Ovarian cancer is frequently controlled with chemotherapy, and although you can feel fit and well, the disease often returns. This is known as relapse, or recurrence.

If your ovarian cancer returns after initial, first-line chemotherapy, you can use a different, second-line drug to achieve another remission. Some people may go on to receive third-line or fourth-line chemotherapy to control the cancer.

Your second treatment will depend on how successful your first treatment was. This is judged by how long the cancer has taken to come back.

Relapsed ovarian cancer is put into two different groups:

1. Cancer that has come back less than six months after finishing first line platinum-based chemotherapy, such as Carboplatin or Cisplatin. This is called platinum-resistant cancer. If the cancer never responded to platinum-based chemotherapy, this is called platinum refractory ovarian cancer. In these situations your oncologist will discuss treatment options such as Taxol, Caelyx, or suggest you try new treatments available in a clinical trial.

2. Cancer that responded to first line platinum chemotherapy, which has come back more than six months after the end of treatment. This is called platinum sensitive ovarian cancer. This is usually treated with platinum-based chemotherapy, plus another drug such as Taxol or Caelyx. Your doctor may suggest adding additional drugs that are available in a clinical trial.

You and your oncologist will need to consider other issues to decide second-line treatment. These are:

• How did your illness respond to the drugs before?
• What are the drug’s possible side effects?
• Do you have an allergy to platinum-based drugs?
• What are the likely benefits of the second line drug?

 

Further surgery

Research has shown that some people can benefit from having a second operation before having platinum-based chemotherapy. These are people who have had all visible signs of ovarian cancer removed at their first surgery, their cancer returned  more than six months after the end of their first-line chemotherapy, they do not have ascites and they are physically well and the surgeon expects to remove all visible cancer.

For people in these circumstances, a second surgery followed by chemotherapy can result in a significant delay in the cancer returning.

 

Other treatments

Hormonal treatments such as tamoxifen and letrozole can control cancer by blocking hormones.

Targeted therapies such PARP inhibitors olaparib, niraparib and rucaparib work by interfering with the cancer’s DNA.

Avastin (bevacizumab) is a drug that interferes with the cancer’s blood supply.

You may also want to talk to your oncologist, to see if there is a suitable clinical trial that you can take part in.

You may want to get a second opinion about your situation. There is more information in our booklet Treatments for relapsed ovarian cancer.

Please call our free support line 0800 008 7054 for more information.

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Last review August 2020

Date of next review August 2022