Treatments for stromal ovarian cancer

The following are treatment options for the stages of stromal cell ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Stage 1 stromal cell ovarian cancer is usually treated with surgery and sometimes chemotherapy.

Surgery is the main treatment for stage 1 stromal cell ovarian cancer. It’s usually the only treatment used. The types of surgery that may be done are:

• removing the ovary that has the cancer in it and the fallopian tube on the same side (called a unilateral salpingo-oophorectomy)
• removing the uterus and cervix (called a total hysterectomy) and removing both ovaries and both fallopian tubes (called a bilateral salpingo-oophorectomy)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This is called surgical staging.

Find out more about surgery for ovarian cancer.

Chemotherapy uses drugs to destroy cancer cells. If there is a high risk of the tumour coming back (recurring), you may be given chemotherapy to destroy any cancer cells left behind after surgery (called adjuvant chemotherapy). Tumours that are large, high grade or have broken open (ruptured) have a high risk of recurrence.

You may be offered a chemotherapy combination with carboplatin or cisplatin.

Find out more about chemotherapy for ovarian cancer.

The following are treatment options for stages 2, 3 and 4 stromal cell ovarian cancer.

Surgery is the main treatment for stages 2, 3 and 4 stromal cell ovarian cancer. Surgical staging happens during surgery to find out if the cancer has spread. The types of surgery that may be done are:

• unilateral salpingo-oophorectomy
• total hysterectomy and bilateral salpingo-oophorectomy
• surgical debulking (removing as much of the cancer as possible)

Adjuvant chemotherapy may be offered after surgery for stages 2, 3 and 4 stromal cell ovarian cancer. The chemotherapy combinations that may be offered are:

• carboplatin and paclitaxel
• PEB (or BEP) – cisplatin, etoposide and bleomycin

Hormone therapy adds, blocks or removes hormones to slow or stop the growth of cancer cells that need hormones to grow. It may be offered after surgery for stages 2, 3 and 4 stromal ovarian cancer.

Hormone therapy is often offered if you can’t tolerate chemotherapy because of the side effects or other health issues. The hormone therapy drugs that may be offered are:

• tamoxifen
• letrozole (Femara)
• anastrozole (Arimidex)
• leuprolide (Lupron, Lupron Depot, Eligard)
• goserelin (Zoladex)

Find out more about hormone therapy for ovarian cancer.

Recurrent stromal cell ovarian cancer means that the cancer has come back after it has been treated.

Persistent cancer means that the cancer didn’t go away completely after treatment.

Refractory cancer means the cancer has stopped responding to treatment or continues to grow during treatment.

Treatments offered for recurrent, persistent or refractory stromal cell ovarian cancer may include:

• surgery to remove as much of the tumour as possible (surgical debulking)
• chemotherapy combinations used for stages 2, 3 and 4, sometimes with a different drug combination
• hormone therapy used for stages 2, 3 and 4
• external radiation therapy for small recurrences in the pelvis

Talk to your doctor about clinical trials open to people with ovarian cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.