The second line of attack against ovarian cancer is typically chemotherapy treatment, using drugs to kill cancer cells. These drugs may be prescribed before or after surgery and may be administered in different ways:
- By vein (IV): The drugs can be given through a thin tube inserted into a vein.
- By vein and directly into the abdomen: Some women get IV chemotherapy along with Intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen. This highly specialized procedure must be administered by experienced providers and is typically only offered at large, comprehensive cancer centers.
- By mouth: Some drugs for ovarian cancer can be taken orally.
Intraperitoneal (IP) chemotherapy is a form of regional chemotherapy in which the drugs are delivered directly to the abdomen. This highly specialized procedure must be administered by experienced providers and is typically only offered at large, comprehensive cancer centers.
How it works
IP chemotherapy uses the same drugs as intravenous (IV) chemotherapy, but at 10 times to 100 times the concentration. A port is placed in the patient’s abdomen for easier drug delivery and the port likely stays in place several months, until the patient’s treatment is completed. Once the drugs are in the abdomen, the patient is rolled from side to side, bathing the peritoneal cavity in anticancer agents.
IP chemotherapy usually begins a couple weeks post surgery and continues every 3 weeks for six treatments. Because the toxicity of the drugs is higher, side effects may be more pronounced. The quality of the surgery is a factor in its effectiveness as well, as optimal debulking (removing all visible signs of tumor) is essential. Patients with early-stage ovarian cancer or those with certain risk factors may not be candidates for IP chemotherapy. Be sure to discuss this option, the risks and benefits, with your care team.
Hyperthermic Intraperitoneal Chemoperfusion (HIPEC) is another form of regional chemotherapy reserved for specific ovarian diagnoses. Similar to IP chemotherapy, HIPEC delivers high doses of chemotherapy drugs directly to the abdomen at the time of surgery, however these drugs are heated to fever range (107.6F), which improves their effectiveness.