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.