How is Ovarian Cancer Treated?

This is the eighth page in the Understanding Ovarian Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on May 20, 2026.

The treatment for ovarian cancer depends on several factors, including the type of ovarian cancer, the stage, the genetic features of the tumor, your age, your desire for future fertility, and your overall health.

Most people with epithelial ovarian cancer receive a combination of surgery and chemotherapy, often followed by maintenance therapy. Targeted therapies and immunotherapies play an increasingly important role, particularly for cancers with specific genetic features. Treatment is best directed by a gynecologic oncologist, a specialist surgeon trained in gynecologic cancers. Multiple studies have shown that outcomes are better when ovarian cancer surgery is performed by a gynecologic oncologist.

Getting a second opinion from another gynecologic oncologist or medical oncologist is normal and encouraged.

Surgery for ovarian cancer

Surgery has two main goals: confirming the diagnosis and stage, and removing as much cancer as possible. The amount of cancer remaining after surgery is one of the most important factors affecting outcome. When all visible cancer can be removed, this is called “optimal” or “complete” cytoreduction.

Staging surgery

For early-stage ovarian cancer, surgery focuses on confirming the diagnosis, determining the stage, and removing the cancer. This typically includes removing the uterus, both ovaries and fallopian tubes, the omentum (a fatty tissue layer that drapes over the abdominal organs), and sampling of lymph nodes and the peritoneum. For young patients with very early-stage disease who wish to preserve fertility, more limited surgery may be considered in selected cases.

Cytoreductive (debulking) surgery

For advanced ovarian cancer, the surgeon removes as much visible tumor as possible. This can include parts of the bowel, peritoneum, diaphragm, spleen, or other organs as needed. Achieving complete or near-complete removal of visible cancer significantly improves outcomes.

Interval debulking surgery

In some cases of advanced ovarian cancer, chemotherapy is given first to shrink the tumors. This is called neoadjuvant chemotherapy. Surgery is then performed in the middle of the chemotherapy course, followed by additional chemotherapy. This approach is often considered when complete surgical removal is unlikely up front or when a patient is not strong enough for major surgery initially.

Chemotherapy for ovarian cancer

Chemotherapy is a cornerstone of ovarian cancer treatment. The standard initial chemotherapy combines a platinum drug with a taxane:

• Platinum-based drugs. Carboplatin is most commonly used. Cisplatin is sometimes used in specific situations.
• Taxanes. Paclitaxel (Taxol) is most often used. Docetaxel (Taxotere) is an alternative.

Chemotherapy is most often given intravenously every three weeks for several cycles. In select cases, chemotherapy may be given directly into the abdomen or as heated intraperitoneal chemotherapy (HIPEC) at the time of surgery.

Chemotherapy for recurrent ovarian cancer

When ovarian cancer returns, the choice of chemotherapy depends on how long it has been since the last platinum-based treatment. Drugs that may be used include carboplatin combinations, pegylated liposomal doxorubicin (Doxil), gemcitabine, topotecan, and weekly paclitaxel.

Targeted therapy for ovarian cancer

Targeted therapies are drugs that attack specific proteins or gene mutations in cancer cells:

PARP inhibitors

PARP inhibitors block an enzyme that cancer cells use to repair DNA damage. They are particularly effective in cancers with BRCA mutations or other defects in DNA repair (HRD-positive). PARP inhibitors are most often used as maintenance therapy after a good response to chemotherapy:

• Olaparib (Lynparza)
• Niraparib (Zejula)
• Rucaparib (Rubraca)

Anti-angiogenic therapy

Bevacizumab (Avastin) is an antibody that blocks the formation of new blood vessels that tumors need to grow. It is used in combination with chemotherapy and as maintenance therapy in selected patients with advanced or recurrent ovarian cancer.

Targeted therapies for less common subtypes

MEK inhibitors such as trametinib (Mekinist) have shown benefit in recurrent low-grade serous ovarian cancer. Other targeted therapies may be used for cancers with specific genetic features, such as NTRK fusions or BRAF mutations.

Immunotherapy for ovarian cancer

Immunotherapy helps the immune system find and destroy cancer cells. Its role in ovarian cancer is still evolving:

• Checkpoint inhibitors such as pembrolizumab (Keytruda) may be used for ovarian cancers with high microsatellite instability (MSI-H), mismatch repair deficiency, or high tumor mutational burden.
• Antibody-drug conjugates such as mirvetuximab soravtansine (Elahere) target the folate receptor alpha protein, which is highly expressed in many ovarian cancers. It is used in platinum-resistant ovarian cancer that expresses folate receptor alpha.

Hormone therapy for ovarian cancer

Hormone therapy is sometimes used for low-grade serous ovarian cancer, certain stromal tumors, and selected cases of recurrent disease. Drugs may include aromatase inhibitors such as letrozole or anastrozole, or tamoxifen.

Treating recurrent and metastatic ovarian cancer

When ovarian cancer returns, treatment is typically focused on controlling the cancer, extending life, and maintaining quality of life. The choice of treatment depends on the timing of recurrence (platinum-sensitive vs. platinum-resistant), prior treatments, BRCA and HRD status, and individual patient factors. Many patients with recurrent ovarian cancer live for years with treatment, often cycling through multiple lines of therapy.

Supportive and palliative care for ovarian cancer

Treating the symptoms of cancer and side effects of treatment is called supportive and palliative care. This is an important part of cancer treatment at every stage, not just at the end of life. Palliative care can include:

• Pain management
• Management of treatment-related side effects (such as nausea, fatigue, neuropathy, and low blood counts)
• Management of ascites and bowel obstruction
• Nutritional support from a registered dietitian
• Physical and occupational therapy
• Mental health support and counseling
• Sexual health and intimacy support

There is a common misconception that palliative care is only given at the end of life. Palliative and supportive care can be given at any time during cancer treatment.

Follow-up care after treatment

After ovarian cancer treatment ends, regular follow-up appointments are essential to watch for signs of recurrence and to monitor for side effects of treatment. Follow-up typically includes physical and pelvic exams, CA-125 blood tests, and imaging as clinically indicated. Schedules vary based on stage and treatment, but follow-up generally continues for at least 5 years.