Although ovarian cancer can be controlled with surgery and chemotherapy, allowing you to feel well, the disease often returns. This is known as relapse, or recurrence of the cancer. It is difficult to predict how long the benefits of your treatment will last, as it varies in each individual case. Some treatments may work for a few months, while other women have such a good response to chemotherapy that they remain in remission for five years and beyond - and they are considered cured.
If your ovarian cancer returns after initial, first-line, chemotherapy, it is often appropriate to use further chemotherapy (second-line chemotherapy) to bring about another remission. Some women may go on to receive third-line or even fourth-line chemotherapy to control the cancer depending on their individual circumstances.
The following categories may be helpful to you and your oncologist when deciding which drugs to give you as second-line chemotherapy:
• Platinum refractory ovarian cancer; this is cancer that has not responded to first-line platinum based chemotherapy such as carboplatin or cisplatin.
• Platinum resistant ovarian cancer; this is cancer that returns within six months of finishing first-line platinum based chemotherapy.
• Platinum sensitive ovarian cancer; this is cancer that had responded to first-line platinum based chemotherapy but has returned 12 months or more after finishing first-line treatment.
• Partially platinum sensitive ovarian cancer; this is cancer that had responded to first-line platinum based chemotherapy but has returned between 6 and 12 months after finishing first-line treatment.
Other considerations when deciding on second line chemotherapy may be:
• how you responded to the drug before
• possible side effects
• whether you have an allergy to platinum-based drugs
• the likely benefits of the drug
Your oncologist will discuss the risks and benefits of each treatment option with you before making any decision on second-line or subsequent chemotherapy.
You should be given time to discuss your treatment options with your healthcare team, members of your family and others, such as your GP if you wish.
If there is a clinical trial for which you may be eligible, your oncologist will discuss this option with you.
Facing relapsed disease you may feel as you felt when you were newly diagnosed, but some women say that they feel even more uncertain following a relapse.
Many find it harder to deal with than their original diagnosis. You will have put a lot of time and energy into getting well so you might feel upset, angry, worried or depressed.
Every woman is different so there is no right or wrong way to react.
Try to stay positive, keep yourself informed, focus your strength, accept support from your family, friends and support groups and remain hopeful.