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 and 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 and 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

Pelvic exam – The doctor inserts one or two lubricated, gloved fingers of one hand into the vagina. The other hand is placed over the lower abdomen to feel for masses. After examining the vagina, a rectal exam done to check for spread of cancer.

  • An instrument called a speculum is inserted into the vagina to check for signs of disease.
  • If a pelvic mass is found during the exam, additional testing (described below) is done. 

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.

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.

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

PET scan (positron emission tomography scan) – This complements a CT scan and is some times done at the same time. A small amount of safe radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells.

Surgery

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

Laparoscopic surgery – Less invasive (smaller cut) surgery to diagnose and possibly remove the abnormal mass. It may or may not include removal of the uterus and the tubes in the ovaries.

Laporotomy – A large incision is made to explore the abdomen and remove the mass. This is usually done when cancer is detected or when the mass is too large to consider removal through a less invasive laparoscopic surgery.

Complete staging operation – Surgery to check for the spread of cancer.

A debulking operation – Surgery to remove as much cancer as possible.

Unilateral salpingo-oophorectomy – A surgical procedure to remove one ovary and one fallopian tube. This is occasional done in early ovarian cancer that involves one ovary for women who want to preserve fertility.

Bilateral salpingo-oophorectomy – A surgical procedure to remove both ovaries and both fallopian tubes. This is done in women who have cancer in both ovaries or in women who are not interested in maintaining fertility.

Omentectomy – A surgical procedure to remove a fatty apron, called the omentum, which is attached to the large intestine.

Lymph node removal – The removal of all or part of a lymph nodes in pelvis and abdomen where ovarian cancer can spread. A large incision is made to explore the abdomen and remove the mass. This is usually done when cancer is detected or when the mass is too large to consider removal through a less invasive laparoscopic surgery.

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.

We do two kinds of chemotherapy:

Intraperitoneal (IP) chemotherapy – Anticancer drugs are carried directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.

Intravenous (IV) chemotherapy – Anti-cancer drugs infused into the veins.

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 chemotherap
  • 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

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