Tests, Treatments & Therapies for Ovarian Cancer at the University of Colorado Cancer Center

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of ovarian cancer. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging & Detection Tests

Tests are only as good as the doctors who report and interpret them. That’s why our doctors-who work together as a patient’s care team-are the highest trained specialists in the state.

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

  • Different types of scans
  • Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans & other tests may also be used:

  • In a “surveillance program” looking for any signs of relapse after treatment
  • In a “screening program” to detect cancer early in individuals at high-risk
  • To monitor responses to treatment

Tests

Diagnostic Tests

Because endometrial and uterine cancers begin inside the uterus, they do not usually show up in the results of a Pap test. However, these cancers frequently cause some kind of abnormal bleeding. For this reason, a sample of tissue is removed from inside the uterus and examined under a microscope to look for cancer cells. These tests include:

Endometrial biopsy – Usually done in the doctor’s office. The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. A doctor, called a pathologist, views the tissue under a microscope to look for cancer cells.

Dilatation and curettage (D&C) – Usually done in the operating room, so patients can be under anesthesia. Removal of tissue samples from the inner lining of the uterus and cervix.

Staging Tests

After cancer has been diagnosed, more tests will be done to find out the “stage” of the cancer (how far it has spread). Tests include:

Blood chemistry studies – A blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

CA 125 assay – Measures the “CA 125” in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA 125 level is sometimes a sign of cancer or other condition.

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.

Ultrasound exam – High-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

CT scan (CAT scan) – A series of detailed pictures are taken of areas inside the body. 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
  • Computerized axial tomography

MRI (magnetic resonance imaging) – This is often used by the radiation oncologist to plan radiation treatment. A magnet, radio waves, and a computer are used to make a series of detailed pictures of areas inside the body. Also called nuclear magnetic resonance imaging (NMRI).

Surgery

Operations and procedures to remove ovarian cancer are done by doctors who have specialized training, called gynecologic oncologists.

Laparoscopic-focused treatment

We focus on laparoscopic treatment for this type of cancer. This enables patients to recover quicker than they would from regular surgical procedures.

Total hysterectomy and cancer staging – Removal of the uterus, including the cervix. Removal of the lymph nodes in the lower abdomen and pelvis to determine the spread of cancer. The different types of hysterectomies that may be performed are:

  • Laparoscopic assisted vaginal hysterectomy – The uterus and cervix are taken out through the vagina.
  • Total abdominal hysterectomy – The uterus and cervix are taken out through a large incision (cut) on the abdomen.
  • Total laparoscopic hysterectomy – The uterus and cervix are taken out through the vagina, however, the operation is done through small incisions on the abdomen called laparoscopy.
  • Radical hysterectomy – A surgical procedure to remove the uterus, cervix, upper part of the vagina and the tissue next to these organs. Nearby lymph nodes in the pelvis will also be removed to check for the spread of cancer.

Bilateral salpingo-oophorectomy – A surgical procedure to remove both ovaries and both fallopian tubes. This is usually necessary with endometrial cancer because of the risk of spread.

Abdominal and pelvic washings – A saline solution is placed into the abdominal and pelvic body cavities. After a short time, the fluid is removed and viewed under a microscope to check for cancer cells.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

  • Kill cancer cells
  • Prevent cancer cells from developing or recurring
  • Improve many of the symptoms caused by cancer

Radiation therapy can be:

  • Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
  • Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
  • Almost as effective as surgery in people who are not fit enough for an operation
  • Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments: Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current ovarian cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

  • Single drugs or combinations of drugs
  • Intravenous injections or tablets/capsules
  • Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
  • Taking some drugs every day or only on a few days within the cycles
  • Taking other medicines to reduce or eliminate side effects associated with chemotherapy
  • Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
  • Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

  • Be given before surgery to make the operation easier
  • Be given in combination with radiotherapy to make both treatments more effective
  • Be given after surgery to reduce the chances of cancer coming back
  • Successfully control advanced cancer and many cancer-related symptoms

Hormone Therapy

According to the National Cancer Institute, hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

  • New drugs
  • New combinations of therapies
  • New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center -one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC