Learn about the flu shot, COVID-19 vaccine, and our masking policy »
New to MyHealth?
Manage Your Care From Anywhere.
Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill.
ALREADY HAVE AN ACCESS CODE?
DON'T HAVE AN ACCESS CODE?
NEED MORE DETAILS?
MyHealth for Mobile
Get the iPhone MyHealth app »
Get the Android MyHealth app »
Treatments
At Stanford Health Care, our team delivers customized treatments for ovarian cancer. Experts at the Stanford Women’s Cancer Center come together to evaluate each person and decide on the most appropriate treatment plan. Our nationally recognized specialists, including pathologists, geneticists, and radiation oncologists, are skilled at delivering effective care in a supportive environment.
- Nationally recognized expertise to treat every stage and type of ovarian, fallopian tube, and peritoneal cancer.
- Precise diagnosis options that use advanced biopsy and imaging technologies to evaluate the unique biology of tumors so we can make treatments more effective.
- Team-based treatment planning, including weekly meetings that bring together specialists from diverse disciplines to tailor care to your needs.
- Advanced treatment options, including minimally invasive approaches and robot-assisted techniques that use smaller incisions and offer faster recovery.
- Tumor genomic profiling services to target the genetic fingerprint of hard-to-treat ovarian, fallopian tube, and peritoneal cancer with therapies only available through clinical trials.
- Genetic counseling services to assess your genetic risk for ovarian cancer and develop a care plan for you and your family.
- Comprehensive support services, including dedicated care coordination, counseling, nutrition services, pain management, massage therapy, and sexual medicine services.
Connect to Care
Let us help find personalized care options for you and your family.
Interested in an Online Second Opinion?
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Visit our online second opinion page to learn more.
Goals of Ovarian Cancer Treatment
Your care team will explain the recommended options and possible sequence for your treatment plan. They will help you make an informed decision about which options may be right for you. We work with you to consider your medical and personal goals while minimizing treatment side effects.
For stage 1 cancer that’s limited to the ovary, there is a five-year ovarian cancer survival rate of more than 90% following treatment. People who have advanced ovarian cancer that has spread to other areas of the body have a higher risk of the cancer returning after initial treatment. Surgery and cancer medications can delay the return or growth of cancer. These treatments can also improve your quality of life by relieving symptoms.
Treatment options vary depending on:
- Stage (or extent) of the cancer
- Type of cancer and whether it’s slow-growing or fast-growing
- Your age, health history, preferences, and goals
Your care team may recommend surgery to diagnose, stage, or treat cancer:
- Diagnosis: You may need a biopsy so your doctor can take tissue samples and determine a more precise diagnosis.
- Staging: Surgery can help determine the stage of ovarian cancer by showing the size of the tumor and other details.
- Treatment: Surgically removing the tumor may be the most appropriate treatment for you.
If your doctor recommends ovarian cancer surgery, you will meet with a gynecologic oncologist to develop a plan. Surgery for ovarian cancer is different for each person. Your care team will work with you to determine the least invasive and most effective surgery for the type of ovarian cancer you have. They may recommend:
- Salpingo-oophorectomy: During this procedure, a surgeon removes the ovaries and fallopian tubes. Your doctor may also recommend removing the pelvic lymph nodes and other reproductive organs.
- Hysterectomy: A surgeon removes the uterus during this procedure. The surgeon usually removes the cervix as well as the uterus, and they may also recommend removing the ovaries and fallopian tubes.
Your doctor may use a technique called laparoscopic surgery. To perform these operations, the surgeon inserts a tiny camera and little surgical tools through a small incision. Sometimes, surgeons use robotic equipment to guide the tools (robotic surgery). These minimally invasive surgeries involve less recovery time and a lower risk of complications than traditional (open) surgery.
Combining surgery with other treatments
To achieve the best possible outcome, your care team may recommend combining surgery with other treatments such as radiation therapy or chemotherapy. You may receive additional treatment in one of two ways:
- Neoadjuvant therapy: This treatment occurs before surgery to make it easier and more effective. Undergoing chemotherapy before surgery, for example, may shrink a tumor and make removal more successful.
- Adjuvant therapy: This treatment occurs after surgery to reduce the risk of the cancer coming back. Chemotherapy or radiation therapy after surgery can destroy remaining cancer cells.
Cancer medications, also called systemic or medical therapy, are treatments that work throughout the body to fight endometrial cancer. These medications slow the growth of cancer cells or destroy them. At Stanford Health Care, we are at the forefront of developing and improving medical therapies. Our gynecologic oncologists use several types of cancer medications, including:
- Chemotherapy: This group of medications stops the growth of rapidly dividing cells in the body, both cancerous and noncancerous. Although it is powerful, chemotherapy can cause more side effects than other medication types because it cannot distinguish between cancerous and healthy cells. Chemotherapy is a treatment option for many cancers.
- Hormone (endocrine) therapy: Some cancers grow in response to hormones such as estrogen. Hormone therapy lowers the amount of these hormones or blocks their effect, slowing or even stopping the cancer’s growth.
- Immunotherapy: These medications help your body’s own immune system target and destroy cancer cells.
- Investigational treatments: These may include PARP inhibitors, immunotherapies such as dendritic cell therapy, and ovarian cancer vaccines. PARP inhibitors are cancer medications that block a certain protein in the cell. When the protein is blocked, the cancerous cells cannot duplicate and multiply.
You can receive cancer medications:
- By mouth (orally) as a pill
- Through the blood vessels (intravenously, or IV) as an injection or infusion
- Through an injection directly to your abdomen (intraperitoneal chemotherapy)
Scheduling cancer medication treatments
If your treatment plan involves cancer medications, you will have routine visits to have lab work done, see your doctor, and receive medication. You may need to come in once or twice per week. If you need an infusion, you will visit one of Stanford’s infusion treatment centers, where a nurse specializing in ovarian cancer care will provide your treatment.
Cancer medication side effects
Side effects from cancer medications vary depending on the type of medication you receive. Ask your care team—we can help you manage or prevent many symptoms and side effects that can affect your everyday life.
Radiation therapy is a painless treatment that uses high-energy X-rays or other types of radiation to destroy cancer cells. This treatment can be vital if you are newly diagnosed because radiation destroys cancer cells that may be left behind after surgery. Minimizing any remaining cancer cells can significantly reduce the risk of recurrence.
Your doctor may also recommend radiation therapy if ovarian cancer comes back (recurs). Using the latest technology, we can precisely target tumors and minimize damage to nearby healthy tissue.
Radiation therapy may provide effective treatment for the type of ovarian cancer you have. If so, your doctor will speak with you about the best options. The types of radiation therapy we use for ovarian cancer treatment at Stanford Health Care include:
External radiation
External radiation uses a machine called a linear accelerator (LINAC) to deliver radiation to the area where the cancer cells are located. We’re skilled at using several types of external radiation, including:
- 3D conformal radiation therapy (3D-CRT): With this method, 3D images help the doctor better target the tumor. A special machine—using computed tomography (CT) or magnetic resonance imaging (MRI) technology—creates the images. Your doctor can aim the radiation beams from many different angles to match the exact shape of the cancer.
- Intensity-modulated radiation therapy (IMRT): IMRT is similar to 3D-CRT, but the doctor can adjust how much radiation you get from each beam. In certain situations, this adjustment enables the doctor to avoid nearby healthy cells to reduce the risk of side effects.
- Stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR): This method works like the first two methods, and the total amount of radiation you get is similar. With SBRT, you receive fewer radiation doses, but each dose is stronger. Doctors often use SBRT to treat cervical cancers or other cancers.
Most ovarian cancers are not tied to hereditary risk. If you or one of your family members has a genetic mutation related to ovarian cancer, genetic testing and counseling may be helpful. Because inherited mutations cause approximately 25% of ovarian cancers, we do not want to miss anyone we can potentially help. Learn more about our Cancer Genetics Program.
Risk assessment
Assessing your risk involves looking at your personal and family medical histories. We may also recommend genetic testing. We use the most advanced techniques to evaluate many genes at once.
Throughout the process, our genetic counselors discuss the implications for your health, life, and family. We can also help you share information with relatives. Learn about cancer risk assessment with genetic testing and counseling.
Risk management
Our team continues to work on improving ovarian cancer screening methods. But current screening approaches often do not detect the disease until symptoms appear. Stanford Health Care doctors help write the national guidelines to reduce the risk of developing ovarian cancer, which include:
- Surgery: Many people with high inherited risk will not develop ovarian cancer. But, because we don’t yet have reliable screening methods for this type of cancer, we recommend having your ovaries and fallopian tubes removed if you have a high risk. The recommended age for this surgery ranges from the late 30s to late 40s and depends on the particular gene mutation. For people with Lynch syndrome, we also recommend removing the uterus.
- Support after surgery: We offer hormone replacement to counter the early-onset menopause that results from surgical removal of the ovaries and uterus. Our team also offers nonhormonal options for women with cancer or those who have already gone through menopause. A sexual medicine specialist can provide further help as needed.
- Oral contraceptives: Taking birth control medications can help prevent ovarian cancer in the short term. We still recommend eventual removal of the ovaries and fallopian tubes. We may suggest contraception if you want to have children or are years away from the recommended age for surgery.
- Cancer treatment: If you have ovarian cancer and a BRCA1 or BRCA2 mutation, we may recommend a PARP inhibitor. We may also recommend other treatments as necessary.
Genetic mutations and ovarian cancer
Mutations in specific genes can increase ovarian cancer risk. While researchers have not identified them all, the mutations we do know include:
- BRCA1 and BRCA2: Mutations in these genes cause most hereditary ovarian cancers, with ties to breast cancer and other cancers. Approximately 40% of people with a BRCA1 mutation develop ovarian cancer. Approximately 10% to 20% of people with a BRCA2 mutation develop ovarian cancer. In people without a mutation, fewer than 2% develop these cancers. Stanford doctors and scientists created a BRCA decision tool. People around the world use this tool to weigh their options.
- Genes related to Lynch syndrome: Mutations in MLH1, MSH2, EPCAM, MSH6, and PMS2 genes can raise ovarian cancer risk. These mutations can also cause skin, brain, colorectal, and other gastrointestinal cancers. Together, such familial cancers are called Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC).
- Other, rare mutations: Mutations in BARD1, BRIP1, RAD51C, RAD51D, DICER1, and other genes can increase your ovarian cancer risk. DICER1 mutations can cause a rare ovarian cancer called a Sertoli-Leydig cell tumor.
After you complete ovarian cancer treatment, your care team works with you to develop an ongoing care plan. Regular follow-up care, also known as surveillance, is important to:
- Check for possible signs of the cancer coming back (recurring)
- Manage any remaining side effects
- Monitor your overall health
We work closely with your primary care provider throughout your treatment, updating them on a regular basis. We continue this partnership after you finish treatment to coordinate your ongoing care for ovarian cancer and any other health concerns.
Clinical Trials for Ovarian Cancer
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials through the Stanford Cancer Institute.
Open trials refer to studies that are currently recruiting participants or that may recruit participants soon. Closed trials are not currently enrolling additional patients.
To schedule an appointment, please call: 650-498-6000