and it can occur during a woman’s normal menstrual cycle and usually goes away without treatment. Simple ovarian cysts are not cancerous.

Research studies suggest that most ovarian/fallopian tube cancers are high-grade serous cancers (HGSC), and in most cases, the cancer actually starts in the distal, or outer, end of the fallopian tubes and then spreads to the surface of the ovaries and beyond. Based on this new knowledge, some doctors recommend removal of the fallopian tubes rather than tying or banding the tubes for contraception, or when a women is undergoing surgery for benign disease and does not want to get pregnant in the future.This strategy could prevent the development of these cancers in the future.

Because the surfaces of the ovaries, the lining of the fallopian tubes, and the covering cells of the peritoneum are made up of the same types of cells, most of these diseases look alike under a microscope. Peritoneal cancer can still develop after ovaries and fallopian tubes have been removed. Just as with ovarian cancer, some peritoneal cancers may begin in the fallopian tube and spread from the end of the fallopian tubes into the peritoneal cavity.

Types of ovarian and fallopian tube cancer

  • Epithelial carcinoma. Epithelial carcinoma makes up 85% to 90% of ovarian/fallopian tube cancers. The main types of epithelial tumors include serous, endometrioid, clear cell, mucinous, mixed tumors, and several rare malignancies, including Brenner and transitional cell cancers. These types describe how these different ovarian/fallopian tube cancers are classified based on how they look under the microscope. There can be differences in how these cancers behave and which treatments will work best.


    The vast majority of epithelial cancers are serous, meaning they resemble the cells lining the fallopian tube. These cancers are either HGSC or low-grade serous carcinoma (LGSC). HGSCs make up the vast majority of ovarian/fallopian tube cancer. LGSC is uncommon.

  • Germ cell malignancies. This uncommon type of ovarian cancer develops in the egg-producing cells of the ovaries. Germ cell malignancies typically occur in females aged 10 to 29 years.

The types of germ cell tumors are dysgerminomas, immature teratoma, endodermal sinus tumors (called EST and yolk sac tumors), and embryonal carcinomas.

  • Stromal malignancies. This rare form of ovarian cancer develops in the connective tissue cells, granulosa and theca cells, that hold the ovaries together. This tissue sometimes makes the female hormones estrogen and progesterone. Over 90% of these stromal tumors are called granulosa cell tumors, either adult or childhood types.

Granulosa cell tumors may secrete estrogen, resulting in unusual vaginal bleeding at the time of diagnosis. Other types are theca cell malignancies and mixtures of these 2 types.

Fallopian tube cancer was once thought to be rare, but we now know that most cancers previously labeled “ovarian cancer” actually begin in a fallopian tube. Most cancers arising in the fallopian tube begin in the outer end of the tube, near the fimbria, which is where the opening of the tube is located and where eggs released from the ovary must enter in order to be fertilized. Virtually all of these are serous cancers, and most are HGSC, although in rare cases, other types of cancer can start in the fallopian tube.

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The next section in this guide is Statistics. It helps explain the number of women who are diagnosed with these diseases and their survival rates. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find information about the number of women who are diagnosed with ovarian, fallopian tube, and peritoneal cancer each year. You will also read general information about surviving these diseases. Remember, survival rates depend on several factors. Use the menu to see other pages.

This year, an estimated 22,240 women in the United States will be diagnosed with ovarian cancer, and the vast majority of these are high-grade serous ovarian cancers (HGSC), which begin in a fallopian tube. Ovarian cancer accounts for 2.5% of cancers in women and 5% of deaths from cancer. That is because 4 out of 5 patients are diagnosed when the disease is at an advanced, less curable stage.

Older women and white women have the highest risk of the disease. About half of women diagnosed with ovarian and fallopian tube cancer are 63 or older.

It is estimated that 14,070 deaths from this disease will occur this year. Combined, cancer of the ovaries, fallopian tubes, and peritoneum are the fifth most common cause of cancer-related death in women in the United States.

The 5-year survival rate tells you what percent of women live at least 5 years after cancer is found. Percent means how many out of 100. The 5-year survival rate for women with all types of ovarian and fallopian tube cancer is 47%.  

However, the rate varies widely depending on age and ethnicity of the woman, as well as the stage and grade of the cancer. The 5-year survival rate for white women younger than 65 is 60% compared to 29% for those 65 and older. The survival rates for black women of the same ages are lower. Those younger than 65 have a 51% survival rate, while those 65 and older have a 22% survival rate.

If ovarian and fallopian tube cancers are diagnosed and treated before they spread outside the ovaries and tubes, the general 5-year survival rate is about 93%. Approximately 15% of women with ovarian and fallopian tube cancer are diagnosed at this stage. If the cancer has spread to surrounding tissues or organs, the 5-year survival rate is 73%. If the cancer has spread to a distant part of the body, the 5-year survival rate is 29%. Approximately 60% of women are diagnosed at this stage.

It is important to remember that statistics on the survival rates for women with ovarian, fallopian tube, and peritoneal cancer are an estimate. The estimate comes from annual data based on the number of women with these cancers in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Women should talk with their doctor if they have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2018: Special Section – Ovarian Cancer.

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by ovarian, fallopian tube, and peritoneal cancer. Use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find a drawing of the main body parts affected by these diseases. Use the menu to see other pages.

Women's Cancers Anatomy

This illustration shows a frontal and sagittal (side) view of a woman’s reproductive system. The frontal section shows the fallopian tubes, 2 small ducts that link the 2 ovaries (1 on each side) to the hollow, pear-shaped uterus. The lower, narrow part of the uterus is called the cervix, which leads to the vagina. The uterus is located in the pelvis, between the bladder and rectum, and the vagina is located behind the urethra, which connects to the bladder. Copyright 2003 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.

The next section in this guide is Risk Factors and Prevention. It explains what factors may increase the chance of developing these diseases. You may use the menu to choose another section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find out more about the factors that increase the chance of developing these types of cancer. Use the menu to see other pages.

A risk factor is anything that increases a person's chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a woman's risk of developing ovarian/fallopian tube cancer.

  • Family history. A strong family history of breast or ovarian/fallopian tube cancer puts women at higher risk for ovarian/fallopian tube cancer. Doctors believe this is because many of these families have genetic mutations (changes in the gene) that are passed from generation to generation (see “Genetics,” below). If you are concerned that ovarian/fallopian tube cancer may run in your family, it is important to get an accurate family history, including breast cancers in the family. By understanding your family history, you and your doctor can take steps to reduce your risk and be proactive about your health.

  • Genetics. About 10% to 15% of ovarian/fallopian tube cancers occur because a genetic mutation, or change, has been passed down within a family. A mutation in the BRCA1 or BRCA2 gene is associated with an increased risk of developing these cancers. A woman with an average risk has only a 1% to 2% lifetime risk of developing ovarian/fallopian tube cancer. A woman with a BRCA1 mutation has around a 40% lifetime risk, and a woman with a BRCA2 mutation has about a 10% to 20% lifetime risk.

    While less common, BRCA-related ovarian/fallopian tube cancers can occur in women who do not have a family history of either breast or ovarian/fallopian tube cancer. About 40% of women with ovarian/fallopian tube cancer who are found to have a BRCA mutation do not have a family history. Because of this, all women with ovarian/fallopian tube cancer who are younger than 70 should be offered genetic testing for BRCA1 and BRCA2, regardless of their family history. Women may also want to be tested for the genes related to Lynch syndrome (see below) and other cancer risk genes, based on their type of ovarian/fallopian tube cancer. Read more about the BRCA1 and BRCA2 genes in this website’s section on hereditary breast and ovarian cancer.

  • Genetic conditions. There are several other genetic conditions that cause ovarian/fallopian tube cancer. Some of the most common include:

    • Lynch syndrome. Lynch syndrome, also known as hereditary non-polyposis colorectal cancer, increases a woman's risk of ovarian/fallopian tube cancer and uterine cancer. It is caused by mutations in several different genes. Lynch syndrome increases the risk of colorectal cancer and several other cancers.

    • Peutz-Jeghers syndrome (PJS). PJS is caused by a specific genetic mutation. The syndrome is associated with multiple polyps in the digestive tract that become noncancerous tumors and with increased pigmentation (dark spots on the skin) on the face and hands. PJS raises the risk of ovarian/fallopian tube cancer, breast cancer, colorectal cancer, and several other types of cancer.

    • Nevoid basal cell carcinoma syndrome (NBCCS). Women with NBCCS, also called Gorlin syndrome, have an increased risk of developing fibromas. Fibromas are benign fibrous tumors of the ovaries. There is a small risk that these fibromas could develop into a type of ovarian cancer called fibrosarcoma. People with NBCCS often have multiple basal cell carcinomas and jaw cysts and may develop medulloblastoma, a type of brain tumor, in childhood.

    • Li-Fraumeni syndrome and ataxia-telangiectasia. Women with Li-Fraumeni syndrome or ataxia-telangiectasia may have a slightly increased risk of developing ovarian cancer. 

      There may be other hereditary syndromes linked to these types of cancer, and research in this area is ongoing. Only genetic testing can determine whether a woman has a genetic mutation. Most experts strongly recommend that women who are considering genetic testing first talk with a genetic counselor. This expert is trained to explain the risks and benefits of genetic testing.

  • Age. A woman’s risk of developing ovarian/fallopian tube cancer increases with age. Women of all ages have a risk of these cancers, but women over 50 are more likely to develop the malignancies. About half of the women diagnosed with ovarian/fallopian tube cancer are 63 years or older.

  • Weight. Recent studies show that women who were obese in early adulthood have an increased risk to develop ovarian/fallopian tube cancer. Women who are obese are more likely to die from any condition, including ovarian/fallopian tube cancer.

  • Endometriosis. When the inside lining of a woman’s uterus grows outside of the uterus, affecting other nearby organs, it is called endometriosis. This condition can cause several problems, but effective treatment is available. Researchers are continuing to study whether endometriosis is a risk factor for ovarian cancer. It may increase the risk of certain types of ovarian cancer, including clear cell and endometrioid ovarian cancers.

  • Ethnicity. Women of North American, Northern European, or Ashkenazi Jewish heritage have an increased risk of ovarian cancer.

  • Reproductive history. Women who have never had a child, have unexplained infertility (the inability to bear a child), or have not taken birth control pills may have an increased risk of ovarian/fallopian tube cancer.

  • Hormone replacement therapy. Women who have taken estrogen-only hormone replacement therapy (HRT) after menopause may have a higher risk of ovarian/fallopian tube cancer. The risk becomes higher the longer a woman uses the therapy. The risk decreases over time after the therapy ends.

Fertility drugs were once thought to increase the risk of ovarian/fallopian tube cancer. It has been shown that they do not increase the risk.

Prevention

Different factors cause different types of cancer. Researchers continue to study what factors cause these types of cancer. Although there is no proven way to prevent these diseases completely, you may be able to lower your risk. Talk with your doctor for more information about your personal risk of cancer.

Research has shown that certain factors may reduce a woman's risk of developing ovarian/fallopian tube cancer:

  • Taking birth control pills. Women who took oral contraceptives for 3 or more years are 30% to 50% less likely to develop ovarian/fallopian tube cancer. The decrease in risk may last for 30 years after a woman stops taking the pills.

  • Breastfeeding. The longer a woman breastfeeds, the lower her risk of developing ovarian and fallopian tube cancer.

  • Pregnancy. The more full-term pregnancies a woman has had, the lower her risk of ovarian/fallopian tube cancer.

  • Surgical procedures. Women who have had a hysterectomy or a tubal ligation may have a lower risk of developing ovarian/fallopian tube cancer. A hysterectomy is the removal of the uterus and, sometimes, the cervix. Tubal ligation is having the fallopian tubes “tied” or closed surgically to prevent pregnancy. Doctors recommend a bilateral salpingo-oophorectomy, which is the removal of both ovaries and fallopian tubes, for women with a high risk of ovarian/fallopian tube cancer.

For women with high-risk genetic mutations such as BRCA1, BRCA2, and the genes related to Lynch syndrome, having the ovaries and fallopian tubes removed after having children is recommended to prevent ovarian/fallopian tube cancers as well as possibly reduce the risk of breast cancer. This can reduce ovarian/fallopian tube cancer risk by as much as 96%. If performed before natural menopause, there may be a 40% to 70% reduction in the risk of developing breast cancer.

It is very important for women who are considering preventive surgery to talk with their doctors and genetic counselors so they can understand the risks and side effects of the surgery compared to their personal risk of developing ovarian/fallopian tube cancer.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems these diseases can cause. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

Ovarian/fallopian tube cancer can be hard to find in their earliest stages. That’s because the symptoms are often vague until these diseases are advanced. They have the same symptoms.

It’s possible for women with ovarian/fallopian tube cancer to not show any symptoms. It’s also important to note that symptoms are non-specific and may be caused by a different medical condition that is not cancer.

Symptoms for ovarian/fallopian tube cancer may include:

  • Abdominal bloating

  • Pelvic or abdominal pain

  • Difficulty eating or feeling full quickly

  • Urinary symptoms, such as urgency or frequency

  • Fatigue

  • Upset stomach

  • Indigestion

  • Back pain

  • Pain with intercourse

  • Constipation

  • Menstrual irregularities

  • Swelling in the pelvis or abdomen

  • Vaginal discharge, which may be clear, white, or tinged with blood

For many women, these symptoms occur often and are different from what is normal for their bodies. Women who have any of the symptoms listed above everyday for more than a few weeks should see their primary care doctor or a gynecologist. A gynecologist is a doctor who specializes in treating diseases of the female reproductive organs. Early medical evaluation may help find cancer at the earliest possible stage of the disease, when it is easier to treat.

Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis. If the doctor diagnoses cancer, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may do tests to learn which treatments could work best.

If your primary care doctor suspects that you might have ovarian/fallopian tube cancer, you should see a gynecologic oncologist. A gynecologic oncologist is a doctor who specializes in treating cancers of the female reproductive system.

Laboratory testing the ovarian and fallopian tube tissues is the only sure way for the doctor to know whether an area of the body has cancer. In most cases, this requires surgical removal of these organs.

This list describes options for diagnosing ovarian/fallopian tube cancer. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

While early detection and treatment is important, this is often not possible for ovarian/fallopian tube cancer. There are no effective screening methods until cancer is suspected. Often, women don’t have any symptoms until the tumor is large or in later stages of the disease. About 70% of epithelial ovarian/fallopian tube cancers are not found until the disease is in an advanced stage and has spread to other parts of the body, most commonly the abdomen.

The following tests may be used to diagnose ovarian/fallopian tube cancer:

  • Abdominal-pelvic examination. Usually, the first exam is the abdominal-pelvic examination. The doctor feels the uterus, vagina, ovaries, bladder, and rectum to check for any unusual changes, such as a mass. Some cancers are very small before they spread and cannot be reliably felt and detected by pelvic examination. A Pap test, usually done with a pelvic examination, is not likely to find or diagnose these cancers because that test is used to find cervical cancer. However, research advances in DNA testing may help find cells trapped in the cervix that could be studied for changes that indicate cancer elsewhere in a woman’s reproductive system. These findings are considered experimental.

  • Transvaginal ultrasound. An ultrasound probe is inserted in the vagina and aimed at the ovaries and uterus. An ultrasound uses sound waves to create a picture of the ovaries, including surrounding tissues, cysts, and tumors. Researchers are studying whether this test can help with early detection of ovarian/fallopian tube cancer.

  • Blood tests/CA-125 assay. There is a blood test that measures a substance called CA-125, a tumor marker. This marker is found in higher levels in women with ovarian/fallopian tube cancer. Woman younger than 50 with conditions such as endometriosis, pelvic inflammatory disease, and uterine fibroids may also have an increased CA-125 level. This test is more accurate in women who have had menopause. Other tumor marker tests, such as HE4, are available, but these markers have not been found to be effective for the early detection of these cancers.

  • Computed tomography (CT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. An x-ray is a way to create a picture of the structures inside the body using a small amount of radiation. A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a liquid to swallow. A CT scan can be used to measure the tumor’s size and find out how much the cancer has spread. While the technology of CT scanning has continued to evolve, tumors or abnormalities smaller than about 5 millimeters (1/5th of an inch) are difficult to see.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure as just a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to actively use energy, it absorbs more of the radioactive substance. A scanner detects this substance to produce images of the inside of the body.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein.

  • Paracentesis. This is a medical procedure that removes peritoneal fluid that has built up in a person’s abdomen. This fluid buildup may be called ascites. A sample of the fluid is examined under a microscope for signs of cancer (see “Biopsy,” below).

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definitive diagnosis. A pathologist analyzes the samples(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

Biopsies for ovarian/fallopian tube cancer are often done during a first surgery. During the surgery, doctors may remove as much of the tumor as possible (see Treatment Options). A tumor sample will be analyzed by a pathologist after the surgery is over. A biopsy alone is sometimes used if the diagnosis is uncertain or if there is too much tumor to remove initially with surgery. This is usually done when chemotherapy is planned as the first treatment, with possible surgery afterward.

After diagnostic tests are done, your doctor will review all of the results with you. As noted above, surgery and an examination of the lymph nodes may be needed before results are complete. If the diagnosis is cancer, these test results help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of the disease. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Stages and Grades

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will learn how doctors describe the disease’s growth or spread. This is called the stage. Use the menu to see other pages.

Staging is a way of describing where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out a cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best. Knowing the stage can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For ovarian/fallopian tube cancer, the staging system developed by the International Federation of Obstetrics and Gynecology (Federation Internationale de Gynecologie et d'Obstetrique or FIGO) is used.

FIGO stages for ovarian, fallopian tube, and peritoneal cancer

The stage provides a common way of describing the cancer, enabling doctors to work together to plan the best treatments. Doctors assign the stage of cancer using the FIGO system.

Stage I: The cancer is only in the ovaries or fallopian tubes.

  • Stage IA: The cancer is only inside 1 ovary or fallopian tube. No cancer is found on the ovarian or fallopian tube surface or in the abdomen.

  • Stage IB: The cancer is in both ovaries or fallopian tubes. No cancer is found on the surface of the ovary or fallopian tube or in the peritoneal fluid or washings.

  • Stage IC: The cancer is in 1 or both ovaries or fallopian tubes, with any of the following:

    • Stage IC1: The tumor ruptures while it is being removed surgically, called intraoperative surgical spill.

    • Stage IC2: The tumor wall is ruptured before surgery, or there is cancer on the surface of the ovary or fallopian tube

    • Stage IC3: Cancer cells are found in fluid buildup in the abdominal cavity, called ascites,) or in the samples of fluid from the peritoneal cavity taken during surgery.

Stage II: The cancer involves 1 or both of the ovaries or fallopian tubes and has spread below the pelvis, or it is peritoneal cancer.

  • Stage IIA: The cancer has spread to the uterus and/or fallopian tubes and/or the ovaries.

  • Stage IIB: The cancer has spread to other tissues within the pelvis.

Stage III: The cancer involves 1 or both of the ovaries or fallopian tubes, or it is peritoneal cancer. It has spread to the peritoneum outside the pelvis and/or to lymph nodes in the retroperitoneum (lymph nodes along the major blood vessels, such as the aorta) behind the abdomen.

  • Stage IIIA1: The cancer has spread to the retroperitoneal lymph nodes, which are found at the back of the abdomen, but not to the peritoneal surfaces.

    • Stage IIIA1(i): Metastases are 10 millimeters (mm) or smaller.

    • Stage IIIA1(ii): Metastases are larger than 10 mm.

  • Stage IIIA2: The cancer has spread microscopically from the pelvis to the abdomen. Cancer may or may not have spread to lymph nodes in the back of the abdomen.

  • Stage IIIB: The cancer has visibly spread past the pelvis to the abdomen and is 2 centimeters (cm) or smaller, with or without spread to the retroperitoneal lymph nodes.

  • Stage IIIC: The cancer has visibly spread past the pelvis to the abdomen and is larger than 2 cm, with or without spread to the retroperitoneal lymph nodes.

Stage IV: The cancer has spread to organs outside of the abdominal area.

  • Stage IVA: The cancer has spread to fluid around the lungs.

  • Stage IVB: The cancer has spread to the liver or spleen or to organs beyond the abdomen, including lymph nodes in the groin outside of the abdominal cavity.

Recurrent: Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Grade

Doctors also describe these types of cancer by its grade, which describes how much cancer cells look like healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. This helps the doctor predict how quickly the cancer may spread and may help the health care team make decisions about the treatment plan. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and contains different cell groupings, it is called “differentiated” or a “low-grade tumor.” If the cancerous tissue looks very different from healthy tissue, it is called “poorly differentiated” or a “high-grade tumor.” In general, the lower the tumor’s grade, the better the prognosis.

Some tumors are called borderline tumors, which are tumors of low malignant potential (LMP). They are very different from high-grade cancers. Most epithelial ovarian/fallopian tube cancers are the serous type, and they are they graded as low-grade serous carcinoma (LGSC) or high-grade serous carcinoma (HGSC).

Other types of ovarian/fallopian tube cancer, such as endometrioid cancers, may be given these grades:

  • Grade 1: The tissue is well differentiated. It contains many healthy-looking cells.

  • Grade 2: The tissue is moderately differentiated. More cells appear abnormal than healthy.

  • Grade 3: The tissue is poorly differentiated. All or most cells appear abnormal.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Treatment Options

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will learn about the different treatments doctors use for women with this type of cancer. Use the menu to see other pages.

This section tells you the treatments that are the standard of care for these types of cancer. “Standard of care” means the best treatments known. Ovarian/fallopian tube epithelial cancers are treated the same way.

When making treatment plan decisions, patients are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Descriptions of the most common treatment options for ovarian/fallopian tube cancers are described below. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health or personal considerations, such as a woman’s age and if she is planning to have children in the future.

Your care plan may include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Women with these cancers may have concerns about if or how their treatment may affect their sexual health and their ability to have children in the future. All patients are encouraged to talk with the health care team about these topics before treatment begins.

Surgery

Surgery is an important treatment for these types of cancer. A gynecologic oncologist is a doctor who specializes in the treatment of gynecologic cancers, including surgery and chemotherapy.

As mentioned in Diagnosis, surgery is often needed to find out the complete extent of the disease. The goal is to provide an accurate stage. This is important because imaging tests aren’t always able to see the true extent of a disease.

To find out whether ovarian/fallopian tube cancer has spread, the surgeon will remove lymph nodes, tissue samples, and fluid from the abdomen for testing. If it is obvious during the surgery that the cancer has spread, the surgeon will remove as much of the cancer as possible. This procedure has been shown to provide the best benefit when combined with chemotherapy (see below) after surgery.

There are several surgical options for ovarian/fallopian tube cancer. The stage of the tumor determines the types of surgery. Sometimes doctors perform 2 or more procedures during the same surgery:

  • Salpingo-oophorectomy. This surgery involves removal of the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy. If the woman wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only 1 ovary and 1 fallopian tube if the cancer is located in only 1 ovary. That surgery is called a unilateral salpingo-oophorectomy. For women with a germ cell type of ovarian tumor, often only the ovary with the tumor needs to be removed, which preserves the woman’s ability to become pregnant.

  • Hysterectomy. This surgery focuses on the removal of a woman’s uterus and, if necessary, surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when a woman’s uterus and cervix are removed.

  • Lymphadenectomy/lymph node dissection. During this procedure, the surgeon may remove lymph nodes in the pelvis and paraortic areas.

  • Omentectomy. This is surgery to remove the thin tissue that covers the stomach and large intestine.

  • Cytoreductive/debulking surgery. This surgery is used for women with metastatic cancer, which is cancer that has spread to another part of the body. The goal of cytoreductive surgery is to remove as much tumor as is safely possible. This may include removing tissue from nearby organs, such as the spleen, liver, and part of the small bowel or colon. This may involve removing part of each of these organs. This procedure can help reduce a person’s symptoms. It may help increase the effectiveness of other treatment, such as chemotherapy, given after surgery to control the disease that remains. If the disease has spread beyond the ovaries, fallopian tubes, or peritoneum, doctors may use chemotherapy to shrink the tumor before cytoreductive or debulking surgery. This is called neoadjuvant chemotherapy.

Debulking surgery should be performed by an experienced gynecologic oncologist. Talk with your doctor before surgery about the risks and benefits of this procedure. Ask about the surgeon’s experience with debulking surgery for your type of cancer.

Side effects of surgery

Surgery causes short-term pain and tenderness. If there is pain, the doctor will prescribe an appropriate medication. For several days after the operation, you may have difficulty emptying your bladder (urinating) and having bowel movements.

If the surgeon removes both ovaries, a woman can no longer become pregnant. The loss of both ovaries eliminates the body's source of sex hormones, resulting in early menopause. Soon after surgery, a woman is likely to have menopausal symptoms, including hot flashes and vaginal dryness.

Studies have shown that women who have their surgeries performed by a gynecologic oncologist are more likely to be successfully treated with surgery and have fewer side effects.

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Talk with your doctor about your sexual and reproductive health concerns, including ways to address these concerns before and after cancer treatment.

Learn more about the basics of cancer surgery.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide. Chemotherapy is given by a gynecologic oncologist or a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs given at the same time. The type of the chemotherapy used depends on several factors.

Side effects of chemotherapy

For these types of cancer, the side effects of chemotherapy depend on the individual and the dose used. Side effects can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Possible side effects of chemotherapy include difficulty with concentration and memory. For example, the patient may have issues with attention span or memory, sometimes called “chemobrain.” Other possible side effects include losing the ability to become pregnant, called infertility, and causing early menopause. Rarely, certain drugs may cause some hearing loss or kidney damage. Patients may be given extra fluid intravenously to protect their kidneys. Before treatment begins, patients should talk with their health care team about possible short-term and long-term side effects of the specific drugs they will receive. It is important to note that many side effects can be reduced by adjusting the dose and/or schedule.

Learn more about the basics of chemotherapy and preparing for treatment. Researchers are continually evaluating the medications that treat cancer. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

For ovarian/fallopian tube cancer, some targeted therapy drugs are directed at specific genes that might be found with abnormalities in certain types of epithelial ovarian/fallopian tube cancer. Standard chemotherapy has been effective in treating most ovarian/fallopian tube cancer. Typically, high-grade tumors have mutations in the TP53 gene and about 20% have mutations in the BRCA genes. These are usually diagnosed at later stages. Other tumor mutations are less common.

The BRCA mutation, even if found only in the tumor and not in the blood, may increase the effectiveness of certain classes of drugs, such as poly ADP-ribose polymerase (PARP) inhibitors (see below).

Other types of less common ovarian/fallopian tube cancer include low-grade serous, endometrioid, clear cell, and mucinous cancers. These tumors have a variety of mutations, including KRAS, BRAF, PI3KCA, and PTEN, which may mean targeted treatment may be available. Clinical trials studying these mutations are ongoing. 

  • PARP inhibitors. PARP inhibitors block an enzyme involved in repairing damaged DNA. By blocking this enzyme, DNA inside cancer cells may be less likely to be repaired, leading to cell death and possibly slowing down or stopping tumor growth. The BRCA genes (BRCA1 and BRCA2) are normally involved in DNA repair, and a mutation in these genes interferes with this pathway function. PARP inhibitors make it difficult for cells that otherwise have a BRCA mutation to grow and divide.

  • Studies are underway with other PARP inhibitors that do not all require the inherited BRCA mutation. Researchers are further testing to see if PARP inhibitors can keep the cancer from coming back after chemotherapy. Talk with your doctor about the potential benefits and risks of PARP inhibitors.

  • Anti-angiogenesis inhibitors. Drugs called anti-angiogenesis inhibitors block the action of a protein called vascular endothelial growth factor (VEGF). These drugs have been shown to increase the cancer’s response to treatment and delay the time it takes for the cancer to return. VEGF promotes angiogenesis, which is the formation of new blood vessels. Because a tumor needs nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. Bevacizumab (Avastin), an antibody that binds VEGF and prevents it from being active, has been shown to be effective in ovarian/fallopian tube cancer. It is currently approved for use in combination with certain chemotherapy drugs for maintenance therapy (see below).

First-line drug treatments (updated 06/2018)

The initial treat of chemotherapy or targeted therapy is referred to as “first-line treatment” or “first-line therapy.”

Adjuvant chemotherapy

Adjuvant chemotherapy is given to destroy cancer remaining after surgery. It typically consists of carboplatin (Paraplatin) given with paclitaxel (Taxol) or docetaxel (Docefrez, Taxotere) intravenously (IV). Most of these drugs are given every 3 weeks.

Another approach is called “dose-dense” chemotherapy. This is when paclitaxel is given weekly instead of every 3 weeks. Research studies have shown conflicting results: some show better outcomes with dose-dense chemotherapy, and others show that the outcomes are the same.

Another way to give adjuvant chemotherapy is to infuse it directly into the abdomen. This is called intraperitoneal or “IP” chemotherapy. This approach can be considered for women with stage III disease after a successful debulking surgery. However, studies have either shown that IV and IP treatments every 3 weeks are equally effective or shown the IP treatment to be more effective. Recently, studies comparing IV chemotherapy with carboplatin and paclitaxel to IP chemotherapy with the same drugs have shown similar outcomes. 

Talk with your doctor about which scheduling option is best for your situation.

With each of these approaches, doctors consider a variety of factors, such as age, kidney function, and other existing health problems.

In 2018, the U.S. Food and Drug Administration (FDA) approved adding bevacizumab to adjuvant chemotherapy with carboplatin and paclitaxel, followed by a course of bevacizumab alone. Bevacizumab is a targeted therapy that stops blood vessel growth. This adjuvant treatment is approved for women with stage III or stage IV ovarian/fallopian tube/peritoneal cancer. 

Research studies are underway to see if additional medications, such as PARP inhibitors (see “Targeted therapy” above), should be used. Several studies have evaluated whether adding bevacizumab to standard chemotherapy following initial surgery is helpful. In general, bevacizumab used for ovarian/fallopian tube cancer has prolonged the time before the cancer returns in some patients.

Neoadjuvant chemotherapy

Neoadjuvant chemotherapy is chemotherapy that is given before surgery. It is done to reduce the size of a tumor before surgery. It is usually started after a biopsy, so the doctors can determine where the tumor began. Neoadjuvant chemotherapy is usually given for 3 to 4 cycles before considering surgery, called interval surgery. Similar to adjuvant chemotherapy (see above), this treatment usually consists of carboplatin given intravenously with paclitaxel or docetaxel. The typical treatment cycle is to give these drugs every 3 weeks. Talk with your doctor about which scheduling option is best for your treatment plan.

In August 2016, the American Society of Clinical Oncology (ASCO) and the Society of Gynecologic Oncology (SGO) released a joint clinical practice guideline on the use of neoadjuvant chemotherapy for women with newly diagnosed, advanced ovarian/fallopian tube cancer. Listen to a podcast about what this treatment guideline means for patients.

Maintenance therapy after chemotherapy-induced remission (updated 04/2018)

Maintenance therapy is treatment used to reduce the risk of cancer coming back, called a recurrence, or to delay the time to recurrence. The drugs are used to “maintain” a clinical remission, which is when there is no evidence of disease after the patient has completed their course of chemotherapy treatment.

A new class of drugs called PARP inhibitors is approved to maintain remission in women whose ovarian/fallopian tube/peritoneal cancer has completely responded to their initial chemotherapy and the disease is in a “clinical remission.”  PARP inhibitors are a type of targeted therapy (see “Targeted therapy” above).

Niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca) are PARP inhibitors that are FDA-approved targeted therapies used for women with ovarian/fallopian tube/peritoneal cancer. These drugs are used to maintain a clinical remission after chemotherapy and are also approved to treat women whose disease has recurred (see “Drug treatment for recurrent ovarian/fallopian tube/peritoneal cancer” below). They are effective in patients who carry a BRCA mutation and those who do not carry the mutation. The advantage of these PARP inhibitors is that they can be taken by mouth, and the drugs are taken daily and generally well tolerated.

Another type of targeted therapy that is approved to maintain a clinical remission is a group of drugs that target blood vessel growth in tumors, so-called anti-vascular growth factor blockers. The drug in this type that is approved maintenance treatment for ovarian/fallopian tube/peritoneal cancer is bevacizumab (Avastin).  Bevacizumab, which is given by vein, is also approved for treatment of women with these cancers that recur after chemotherapy.

Drug treatment for recurrent ovarian/fallopian tube/peritoneal cancer

Chemotherapy is used to treat cancer recurrence. A primary goal of the treatment of recurrent disease is to reduce or prevent symptoms of the disease while keeping the side effects of treatment to a minimum. Treatment for women with recurrent disease is generally based on the time since her last treatment using a platinum chemotherapy drug. Platinum chemotherapy drugs include carboplatin and cisplatin (Platinol). There is also evidence that surgery may be an effective option for certain patients with recurrent disease, and this should be discussed with your gynecologic oncologist.

  • Platinum-sensitive disease. If the cancer returns more than 6 months after platinum chemotherapy, doctors call it “platinum sensitive.” If it is localized, additional surgery may be beneficial. You can discuss this with your doctor. Surgery is usually considered only if the time following chemotherapy has been 1 year or longer. If the cancer comes back to more than 1 place in the body, chemotherapy is the appropriate next step. For patients with platinum-sensitive disease, clinical trials suggest using IV carboplatin and combining it with liposomal doxorubicin (Doxil), paclitaxel, or gemcitabine (Gemzar) may be beneficial.

  • A clinical trial evaluated adding bevacizumab (see “Targeted therapy,” below) to the gemcitabine and carboplatin combination. This extended the time before the disease came back but did not change how long patients lived. You should discuss the risks and possible benefits of this approach with your doctor.

  • The following PARP inhibitors are approved for the treatment of ovarian/fallopian tube/peritoneal cancer:

  • Platinum-resistant disease. If the cancer returns in less than 6 months after platinum chemotherapy, doctors call it “platinum-resistant.” In general, the next chemotherapy is selected from a variety of medications that have all shown similar ability to shrink cancer. Doctors choose them based on possible side effects and preference based on schedule of dosing. These medications may include, but are not limited to:

    • Olaparib (Lynparza). Olaparib is approved for the treatment of persistent or recurrent ovarian/fallopian tube/peritoneal cancer in patients who have the inherited BRCA mutation and who have received 3 or more lines of chemotherapy.

    • Rucaparib (Rubraca). Rucaparib is approved for the treatment of BRCA-positive advanced ovarian/fallopian tube/peritoneal cancer in patients who have received 2 or more lines of chemotherapy.

    • Niraparib (Zejula). Niraparib is approved for maintenance therapy in adults with recurrent ovarian/fallopian tube/peritoneal cancer and can be used after treatment for recurrent disease (see “Maintenance therapy” above).

  • Liposomal doxorubicin (Doxil)

  • Paclitaxel (Taxol)

  • Docetaxel (Taxotere)

  • Nab-paclitaxel (Abraxane)

  • Gemcitabine (Gemzar)

  • Etoposide (Toposar, VePesid)

  • Pemetrexed (Alimta)

  • Cyclophosphamide (Cytoxan)

  • Topotecan (Hycamtin)

  • Vinorelbine (Navelbine)

  • Irinotecan (Camptosar)

For platinum-resistant cancer, most doctors recommend single and sequential use (1 drug after another) of these medications, but they are sometimes used in combination.

Bevacizumab can be combined with liposomal doxorubicin, paclitaxel, or topotecan to treat platinum-resistant cancer. Doctors believe this is best used with patients who have received 1 or 2 treatments of chemotherapy, who have not previously received bevacizumab, and who do not have evidence of significant bowel involvement, verified by a CT scan. By adding bevacizumab to the chemotherapy, the time to disease recurrence may be lengthened. You should discuss the risks and possible benefits of this approach with your doctor.

Clinical trials are always an option to consider. Talk with your doctor about clinical trials available for you.

Radiation therapy

Radiation therapy is not used as a first treatment for ovarian/fallopian tube cancer. Occasionally, it can be an option for treating small, localized recurrent cancer. See “Remission and the chance of recurrence” below for more information about treatment options for recurrent ovarian/fallopian tube cancer.

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy. This type of radiation is given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy.

For more information on radiation therapy for gynecologic cancers, see the American Society for Therapeutic Radiology and Oncology's pamphlet, Radiation Therapy for Gynecologic Cancers (PDF).

Hormone therapy

Hormone therapy may be used to treat some low-grade tumors after they have relapsed. These include tamoxifen (Novladex) and aromatase inhibitors, such as letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin). Hormone therapy is more often used to treat stromal tumors.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatments intended to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care. Palliative care includes supporting the patient with her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. Palliative care works best when it is started as early as needed in the cancer treatment process. People often receive treatment for the cancer at the same time that they receive treatment to ease side effects. Patients who receive both at the same time often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy or surgery. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. During and after treatment, be sure to tell your doctor or another health care team member if you experience a problem so it can be addressed as quickly as possible. Learn more about palliative care.

How epithelial ovarian/fallopian tube cancer is treated

As discussed in the Introduction, most cases of ovarian/fallopian tube cancer are epithelial carcinoma, and of those, a great majority are high-grade serous cancer. Treatment for early ovarian/fallopian tube cancer often involves surgery and adjuvant chemotherapy. Treatment for more advanced disease includes surgery with adjuvant chemotherapy and/or targeted therapy, neoadjuvant chemotherapy followed by surgery, or chemotherapy alone if surgery is not possible.

How ovarian germ cell tumors are treated

For patients with ovarian germ cell tumors, the first treatment is surgery. In some cases, doctors can perform the surgery in a way that preserves fertility. Doctors may recommend adjuvant chemotherapy after surgery. Adjuvant chemotherapy is treatment given after surgery to destroy any remaining cancer cells. Chemotherapy usually consists of a combination of IV bleomycin (Blenoxane), cisplatin, and etoposide. The overall approach and medications given are similar to those used in male germ cell cancer, which is a type of testicular cancer. To learn more about this type of cancer, visit the Cancer.Net guides to testicular cancer and childhood germ cell tumors.

How stromal tumors are treated

Stromal tumors are a rare form of ovarian cancer. They are found in the connective tissue that holds the ovaries together. For a stage I stromal tumor, treatment usually consists of surgery only. For high-risk, early-stage tumors or stage III or stage IV disease, doctors often consider combination chemotherapy (see Stages and Grades). You should discuss the risks and potential benefits with your doctor.

Chemotherapy for a stromal tumor usually involves the combination of bleomycin, cisplatin, and etoposide. Chemotherapy can be used after surgery or for tumors that have come back after treatment, called recurrent disease. Researchers are looking at chemotherapy with carboplatin and paclitaxel as alternatives. For recurrent disease, doctors use the hormonal therapy leuprolide (Eligard, Lupron, Viadur). Clinical trials are evaluating the effectiveness of bevacizumab to block the growth of blood vessels. Studies are being done to test tumors to find other, more targeted drugs to treat this type of cancer.

Metastatic cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

New treatments for these types of cancer include experimental combinations of chemotherapy, targeted therapy, and immunotherapy, also called biologic therapy. These combinations are designed to boost the body’s natural defenses to fight the cancer (see Latest Research). Because the benefits of these options are still being studied, their risks must be weighed against possible improvements in symptoms and lifespan. Palliative care will be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. It’s important to talk with your doctor about the possibility of the cancer returning. This is particularly important after treatment for ovarian/fallopian tube cancer, as many women experience at least 1 recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a new cycle of testing will begin to discover as much as possible about the recurrence. After this testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery and chemotherapy. However, they may be used in a different combination or given at a different pace. Radiation therapy may be used in some situations. Your doctor may suggest clinical trials that are studying new ways to treat your type of recurrent cancer.

The symptoms of recurrent ovarian/fallopian tube cancer are similar to those experienced when the disease was first diagnosed. The 4 most common symptoms are bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary symptoms (urgency or frequency). However, other symptoms may include persistent indigestion, gas, nausea, diarrhea, or constipation; unexplained weight loss or gain, especially in the abdominal area; abnormal bleeding from the vagina; pain during sexual intercourse; fatigue; and lower back pain.

In addition to monitoring symptoms, doctors may be able to diagnose a recurrence by measuring the level of CA-125 in the blood in women whose levels were elevated prior to treatment (see Diagnosis). CA-125 is a substance that is found in higher levels in women with ovarian/fallopian tube cancer. In 95% of women, a rise in CA-125 indicates a recurrence. However, sometimes a recurrence can happen without an elevation of this marker, depending on the tumor type.

Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment doesn’t work

Recovery from ovarian/fallopian tube cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help. Many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with ovarian/fallopian tube cancer cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the FDA was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn whether a new treatment is safe, effective, and possibly better than standard treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late side effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent cancer.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating ovarian/fallopian tube cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with these cancers.

Insurance coverage of clinical trials costs differs by location and by study. In some programs, some of the patient’s expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” Placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the patient’s options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together.

Because some of these specific types of cancer are quite rare, studies focusing only on these diseases are uncommon. However, many clinical trials on ovarian/fallopian tube cancer are open to women with these diseases because such diseases often respond to the same treatment.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for ovarian, fallopian tube, and peritoneal cancers, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

This website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for this type of cancer. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 10/2017

ON THIS PAGE: You will read about the scientific research being done to learn more about this type of cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about ovarian/fallopian tube cancer. They are looking for ways to prevent them, as well as looking for the best ways to treat them and provide care to people diagnosed with these diseases. The following areas of research may include new options for patients through clinical trials. Most ovarian cancer trials now include patients with fallopian tube and peritoneal cancers. Always talk with your doctor about the best diagnostic and treatment options for you.

  • Screening. Screening is used to look for cancer before a person has any signs or symptoms. There are no effective screening methods for these diseases suitable for the general symptom-free population. A screening method that uses serial CA-125 blood tests and pelvic ultrasonography for detecting early-stage ovarian/fallopian tube cancer has been completed, and it is not clear whether this approach will help people live longer. As noted in Diagnosis and Treatment Options, CA-125 is a substance called a tumor marker that is found in higher levels in women with ovarian/fallopian tube cancer and in women with many benign conditions.

The U.S. Preventive Services Task Force’s statement says that, for the general population of women with no symptoms, screening for ovarian/fallopian tube cancer is not helpful and may lead to harm.

Some have recommended that women at high risk of developing ovarian/fallopian tube cancer because of their family history or presence of BRCA1 or BRCA2 or other high-risk gene mutation(s) (see Risk Factors) should be screened with CA-125 blood tests and transvaginal ultrasound. As stated above, this approach has not been shown to help women live longer or find cancers at an earlier and more curable stage. Therefore, if a high-risk gene mutation exists, the recommendation is to remove both fallopian tubes and ovaries after a woman finishes having children or around the time she turns 40.

  • Other targeted therapies. As described in Treatment Options, clinical trials are ongoing on many treatments that target different mutations, including KRAS, BRAF, PI3KCA, and PTEN. Many other new, targeted treatments are now being studied in clinical trials. Increasingly, doctors are learning about each patient’s individual tumor's biology through molecular testing. This information may be useful in matching patients with a clinical trial for a specific targeted therapy. Learn more about the basics of targeted therapy.

  • Immunotherapy. Immunotherapy is usually designed to boost the body’s natural defenses to fight a cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function. Researchers are examining whether drugs called checkpoint inhibitors may boost the immune system's ability to destroy cancer cells. Drugs in this category target PD-1, PD-L1, and CTLA4. They have been shown to shrink tumors in other types of cancer, such as melanoma and some lung cancers, and have had some effectiveness in patients with ovarian/fallopian tube cancer.

    Cancer vaccines are another type of immunotherapy researchers are testing for use against ovarian/fallopian tube cancer. Some approaches, called “adoptive cell therapy,” use killer T cells from the immune system in an individual patient. Researchers take these cells and grow them in the laboratory, training them to attack certain targets, such as MUC 16 (CA-125), that are found on ovarian/fallopian tube cancer cells. Doctors then put the T cells back into the patient via an IV. This approach has been tried with some early success in patients with blood cancers. Clinical trials are opening for ovarian/fallopian tube cancer. Learn more about the basics of immunotherapy.

  • Hormone therapy. For treatment of recurrent or later-stage ovarian/fallopian tube cancer, tamoxifen, aromatase inhibitors, and enzalutamide (Xtandi), a blocker of the androgen receptor, are being studied.

  • Gene therapy. A new area of research is discovering how damaged genes in ovarian/fallopian tube cancer cells can be corrected or replaced. Researchers are studying the use of specially designed viruses that carry normal genes into the core of cancer cells and then replace the defective genes with functional ones.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of standard cancer treatments to improve a patient’s comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding ovarian/fallopian tube cancer, explore these related items that take you outside of this guide:

  • To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.

  • Visit the Cancer.Net Blog to read reviews of recent research in ovarian/fallopian tube cancer and to listen to podcasts with expert perspectives on the topic.

  • Visit the website of the Conquer Cancer Foundation to find out how to help support cancer research. Please note that this link takes you to a separate ASCO website.  

The next section in this guide is Coping with Treatment. It offers guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. You may use the menu to choose a different section to continue reading in this guide.

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ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. This page includes several links outside of this guide to other sections of this website. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for ovarian/fallopian tube cancer are described within the Treatment Options section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a cancer diagnosis. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in response.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with ovarian/fallopian tube cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during and after treatment. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of checkups after you finish cancer treatment. You may use the menu to choose a different section to read in this guide.

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ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for women diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Follow-up care for ovarian/fallopian tube cancer may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead.

Although there are no specific guidelines for follow-up care for women treated for ovarian/fallopian tube cancer, many doctors recommend a pelvic examination every 2 to 4 months for the first 4 years after treatment and every 6 months for the next 3 years.

For all 3 cancers, other tests may include x-rays, CT scans, MRI scans, ultrasound studies, and blood tests, such as a CA-125 test.

Women treated for ovarian/fallopian tube cancer may have an increased risk of breast cancer, colon cancer, or Lynch syndrome (for certain types of ovarian/fallopian tube cancer). Talk with your doctor about screening tests for these cancers.

Any new problem should be reported to your doctor, including pain, loss of appetite or weight, changes in your menstrual cycle, unusual vaginal bleeding, urinary problems, blurred vision, dizziness, coughing, hoarseness, headaches, backaches or abdominal pain, bloating, difficulty eating, or digestive problems that seem unusual or don’t go away. These symptoms may be signs that the cancer has come back or signs of another medical condition.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer originally diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. You may use the menu to choose a different section to read in this guide.

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ON THIS PAGE: You will read about how to with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Changing role of caregivers

Family members and friends may go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

As treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from ovarian/fallopian tube cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health. Cancer rehabilitation may be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank forms for treatment summaries and survivorship care plans. This booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Questions to Ask the Health Care Team

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ON THIS PAGE: You will find some questions to ask your doctor, or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with your health care team is important for making informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of ovarian/fallopian tube cancer do I have?

  • Where did this cancer start?

  • Can you explain my pathology report (laboratory test results) to me?

  • What is the stage and grade of my cancer? What does this mean?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available to me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of each treatment, in the short term and the long term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment and follow-up care?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or bear a child in the future? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • Whom should I call with questions or problems?

  • Is there anything else I should be asking?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

  • Will I have chemotherapy after the surgery?

Questions to ask about having chemotherapy, targeted therapy, or radiation therapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

  • How can I keep myself as healthy as possible during treatment?

  • Why are ovarian/fallopian tube cancer called “chronic diseases”?

  • Should other women in my family be tested regularly for this type of cancer?

  • Should other women in my family be tested for the BRCA1 or BRCA2 gene?

The next section in this guide is Additional Resources. It offers more website resources beyond this guide that may be helpful to you. You may use the menu to choose a different section to read in this guide.

Ovarian, Fallopian Tube, and Peritoneal Cancer - Additional Resources

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ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Ovarian Cancer, Fallopian Tube Cancer, and Peritoneal Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of the Cancer.Net’s Guide to Ovarian, Fallopian Tube, and Peritoneal Cancer. You may use the menu to choose a different section to read in this guide.