Can ovarian cancer be cured?

Posted in ovarian cancer, treatment; Comments 1 ; Posted 3 years ago by Andreas Obermair

The chance of a cure depends on the type, grade and stage of ovarian cancer.

Cancer Australia estimates that in 2021 there will be over 1,700 patients diagnosed with ovarian cancer in Australia. Ovarian cancer occurs when cells in the ovaries grow and multiply uncontrollably creating a cancerous tumour.

Across all stages, patients diagnosed with ovarian cancer can expect an average 48% five-year survival rate. Ovarian cancer has the lowest five-year survival rate amongst all gynaecological cancers. The poorer survival rates for ovarian cancer may be due to the lack of effective and reliable screening options available, which means that the majority of patients present with symptoms at an advanced stage.

If your doctor suspects you have ovarian cancer, you may be asked to have blood tests (CA125 tumour test), and medical imaging scans (ultrasound, CT scan). These tests can show if there are any abnormalities that may be present and should be examined further. However, these tests don't confirm ovarian cancer. A diagnosis can only be made through examination of tissue under the microscope. Generally, the diagnosis can be confirmed and the cancer is treated together at the same time.

There is a high chance of a cure if ovarian cancer is diagnosed at stage 1 when the cancer is only located in one or both ovaries. We refer to a cure as there being no traces of cancer after treatment.

Stages 3 to 4 ovarian cancer means it is advanced cancer. Stage 3 cancer has spread beyond the pelvis to the lining of the abdomen or lymph nodes. If the cancer has spread to this stage, while this may sound worrying, it can still respond well to treatment and be kept under control.

Stage 4 ovarian cancer involves cancer spread to other organs such as the liver or the chest. If the cancer is diagnosed at stage 4, a cure is less likely than for stage 1. For women diagnosed at an advanced stage, cure rates are lower, and in some patients treatment may aim to slow down the spread of the cancer, increase longevity and improve quality of life.

What treatment will cure early-stage ovarian cancer?

For stage I ovarian cancer, surgery may be the only treatment needed when the tumour is in one or both ovaries only (oophorectomy). Your gynaecological oncologist might recommend also removing the fallopian tubes (salpingectomy), omentum (a fat pad arising from the stomach) or nearby lymph nodes. The uterus is removed in postmenopausal women. Chemotherapy may be suggested for stage I patients who are at a high risk of relapse otherwise.

Overall, surgeons are confident that there is a low likelihood of the cancer returning after this procedure.

Early-stage ovarian cancer in younger patients

If ovarian cancer is stage 1, in one ovary only, and a woman wishes to preserve fertility, the one affected ovary (unilateral oophorectomy) and one fallopian tube (unilateral salpingectomy) may be removed to preserve the ability to become pregnant.

Can treatment cure advanced ovarian cancer?

Treatment of ovarian cancer stages II to IV does not rely on surgical treatment alone. In such patients chemotherapy plays a key role to achieve good patient outcomes. A radical hysterectomy may be performed prior to chemotherapy to remove the tumour, both ovaries, uterus, cervix, soft tissue around the cervix and top of the vagina. Sometimes, chemotherapy can also be given before surgery to shrink the tumours to make them easier to remove. The procedure is often offered in combination with a lymph node removal.

I have treated patients who had far spread tumours that have shrunk with chemotherapy prior to surgery. Subsequent surgery can then remove all traces of the cancer.

Will my cancer return?

There is always a chance that cancer of all types and stages may recur. Recurrence may be local in the pelvis or at distant sites (such as the abdomen or lungs). After surgery and chemotherapy for ovarian cancer, it is important to see your specialist for a few years for follow-up. After five years, the risk of a recurrence becomes much lower. 

A gynaecological oncologist can discuss what type of surgery might be best for you. Like most types of cancer, the outcomes are better when ovarian cancer is found and treated early.

If you would like to read about treatment and outcomes of ovarian cancer, please refer to the Ovarian Cancer page. 

If you wish to discuss your prognosis and treatment options please contact Dr Obermair for an appointment.