Ovarian Cancer: 5 Questions to Ask Your Doctor Before Treatment

Female patient sitting on exam table in exam room
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If you have just been diagnosed with or suspected of having epithelial ovarian cancer, the most common type of ovarian cancer, your mind is probably filled with lots of questions about the type of treatment you will need.

Here are five questions that you can use to help guide your conversation with your doctor.

1.  Will I Need Surgery?

For many women, surgery is performed when ovarian cancer is suspected, and it is this surgery that will yield the diagnosis and the stage of the cancer.

Ovarian cancer surgery usually includes removal of the uterus (i.e., hysterectomy), removal of the ovaries and the fallopian tubes (i.e., salpingo-oophorectomy), lymph node biopsies, removal of the omentum, and removal of as much ovarian cancer as possible (i.e., cytoreduction or debulking). Ovarian cancer surgery should be performed by a gynecologic oncologist.

The tissue samples from the surgery will be sent to a pathologist who will examine each specimen and determine whether cancer is present in those tissues. The pathologist will generate a report that will give details about whether the cancer has spread, and if so, what tissues are involved. From this information, the stage of the ovarian cancer will be determined, from stage I through stage IV.

Sometimes, however, surgery cannot safely be performed when ovarian cancer is suspected. If you have medical conditions that might make surgery dangerous or if your gynecologic oncologist feels that surgery would be too risky, she may not recommend surgery for you, or she may recommend that you receive chemotherapy before having surgery.

2. Will I Need Chemotherapy?

Chemotherapy is often recommended for women with epithelial ovarian cancer, especially for women with advanced stage disease. Chemotherapy may be given after surgery (called “adjuvant”) or before surgery (called “neoadjuvant”), and it may be given intravenously (through a vein) or through a port in your abdomen (“intraperitoneal”).

Though there are lots of chemotherapy drugs available to oncologists, the recommended treatment for ovarian cancer includes a platinum (such as carboplatin or cisplatin) and a taxane (such as paclitaxel or docetaxel). These are the drugs that have been shown to be most effective in the initial treatment of ovarian cancer.

3. Who Will Give My Chemotherapy?

Chemotherapy can be administered by your gynecologic oncologist, the same doctor who performed your ovarian cancer surgery, or it may be administered by a medical oncologist. Either specialist is capable of prescribing chemotherapy drugs for ovarian cancer and other gynecologic cancers.

While gynecologic oncologists specialize in all gynecologic cancers, medical oncologists may treat a variety of cancer types. However, some medical oncologists, especially at academic medical centers, may specialize in the treatment of  gynecologic cancers such as ovarian cancer.

4. Do I Need a Second Opinion?

A cancer diagnosis can be overwhelming and treatment choices can often be confusing.

If you don’t feel completely comfortable with your diagnosis or treatment recommendations, asking for a second opinion might help you to feel better. This is a very common practice, and you should not feel bad asking your oncologist for a referral for a second opinion. Most doctors understand the value of a second opinion and will not be offended or hurt if you decide to seek one. Also, your doctor can likely recommend a doctor to you and can make the referral process more easy. You can also go here to find an oncologist.

5. What Is the Goal of My Treatment?

This is a crucial question to ask of your doctor. Hopefully, the goal of treatment is to cure you of your cancer. This is not always possible, however. When a cure is not possible, other goals might be able to be achieved with treatment. These may include controlling the cancer (either shrinking the cancer or keeping it from growing), prolonging life expectancy, or palliation (relieving symptoms). 

It is important to understand that the goal of treatment might change with time, and this is a discussion that should be had with your oncologist whenever a treatment decision time arises. For example, if your ovarian cancer comes back after you undergo the initial treatment, the goal of your treatment might shift from that of cure to controlling the disease and relieving symptoms. 

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