Ovarian Epithelial, Fallopian Tube, and Primary
Peritoneal Cancer
General Information(Symptoms and Diagnosis)
Stages
Treatment
Treatment Options By Stage
General Information About Ovarian Epithelial, Fallopian Tube,
and Primary Peritoneal Cancer
Key Points
- Ovarian epithelial cancer, fallopian tube cancer, and
primary peritoneal cancer are diseases in which malignant (cancer)
cells form in the tissue covering the ovary or lining the fallopian
tube or peritoneum.
- Ovarian epithelial cancer, fallopian tube cancer, and
primary peritoneal cancer form in the same type of tissue and are
treated the same way.
- Women who have a family history of ovarian cancer are at an
increased risk of ovarian cancer.
- Some ovarian, fallopian tube, and primary peritoneal
cancers are caused by inherited gene mutations (changes).
- Women with an increased risk of ovarian cancer may consider
surgery to lessen the risk.
- Signs and symptoms of ovarian, fallopian tube, or
peritoneal cancer include pain or swelling in the abdomen.
- Tests that examine the ovaries and pelvic area are used to
detect (find) and diagnose ovarian, fallopian tube, and peritoneal
cancer.
- Certain factors affect treatment options and prognosis
(chance of recovery).
Ovarian
epithelial cancer, fallopian tube cancer, and primary peritoneal cancer
are diseases in which malignant (cancer) cells form in the tissue
covering the ovary or lining the fallopian tube or peritoneum.
The ovaries
are a pair of organs
in the female reproductive
system. They are in the pelvis,
one on each side of the uterus
(the hollow, pear-shaped organ where a fetus
grows). Each ovary is about the size and shape of an almond. The
ovaries make eggs and female hormones
(chemicals that control the way certain cells
or organs work).
The fallopian
tubes are a pair of long, slender tubes, one on each side
of
the uterus. Eggs pass from the ovaries, through the fallopian tubes, to
the uterus. Cancer
sometimes begins at the end of the fallopian tube near the ovary and
spreads to the ovary.
The peritoneum
is the tissue
that lines the abdominal
wall and covers organs in the abdomen.
Primary
peritoneal cancer is cancer that forms in the peritoneum
and
has not spread there from another part of the body. Cancer sometimes
begins in the peritoneum and spreads to the ovary.
Anatomy of the female
reproductive system. The organs in the female reproductive system
include the uterus, ovaries, fallopian tubes, cervix, and vagina. The
uterus has a muscular outer layer called the myometrium and an inner
lining called the endometrium.
Ovarian
epithelial cancer is one type of cancer that affects the
ovary. See the following PDQ
treatment summaries for information about other types of ovarian tumors:
- Ovarian
Germ Cell Tumors
- Ovarian
Low Malignant Potential Tumors
- Unusual
Cancers of Childhood Treatment (ovarian cancer in children)
Ovarian
epithelial cancer, fallopian tube cancer, and primary peritoneal cancer
form in the same type of tissue and are treated the same way.
Women
who have a family history of ovarian cancer are at an increased risk of
ovarian cancer.
Anything that increases
your risk of getting a disease is called a risk
factor. Having a risk factor does not mean that you will
get
cancer; not having risk factors doesn't mean that you will not get
cancer. Talk with your doctor if you think you may be at risk.
Women who have one first-degree
relative (mother, daughter, or sister) with a history
of ovarian
cancer have an increased risk of ovarian cancer. This risk
is
higher in women who have one first-degree relative and one
second-degree relative (grandmother or aunt) with a history of ovarian
cancer. This risk is even higher in women who have two or more
first-degree relatives with a history of ovarian cancer.
Some
ovarian, fallopian tube, and primary peritoneal cancers are caused by
inherited gene mutations (changes).
The genes
in cells carry the hereditary
information that is received from a person's parents. Hereditary
ovarian cancer makes up about 20% of all cases of ovarian cancer. There
are three hereditary patterns: ovarian cancer alone, ovarian and breast
cancers, and ovarian and colon
cancers.
Fallopian
tube cancer and peritoneal cancer may also be caused by
certain inherited
gene mutations.
There are tests that can
detect gene mutations. These genetic
tests are sometimes done for members of families with a
high
risk of cancer. See the following PDQ summaries for more information:
- Ovarian,
Fallopian Tube, and Primary Peritoneal Cancer Prevention
- Genetics
of Breast and Gynecologic Cancers (for health professionals)
Women
with an increased risk of ovarian cancer may consider surgery to lessen
the risk.
Some women who have an
increased risk of ovarian cancer may choose to have a risk-reducing oophorectomy
(the removal of healthy ovaries so that cancer cannot grow in them). In
high-risk women, this procedure has been shown to greatly decrease the
risk of ovarian cancer. (See the PDQ summary on Ovarian,
Fallopian Tube, and Primary Peritoneal Cancer Prevention for
more information.)
Signs
and symptoms of ovarian, fallopian tube, or peritoneal cancer include
pain or swelling in the abdomen.
Ovarian, fallopian tube,
or peritoneal cancer may not cause early signs
or symptoms.
When signs or symptoms do appear, the cancer is often advanced.
Signs and symptoms may include the following:
- Pain, swelling, or a feeling of pressure in the abdomen or
pelvis.
- Vaginal
bleeding that is heavy or irregular, especially after menopause.
- Vaginal discharge
that is clear, white, or colored with blood.
- A lump in the pelvic area.
- Gastrointestinal
problems, such as gas, bloating,
or constipation.
These signs and symptoms
also may be caused by other conditions
and not by ovarian, fallopian tube, or peritoneal cancer. If the signs
or symptoms get worse or do not go away on their own, check with your
doctor so that any problem can be diagnosed
and treated as early as possible.
Tests
that examine the ovaries and pelvic area are used to detect (find) and
diagnose ovarian, fallopian tube, and peritoneal cancer.
The following tests and
procedures may be used:
- Physical
exam and history
: An exam of the body to check general signs of
health, including checking for signs of disease, such as lumps or
anything else that seems unusual. A history of the patient's health
habits and past illnesses and treatments will also be taken.
- Pelvic
exam : An exam of the vagina,
cervix,
uterus, fallopian
tubes, ovaries, and rectum.
A speculum
is inserted into the vagina and the doctor or nurse
looks at the vagina and cervix for signs of disease. A Pap
test of the cervix is usually done. The doctor or nurse
also
inserts one or two lubricated,
gloved fingers of one hand into the vagina and places the other hand
over the lower abdomen to feel the size, shape, and position of the
uterus and ovaries. The doctor or nurse also inserts a lubricated,
gloved finger into the rectum to feel for lumps or abnormal areas.
Pelvic exam. A doctor
or nurse inserts one or two lubricated, gloved fingers of one hand into
the vagina and presses on the lower abdomen with the other hand. This
is done to feel the size, shape, and position of the uterus and
ovaries. The vagina, cervix, fallopian tubes, and rectum are also
checked.
- CA
125 assay
: A test that measures the level of CA 125 in the
blood. CA 125 is a substance released by cells into the bloodstream. An
increased CA 125 level can be a sign of cancer or another condition
such as endometriosis.
- Ultrasound
exam: A procedure in which high-energy sound waves
(ultrasound) are bounced off internal tissues
or organs in the abdomen, and make echoes. The echoes form a picture of
body tissues called a sonogram.
The picture can be printed to be looked at later.
Abdominal ultrasound.
An ultrasound transducer connected to a computer is passed over the
surface of the abdomen. The ultrasound transducer bounces sound waves
off internal organs and tissues to make echoes that form a sonogram
(computer picture).
Some patients may have a transvaginal
ultrasound.
Transvaginal
ultrasound. An ultrasound probe connected to a computer is inserted
into the vagina and is gently moved to show different organs. The probe
bounces sound waves off internal organs and tissues to make echoes that
form a sonogram (computer picture).
- CT
scan (CAT scan): A procedure that makes a
series of detailed pictures of areas inside the body, taken from
different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This
procedure is also called computed tomography, computerized tomography,
or computerized axial tomography.
- PET
scan (positron emission tomography scan): A
procedure to find malignant
tumor cells in the body. A very small amount of radioactive
glucose
(sugar) is injected into a vein. The PET scanner
rotates around the body and makes a picture of where glucose is being
used in the body. Malignant tumor cells show up brighter in the picture
because they are more active and take up more glucose than normal cells
do.
- MRI
(magnetic resonance imaging): A procedure that uses a
magnet, radio
waves, and a computer to make a series of detailed
pictures
of areas inside the body. This procedure is also called nuclear
magnetic resonance imaging (NMRI).
- Chest
x-ray : An x-ray of the organs and bones
inside the chest. An x-ray is a type of energy beam that can go through
the body and onto film, making a picture of areas inside the body.
- Biopsy
: The removal of cells or tissues so they can be
viewed under a microscope
by a pathologist
to check for signs of cancer. The tissue is usually removed during surgery
to remove the tumor.
Certain
factors affect treatment options and prognosis (chance of recovery).
The prognosis
(chance of recovery)
and treatment options depend on the following:
- The type of ovarian cancer and how much cancer there is.
- The stage
and grade
of the cancer.
- Whether the patient has extra fluid
in the abdomen that causes swelling.
- Whether all of the tumor can be removed by surgery.
- Whether there are changes in the BRCA1
or BRCA2
genes.
- The patient's age and general health.
- Whether the cancer has just been diagnosed
or has recurred
(come back).
Stages of Ovarian Epithelial, Fallopian Tube, and Primary
Peritoneal Cancer
Key Points
- After ovarian, fallopian tube, or peritoneal cancer has
been diagnosed, tests are done to find out if cancer cells have spread
within the ovaries or to other parts of the body.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the
body.
- The following stages are used for ovarian epithelial,
fallopian tube, and primary peritoneal cancer:
- Stage I
- Stage II
- Stage III
- Stage IV
- Ovarian epithelial, fallopian tube, and primary peritoneal
cancers are grouped for treatment as early or advanced cancer.
After
ovarian, fallopian tube, or peritoneal cancer has been diagnosed, tests
are done to find out if cancer cells have spread within the ovaries or
to other parts of the body.
The process used to find
out whether cancer
has spread within the organ
or to other parts of the body is called staging.
The information gathered from the staging process determines the stage
of the disease. It is important to know the stage in order to plan
treatment. The results of the tests used to diagnose
cancer are often also used to stage the disease. (See the General
Information section.)
There
are three ways that cancer spreads in the body.
Cancer can spread
through tissue,
the lymph
system, and the blood:
- Tissue. The cancer spreads from where it began by growing
into nearby areas.
- Lymph system. The cancer spreads from where it began by
getting into the lymph system. The cancer travels through the lymph
vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting
into the blood. The cancer travels through the blood
vessels to other parts of the body.
Cancer
may spread from where it began to other parts of the body.
When cancer spreads
to another part of the body, it is called metastasis.
Cancer cells
break away from where they began (the primary
tumor) and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system,
travels through the lymph vessels, and forms a tumor
(metastatic
tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the
blood vessels, and forms a tumor (metastatic tumor) in another part of
the body.
The metastatic tumor is
the same type of cancer as the primary tumor. For example, if ovarian
epithelial cancer spreads to the lung,
the cancer cells in the lung are actually ovarian epithelial cancer
cells. The disease is metastatic ovarian epithelial cancer, not lung
cancer.
The
following stages are used for ovarian epithelial, fallopian tube, and
primary peritoneal cancer:
Stage
I
In stage IA, cancer is
found inside a single ovary or fallopian tube. In stage IB, cancer is
found inside both ovaries or fallopian tubes. In stage IC, cancer is
found inside one or both ovaries or fallopian tubes and one of the
following is true: (a) the capsule (outer covering) of the ovary has
ruptured, (b) cancer is also found on the outside surface of one or
both ovaries or fallopian tubes, or (c) cancer cells are found in the
pelvic peritoneum.
In stage
I, cancer
is found in one or both ovaries
or fallopian
tubes. Stage I is divided into stage IA, stage IB, and
stage
IC.
- Stage
IA: Cancer is found inside a single ovary
or fallopian
tube.
- Stage
IB: Cancer is found inside both ovaries
or fallopian
tubes.
- Stage
IC: Cancer is found inside one or both ovaries
or fallopian
tubes and one of the following is true:
- cancer is also found on the outside surface of one or
both ovaries or fallopian tubes; or
- the capsule
(outer covering) of the ovary ruptured (broke open) before or during surgery;
or
- cancer cells
are found in the fluid
of the peritoneal
cavity (the body cavity
that contains most of the organs
in the abdomen)
or in washings
of the peritoneum
(tissue
lining the peritoneal cavity).
Stage
II
In stage IIA, cancer is
found in one or both ovaries or fallopian tubes and has spread to the
uterus and/or the fallopian tubes and/or the ovaries. In stage IIB,
cancer is found in one or both ovaries or fallopian tubes and has
spread to the colon. In primary peritoneal cancer, cancer is found in
the pelvic peritoneum and has not spread there from another part of the
body.
In stage
II, cancer
is found in one or both ovaries
or fallopian
tubes and has spread into other areas of the pelvis,
or primary
peritoneal cancer is found within the pelvis. Stage II
ovarian epithelial and fallopian tube cancers are divided into stage
IIA and stage IIB.
- Stage
IIA: Cancer has spread from where it first formed to the uterus
and/or the fallopian
tubes and/or the ovaries.
- Stage
IIB: Cancer has spread from the ovary
or fallopian
tube to organs
in the peritoneal
cavity (the space that contains the abdominal
organs).
Pea, peanut, walnut, and
lime show tumor sizes.
Stage
III
In stage
III, cancer
is found in one or both ovaries
or fallopian
tubes, or is primary
peritoneal cancer, and has spread outside the pelvis
to other parts of the abdomen
and/or to nearby lymph
nodes. Stage III is divided into stage IIIA, stage IIIB,
and
stage IIIC.
- In stage
IIIA, one of the following is true:
- Cancer has spread to lymph
nodes in the area outside or behind the peritoneum
only; or
- Cancer cells
that can be seen only with a microscope
have spread to the surface of the peritoneum
outside the pelvis.
Cancer may have spread to nearby lymph
nodes.
In stage IIIA, cancer
is found in one or both ovaries or fallopian tubes and (a) cancer has
spread to lymph nodes in the area outside or behind the peritoneum
only, or (b) cancer cells that can be seen only with a microscope have
spread to the omentum. Cancer may have spread to nearby lymph nodes.
- Stage
IIIB: Cancer has spread to the peritoneum
outside the pelvis
and the cancer in the peritoneum is 2 centimeters
or smaller. Cancer may have spread to lymph
nodes behind the peritoneum.
In stage IIIB, cancer
is found in one or both ovaries or fallopian tubes and has spread to
the omentum, and the cancer in the omentum is 2 centimeters or smaller.
Cancer may have spread to lymph nodes behind the peritoneum.
- Stage
IIIC: Cancer has spread to the peritoneum
outside the pelvis
and the cancer in the peritoneum is larger than 2 centimeters.
Cancer may have spread to lymph
nodes behind the peritoneum or to the surface of the liver
or spleen.
In stage IIIC, cancer
is found in one or both ovaries or fallopian tubes and has spread to
the omentum, and the cancer in the omentum is larger than 2
centimeters. Cancer may have spread to lymph nodes behind the
peritoneum or to the surface of the liver or spleen.
Stage
IV
In stage IV, cancer has
spread beyond the abdomen to other parts of the body. In stage IVA,
cancer cells are found in extra fluid that builds up around the lungs.
In stage IVB, cancer has spread to organs and tissues outside the
abdomen, including the lung, liver, bone, and lymph nodes in the groin.
In stage
IV, cancer
has spread beyond the abdomen
to other parts of the body. Stage IV is divided into stage IVA and
stage IVB.
- Stage
IVA: Cancer cells
are found in extra fluid
that builds up around the lungs.
- Stage
IVB: Cancer has spread to organs
and tissues
outside the abdomen,
including lymph
nodes in the groin.
Ovarian
epithelial, fallopian tube, and primary peritoneal cancers are grouped
for treatment as early or advanced cancer.
Stage I ovarian
epithelial and fallopian tube cancers are treated as early cancers.
Stages II, III, and IV
ovarian epithelial, fallopian tube, and primary peritoneal cancers are
treated as advanced
cancers.
Recurrent or Persistent Ovarian Epithelial, Fallopian Tube,
and Primary Peritoneal Cancer
Recurrent
ovarian
epithelial cancer, fallopian
tube cancer, or primary
peritoneal cancer is cancer
that has recurred (come back) after it has been treated. Persistent
cancer is cancer that does not go away with treatment.
Treatment Option Overview
Key Points
- There are different types of treatment for patients with
ovarian epithelial cancer.
- Three kinds of standard treatment are used.
- Surgery
- Chemotherapy
- Targeted therapy
- New types of treatment are being tested in clinical trials.
- Radiation therapy
- Immunotherapy
- Patients may want to think about taking part in a clinical
trial.
- Patients can enter clinical trials before, during, or after
starting their cancer treatment.
- Follow-up tests may be needed.
There
are different types of treatment for patients with ovarian epithelial
cancer.
Different types of
treatment are available for patients with ovarian
epithelial cancer. Some treatments are standard,
and some are being tested in clinical
trials. A treatment clinical trial is a research
study meant to help improve current treatments or obtain
information on new treatments for patients with cancer.
When clinical trials show that a new treatment is better than the
treatment currently used as standard treatment, the new treatment may
become the standard treatment. Patients with any stage
of ovarian cancer may want to think about taking part in a clinical
trial. Some clinical trials are open only to patients who have not
started treatment.
Three
kinds of standard treatment are used.
Surgery
Most patients have surgery
to remove as much of the tumor
as possible. Different types of surgery may include:
- Hysterectomy:
Surgery to remove the uterus
and, sometimes, the cervix.
When only the uterus is removed, it is called a partial
hysterectomy. When both the uterus and the cervix are
removed, it is called a total
hysterectomy. If the uterus and cervix are taken out
through
the vagina,
the operation is called a vaginal
hysterectomy. If the uterus and cervix are taken out through a large incision
(cut) in the abdomen,
the operation is called a total abdominal
hysterectomy. If the uterus and cervix are taken out through a small
incision (cut) in the abdomen using a laparoscope,
the operation is called a total laparoscopic hysterectomy.
Hysterectomy. The
uterus is surgically removed with or without other organs or tissues.
In a total hysterectomy, the uterus and cervix are removed. In a total
hysterectomy with salpingo-oophorectomy, (a) the uterus plus one
(unilateral) ovary and fallopian tube are removed; or (b) the uterus
plus both (bilateral) ovaries and fallopian tubes are removed. In a
radical hysterectomy, the uterus, cervix, both ovaries, both fallopian
tubes, and nearby tissue are removed. These procedures are done using a
low transverse incision or a vertical incision.
- Unilateral
salpingo-oophorectomy: A surgical procedure to remove one ovary
and one fallopian
tube.
- Bilateral
salpingo-oophorectomy: A surgical procedure to remove both
ovaries and both fallopian tubes.
- Omentectomy:
A surgical procedure to remove the omentum
(tissue
in the peritoneum
that contains blood
vessels, nerves,
lymph
vessels, and lymph
nodes).
- Lymph node biopsy:
The removal of all or part of a lymph node. A pathologist
views the tissue under a microscope
to look for cancer cells.
Chemotherapy
Chemotherapy
is a cancer treatment that uses drugs
to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. When chemotherapy is taken by mouth or injected
into a vein
or muscle, the drugs enter the bloodstream and can reach cancer cells
throughout the body (systemic
chemotherapy). When chemotherapy is placed directly into
the cerebrospinal
fluid, an organ,
or a body cavity
such as the abdomen, the drugs mainly affect cancer cells in those
areas (regional
chemotherapy).
A type of regional
chemotherapy used to treat ovarian
cancer is intraperitoneal
(IP) chemotherapy. In IP chemotherapy, the anticancer
drugs
are carried directly into the peritoneal
cavity (the space that contains the abdominal organs)
through a thin tube.
Treatment with more than
one anticancer drug is called combination
chemotherapy.
The way the chemotherapy
is given depends on the type and stage of the cancer being treated.
See Drugs
Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
for more information.
Targeted
therapy
Targeted
therapy is a type of treatment that uses drugs or other
substances to identify and attack specific cancer cells without harming
normal cells.
Monoclonal
antibody therapy
is a type of targeted therapy that uses antibodies
made in the laboratory, from a single type of immune
system cell. These antibodies can identify substances on
cancer cells or normal substances that may help cancer cells grow. The
antibodies attach to the substances and kill the cancer cells, block
their growth, or keep them from spreading. Monoclonal antibodies are
given by infusion.
They may be used alone or to carry drugs, toxins,
or radioactive material directly to cancer cells.
Bevacizumab
is a monoclonal antibody that may be used with chemotherapy to treat ovarian
epithelial cancer, fallopian
tube cancer, or primary
peritoneal cancer that has recurred (come back).
Poly
(ADP-ribose) polymerase inhibitors (PARP inhibitors) are
targeted therapy drugs that block DNA
repair and may cause cancer cells to die. Olaparib
and niraparib are PARP inhibitors that may be used to treat advanced
ovarian cancer.
See Drugs
Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
for more information.
New
types of treatment are being tested in clinical trials.
This summary section
describes treatments that are being studied in clinical trials. It may
not mention every new treatment being studied. Information about
clinical trials is available from the NCI
website.
Radiation
therapy
Radiation
therapy is a cancer treatment that uses high-energy x-rays
or other types of radiation
to kill cancer cells or keep them from growing. Some women receive a
treatment called intraperitoneal
radiation therapy, in which radioactive liquid is put
directly in the abdomen through a catheter. Intraperitoneal radiation
therapy is being studied to treat advanced ovarian cancer.
Immunotherapy
Immunotherapy
is a treatment that uses the patient's immune
system to fight cancer. Substances made by the body or
made
in a laboratory are used to boost, direct, or restore the body's
natural defenses against cancer. This type of cancer treatment is also
called biotherapy or immunotherapy.
Vaccine
therapy uses a substance to stimulate the immune system to
destroy a tumor. Vaccine therapy is being studied to treat advanced
ovarian cancer.
Patients
may want to think about taking part in a clinical trial.
For some patients,
taking part in a clinical
trial may be the best treatment choice. Clinical trials
are
part of the cancer research process. Clinical trials are done to find
out if new cancer treatments are safe and effective or better than the standard
treatment.
Many of today's
standard treatments for cancer are based on earlier clinical trials.
Patients who take part in a clinical trial may receive the standard
treatment or be among the first to receive a new treatment.
Patients who take
part in clinical trials also help improve the way cancer will be
treated in the future. Even when clinical trials do not lead to
effective new treatments, they often answer important questions and
help move research forward.
Patients
can enter clinical trials before, during, or after starting their
cancer treatment.
Some clinical trials
only include patients who have not yet received treatment. Other trials
test treatments for patients whose cancer has not gotten better. There
are also clinical trials that test new ways to stop cancer from recurring
(coming back) or reduce the side
effects of cancer treatment.
Clinical trials are
taking place in many parts of the country. See the Treatment Options
section that follows for links to current treatment clinical trials.
These have been retrieved from NCI's
listing of clinical trials.
Follow-up
tests may be needed.
Some of the tests
that were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to
continue, change, or stop treatment may be based on the results of
these tests.
Some of the tests
will continue to be done from time to time after treatment has ended.
The results of these tests can show if your condition
has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up
tests or check-ups.
Treatment Options by Stage
Early Ovarian Epithelial and Fallopian
Tube Cancer
Treatment of early ovarian
epithelial cancer or fallopian
tube cancer may include the following:
- Hysterectomy,
bilateral
salpingo-oophorectomy, and omentectomy.
Lymph
nodes and other tissues
in the pelvis
and abdomen
are removed and checked under a microscope
for cancer
cells.
Chemotherapy
may be given after surgery.
- Unilateral
salpingo-oophorectomy may be done in certain women who
wish
to have children. Chemotherapy may be given after surgery.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage
I ovarian epithelial cancer and fallopian
tube cancer. For more specific results, refine the search by
using other search features, such as the location of the trial, the
type of treatment, or the name of the drug. Talk with your doctor about
clinical trials that may be right for you. General information about
clinical trials is available from the NCI
website.
Advanced Ovarian Epithelial, Fallopian
Tube, and Primary Peritoneal Cancer
Treatment of advanced ovarian
epithelial cancer, fallopian
tube cancer, or primary
peritoneal cancer may include the following:
- Hysterectomy,
bilateral
salpingo-oophorectomy, and omentectomy.
Lymph
nodes and other tissues
in the pelvis
and abdomen
are removed and checked under a microscope
to look for cancer
cells.
Surgery
is followed by one of the following:
- Intravenous
chemotherapy.
- Intraperitoneal
chemotherapy.
- Chemotherapy
and targeted
therapy (bevacizumab,
olaparib,
or niraparib).
- Chemotherapy followed by hysterectomy, bilateral
salpingo-oophorectomy, and omentectomy.
- Chemotherapy alone for patients who cannot have surgery.
- A clinical
trial of intraperitoneal
radiation therapy, immunotherapy
(vaccine
therapy), or targeted therapy.
Treatment Options for Recurrent or Persistent Ovarian
Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
Treatment of recurrent
ovarian
epithelial cancer, fallopian
tube cancer, and primary
peritoneal cancer may include the following:
- Chemotherapy
using one or more anticancer drugs.
- Targeted
therapy (bevacizumab)
with or without chemotherapy.
- A clinical
trial of surgery.
- A clinical trial of a new treatment.
