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Chemotherapy and other Medical Oncology Treatments

Ovarian cancer can be one of the most aggressive forms of cancer to attack women. That's why our team of gynecologic and medical oncologists is committed to providing the most comprehensive treatment options and vigilant surveillance available, while consistently focused on preserving patients' quality of life.

We recognize that ovarian cancer does not affect every patient similarly. And we are working hard to gain a better understanding why. One thing our researchers now know is that gene mutations that trigger the development of ovarian cancer vary among patients. We're using this and other cutting-edge information to move closer to treating ovarian cancer on an individualized basis, a philosophy that's part a wider trend in medicine known as personalized medicine.

Ovarian Cancer Treatment

At Johns Hopkins, our standard practice of care options include the most recent treatment advances for ovarian cancer that have been proven safe and effective on patients. In some instances, such as intraperitoneal chemotherapy—whereby chemotherapy is delivered directly into the abdomen—our clinician was the leading investigator on the clinical trial that lead to the regimen's approval.

Some people may wonder why we don't use every therapy they've read about. We only include as part of our standard practice of care "breakthrough" advances that have been thoroughly tested and found to improve patient outcomes. If it's not part of our standard treatment protocol, it's because the treatment's outcomes don't outweigh the adverse side effects, or because the treatment hasn't been proven more effective and safe than currently available treatments.

Ovarian Cancer Clinical Trials

Although, as clinicians, we use the newest methods of treatment on patients that are proven to be safe and effective, as researchers, we are always seeking new ways to advance ovarian cancer therapies. Our team conducts clinical trials and tests developmental therapeutics in an effort to improve ovarian cancer treatment. Some patients we treat may qualify to participate in these clinical trials. Access our clinical trials database for more information.

Chemotherapy: A cornerstone of ovarian cancer treatment

The majority of patients with ovarian cancer require chemotherapy after cytoreductive surgery. The small percentage who don't need chemotherapy have early, stage 1A disease.

New delivery method pioneered at Johns Hopkins                                      

In recent years, Deborah Armstrong, M.D., associate professor at the Johns Hopkins Kimmel Cancer Center, led clinical trials that pioneered a new, more targeted method of delivering chemotherapy that's proven to improve survival rates of patients with advanced ovarian cancer.
 
Called intraperitoneal chemotherapy (IP therapy), it is delivered directly to the abdominal cavity via a surgically-implanted catheter. It results in little scarring and minimal adhesions.

"The catheter allows us to bathe the entire abdominal area with a high concentration of chemotherapy for a long period of time, which appears to be better at destroying lingering cancer cells," says Deborah Armstrong, M.D., associate professor at the Johns Hopkins Kimmel Cancer Center.

While this new form of chemotherapy has raised hopes for longer survival, it is not without side effects. Some patients report toxicities associated with IP therapy including abdominal pain, nausea, and catheter-related problems; some patients do not complete IP therapy because of related adverse effects. Researchers at Hopkins are actively investigating ways to decrease adverse effects of IP therapy.

Traditional, intravenous chemotherapy

For patients with suboptimally debulked disease (more than 1cm residual implant at completion of surgery), intravenous platinum-based chemotherapy (IV therapy) is standard of care. IV chemotherapy is also used as standard of care for patients who are not candidates for IP therapy.  A typical course of IV therapy usually involve six cycles (three weeks apart) of standard platinum-based chemotherapy combinations.

Chemotherapy for recurrent cancer

For platinum-sensitive recurrent ovarian cancer (recurrence more than six months after completion of platinum chemotherapy), patients often respond favorably to the same chemotherapy drugs used during initial chemotherapy cycles.  For patients with platinum-resistant ovarian cancer (recurrence more than six months after completion of chemotherapy), sequential, single agent non-platinum chemotherapy is preferred.

Preserving quality of life during treatment

At Johns Hopkins, we recognize the importance of maintaining the highest quality of life possible for patients during treatment. We achieve this through close observation and prompt management of any adverse effects. Whether that means ensuring hydration in patients who experience nausea or responding quickly to any catheter complications, we consider this a vital part of the treatment regimen.

 

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