Supportive care for ovarian cancer

Supportive care helps with the physical, practical, emotional and spiritual challenges of cancer. This important part of cancer care focuses on improving the quality of life of people with cancer and their loved ones, especially after treatment has ended.

Adjusting to life after treatment is different for everyone. Your recovery will depend on many different factors, such as where the cancer was in your body, the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and side effects.

If you have been treated for ovarian, fallopian or primary peritoneal cancer, you may be concerned about the following.

Self-esteem is how you feel about yourself. Body image is how you see your own body. They are often closely linked. Ovarian, fallopian tube or primary peritoneal cancer and its treatments can affect your self-esteem and body image. Often this is because cancer or cancer treatments change your body in different ways, such as: 

• scars
• hair loss
• changes in body weight
• sexual problems

Some of these changes can be temporary. Others can last for a long time or be permanent.

But treatment can affect your self-esteem or body image even if it does not affect how you look. Other people may not be able to see changes to your body, but you may still worry about how they now see you. This may affect your self-esteem, making you feel angry or upset, afraid to go out or worried that others will reject you.

Find out more about how to cope with problems of self-esteem and body image.

Lymphedema is a type of swelling that occurs when lymph fluid builds up in tissues. It usually occurs in parts of the body where large numbers of lymph nodes have been removed.

Lymphedema is rare for ovarian, fallopian tube or primary peritoneal cancer. However, you may have lymphedema in your legs if lymph nodes were removed from your pelvis or groin. Lymphedema is more likely to occur if you were also given radiation therapy to the pelvis.

If you develop lymphedema, your healthcare team can suggest ways to reduce swelling and pain as much as possible and to help prevent more fluid from building up. Ways to manage lymphedema include propping the limb up so that fluid can drain more easily, exercise, compression stockings and regular physiotherapy. You can also ask for a referral to a healthcare professional who specializes in managing lymphedema.

Find out more about lymphedema.

Ascites is a buildup of fluid in the abdomen (peritoneal cavity). It occurs when the body produces fluid faster than it can remove it. It's very common to develop ascites with ovarian, fallopian tube or primary peritoneal cancer, especially as the cancer progresses.

Find out more about ascites.

A bowel obstruction occurs when the small or large intestine (also called the bowel or the colon) becomes blocked or kinked and the contents cannot pass through the intestine easily. People who have abdominal surgery are at greater risk of developing a bowel obstruction.

Ovarian, fallopian tube or primary peritoneal cancer commonly causes a bowel obstruction because the ovarian tumour or a buildup of fluid in the abdomen puts pressure on the intestines. Bowel obstruction from ovarian cancer develops slowly over a period of weeks or months.

Find out more about a bowel obstruction.

A pleural effusion is a buildup of fluid in the space between the outside covering of the lung and the inside lining of the chest wall (called the pleura). It's more common with cancer that has spread to the lung area.

Find out more about a pleural effusion.

Menopause occurs when the ovaries produce lower levels of hormones. It happens naturally with age, usually by the early 50s. If you’ve been treated for ovarian, fallopian tube or primary peritoneal cancer, you may experience early menopause as a side effect of cancer treatment.

Find out more about treatment-induced menopause.

Most ovarian, fallopian tube or primary peritoneal cancers occur after child-bearing years. If you are diagnosed with one of these cancers at a younger age, you may have concerns about fertility.

Surgery, radiation therapy and chemotherapy can cause fertility problems. These problems may happen only during cancer treatment or for some time after treatment. But other times, cancer treatment causes permanent fertility problems. This is often called infertility or permanent infertility. Most surgeries for ovarian, fallopian tube or primary peritoneal cancer remove both ovaries, meaning you will not be able to get pregnant.

If fertility is important to you, talk about it with your healthcare team before you start cancer treatment. Depending on the type of cancer and where it is, your healthcare team can try to preserve your fertility. Treatments for early-stage cancer may also preserve fertility. For example, a unilateral salpingo-oophorectomy removes only the ovary that has the tumour in it and the fallopian tube on the same side. It is done if the tumour hasn't spread outside of the ovary.

Your healthcare team can refer you to a fertility specialist or clinic. They can give you information about ways to preserve your fertility before treatment starts. They can also help you explore your options after treatment.

Find out more about ways to preserve fertility and how you can manage fertility problems.

It’s very possible to have strong, supportive relationships and a satisfying sex life after cancer. If sexual problems occur because of cancer treatment, there are ways to manage them.

Side effects of treatments including radiation therapy or surgery can make sex painful or difficult. These side effects may include:

• vaginal dryness
• vaginal narrowing, caused by scarring
• treatment-induced menopause

It is common to have a decreased interest in sex around the time of diagnosis and treatment. When you start having sex after treatment, you may be afraid that it will be painful or that you won’t have an orgasm. The first attempts at being intimate with a partner may be disappointing. It may take time for a couple to feel comfortable with each other again. You and your partner may need counselling to help cope with these feelings and the effects of cancer treatments on your ability to have sex.

Find out more about sex and intimacy and sexual problems for women.

After treatment, it’s common to worry that the cancer will come back. It is important to learn how to deal with these fears to maintain a good quality of life.

In addition to the support offered by the treatment team, a mental health professional, such as a social worker or counsellor, can help you learn how to cope and live with a cancer diagnosis.

You may feel anxious or depressed during or after treatment. Levels of anxiety and depression appear to be related to physical symptoms and how much support you have from people close to you, including your caregivers.

You may need help from your healthcare team. You can also ask to be referred to a mental health professional.

To make decisions that are right for you, ask your healthcare team questions about supportive care.