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Advanced or recurrent ovarian cancer can cause symptoms that lead to pain or discomfort. Some symptoms may improve after ovarian cancer treatments, such as surgery, chemotherapy, and targeted therapy. However, cancer can also cause other, more serious problems that require specific treatments.
Locally advanced or advanced ovarian cancer describes stage 2, stage 3, and stage 4 tumors. It also includes advanced fallopian tube or primary peritoneal cancer. Cancers are classified as a higher stage when they have grown and spread to other areas. Some people are first diagnosed when cancer has already advanced. Others may have early-stage cancer that goes into remission after treatment, but returns later at a more advanced stage.
Read more about recurrent ovarian cancer.
Symptoms may start in the early stage of disease, but they are usually more common and more severe with advanced-stage ovarian cancer.
Symptoms may include:
Abdominal pain, bloating, and frequent urination can be caused by cancer spreading in your abdomen. When cancer cells spread and tumors grow, they can block the digestive or urinary system. Larger tumors also encourage fluid buildup in the area. These problems are common in advanced ovarian cancer.
Fluid buildup in the belly is called ascites. When your abdomen is full of liquid, it can cause constipation, breathing problems, nausea, or feeling very full after eating.
Ascites is often treated by draining the fluid. Your doctor will perform a minor procedure to place a tube into your abdomen and remove the extra fluid. This can ease symptoms for many people. If fluid keeps coming back, your doctor may place a tunneled indwelling peritoneal catheter that allows fluid to be drained at home. But what will stop liquid buildup for good is your personalized chemotherapy treatment.
A bowel blockage, also called a bowel obstruction, happens when food cannot pass through the intestines. Symptoms may include severe bloating, stomach pains, constipation, and frequent vomiting.
A bowel obstruction may be treated with medication or surgery. For example, pain relievers and anti-nausea medications may help. Surgery may help relieve symptoms, but it also may be hard for you to heal from, especially if you’re having other health problems. Your healthcare provider may also place a thin tube through your nose into your stomach and intestines to suction out air and fluid.
A ureter is a small tube that helps carry urine from the kidney to the bladder. Everyone has two ureters. If you have a large tumor in your abdomen, it may block one or both of these tubes, causing urine to back up.
There are a couple of different procedures that can fix a blocked ureter. One option is placing a stent, which is a small artificial tube that fits within the ureter and connects the kidney and the bladder. Another option for treating a ureter blockage is a nephrostomy tube. With this method, urine drains from a tube placed in the kidney and into a bag worn outside the body.
Stage 4 ovarian cancer means the cancer has spread to parts of the body far beyond the ovaries. In some cases, stage 4 ovarian cancer spreads to the lungs. This can cause fluid to build up between the lungs and the chest wall. This fluid buildup is called pleural effusion.
Symptoms may include:
There are a few procedures used to treat fluid around the lungs:
Cancer treatments can help ease cancer symptoms. However, they can also cause unpleasant side effects. Ask your doctor what side effects you may expect from your ovarian cancer treatments. Your care team can often help you reduce or eliminate these side effects.
Treatment of ovarian cancer often begins with surgery to remove the tumor. This can include:
Advanced ovarian cancers usually require debulking surgery. This type of surgery aims to remove as much cancer as possible from the abdomen. If cancer has spread to nearby organs, such as the bladder, intestines, or liver, parts of these organs may also need to be removed.
After surgery, you may need to stay in the hospital for a few days. You may also need to limit activity for a few weeks. Pain is common while healing from surgery. Your doctor will likely prescribe painkillers to help.
If both of your ovaries are removed, you’ll begin menopause. This can cause symptoms like hot flashes and vaginal dryness. To ease these symptoms, you can try:
Menopause also increases the risk of bone fractures. Your doctor may recommend vitamin D and calcium supplements to help strengthen your bones. They may also encourage weight-bearing exercise and bone-strengthening medications, depending on your personal medical history.
Advanced chemotherapy often involves one or more chemotherapy drugs. This often includes a platinum-based compound, which can kill cancer cells throughout the body. You may be given these medications before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy).
Chemotherapy side effects can be very unpleasant, but in many cases, they can be managed with medication, lifestyle changes, and physical therapy.
Learn more about treatment options if platinum-based chemotherapy doesn’t work.
Antianxiety and anti-nausea drugs can help. Some people also find ginger helpful.
You may find eating easier by having smaller meals more often, planning enjoyable meals with friends or family, and using nonalcoholic mouthwash to reduce dry mouth. A nutritionist can also offer helpful tips to make eating easier.
Acupuncture, physical therapy, or massage may help counteract the nerve damage that causes numbness.
If you feel unusually tired, try adjusting your sleep schedule to get more rest. Conserving energy during daily tasks, eating healthy foods, and doing light exercise may also help.
Relaxation exercises, doing activities you enjoy, medication, or talking to a counselor or therapist can help you manage anxiety and depression related to cancer.
Some advanced cancers are treated with targeted therapy drugs. These medications may be given along with chemotherapy. If treatments work and your cancer disappears, targeted therapy drugs can be used as maintenance treatment to help prevent your cancer from coming back.
However, targeted therapy can cause side effects. These may include tiredness, a higher risk of bleeding, headaches, or high blood pressure. In rare cases, targeted therapy may cause holes in the intestines, which require surgery.
If you have recurrent ovarian cancer, or if you have a BRCA mutation (a genetic change in the BRCA1 or BRCA2 genes), your doctor may recommend targeted therapy drugs known as PARP inhibitors. These medications make it harder for cancer cells to repair damage to their DNA.
PARP inhibitors can cause side effects, including:
Some people with ovarian cancer receive radiation therapy to help manage symptoms or treat tumors that have spread to other parts of the body. This treatment uses high-energy X-rays to destroy cancer cells.
Side effects from radiation can depend on the part of the body being treated and may include:
Many cancer symptoms can be treated. And most treatment side effects will go away once you stop receiving that treatment. If you experience side effects, talk to your care team. They may be able to help you treat the side effects or switch to a different treatment option.
Relieving cancer symptoms and treatment side effects is an important part of care. It can help you stay on treatment longer and feel better overall. This type of care is called palliative care. Working with a palliative care team can improve your quality of life, mental health, and overall outcomes.
If you have very advanced ovarian cancer, some treatments may not be helpful. Talk to your doctor about what to expect from each treatment, including possible benefits and risks, so you can make informed decisions about your care.
If you decide to stop cancer treatment, you can talk to your doctor about hospice or home care. Hospice care helps you live as comfortably as possible by reducing pain and other symptoms. It may allow you to spend time at home, rather than in the hospital. A hospice team supports both you and your family around the clock.
If you have ovarian cancer symptoms that are becoming worse or more frequent, talk to your doctor. You should also tell your oncology team about any side effects from treatment. Ask your oncologist how often you should have follow-up appointments to help manage your health and symptoms.
On MyOvarianCancerTeam, people share their experiences with ovarian cancer, get advice, and find support from others who understand.
Do you have tips for managing ovarian cancer symptoms? Let others know in the comments below.
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Has Anyone Had Brown Discharge From The Vagina? I Am Stage IV OC, Had Full Debulking Surgery And Been On Chemo For 3 1/2 Years.
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