Ovarian cancer is often called a "silent" disease because its early symptoms (bloating, pelvic discomfort, and frequent urination) are vague and easily mistaken for digestive trouble. Many women are therefore diagnosed only after the disease has spread within the abdomen. The encouraging news is that even advanced ovarian cancer responds well to treatment. The treatment options for ovarian cancer include surgery, chemotherapy, targeted therapy and immunotherapy.

Why Ovarian Cancer Treatment Needs Both Surgery and Chemotherapy

The goal is straightforward to state and demanding to achieve: remove every trace of visible disease, then eliminate the microscopic cancer cells left behind.
Surgery removes the tumor to the fullest extent possible. Chemotherapy picks up where the scalpel stops. Ovarian cancer sheds cells across the peritoneal cavity, and these deposits can be too small to see or feel during surgery.

Surgery for Ovarian Cancer

The extent of surgery depends on the stage of the cancer, the patient's age, and whether she wishes to preserve fertility. The common procedures include the following.

Removal of one ovary
When the cancer is confined to a single ovary, the surgeon may remove only the affected ovary and its fallopian tube. The remaining ovary and the uterus stay in place, so the patient often continues to menstruate and can conceive naturally. This fertility-sparing approach is reserved for young women with early-stage, low-grade disease and is always accompanied by careful staging.
Removal of both ovaries
If both ovaries are involved but the disease has not spread beyond them, both ovaries and fallopian tubes are removed while the uterus is left intact. Natural conception is no longer possible, but pregnancy can still be achieved with frozen embryos or eggs stored earlier, or with donor eggs.
Removal of the uterus and ovaries
When the cancer is more extensive, or fertility is not a priority, surgery is more comprehensive: both ovaries and fallopian tubes, the uterus and cervix, nearby lymph nodes and the omentum, the apron of fatty tissue over the abdominal organs that is a frequent site of spread.
Advanced cancer
In advanced disease, tumor deposits may be scattered across the abdominal cavity, coating the bowel, diaphragm, liver surface or peritoneum. The operation, called debulking or cytoreductive surgery, aims to remove as much cancer as physically possible and may involve removing sections of bowel, stripping the peritoneum or removing the spleen. Chemotherapy is used before or after it, and sometimes both.

Chemotherapy for Ovarian Cancer

Chemotherapy uses drugs that target rapidly dividing cells. Cancer cells are hit hardest, though normal fast-growing cells in hair follicles, bone marrow and the gut lining are affected too, which explains most side effects.
Most regimens combine a platinum-based drug, usually carboplatin, with a taxane such as paclitaxel. Treatment is given in cycles, typically once every three weeks, with rest periods in between that allow healthy tissue to recover. Drugs are most often delivered intravenously, though some are taken orally.

Adjuvant chemotherapy
Given after surgery, this is the standard approach for most patients, usually three to six cycles of combination therapy to destroy residual cancer cells and reduce the chance of recurrence.
Neoadjuvant chemotherapy
It is generally offered to women with widely spread disease, or to those whose general health makes a major operation risky at the outset. Three cycles are commonly given to shrink the tumor burden, after which interval debulking surgery is performed, followed by further chemotherapy. This sequence makes complete removal more achievable and the operation safer [1]
Intraperitoneal chemotherapy
Drugs are delivered directly into the abdominal cavity through a catheter, bathing tumor sites in a high concentration of medication. It is used in selected Stage III patients after optimal debulking surgery. As it causes more discomfort than intravenous therapy, patient selection is careful.

Adverse effects of chemotherapy

Fatigue: Chemotherapy can cause persistent tiredness and weakness. Adequate rest, nutrition, and gentle physical activity may help manage it.
Nausea and vomiting: Some chemotherapy medicines can cause nausea or vomiting. Prescribed anti-nausea medicines can help control these symptoms.
Hair loss: Chemotherapy may cause temporary hair loss on the scalp and other parts of the body. Hair usually begins to grow back after treatment ends.
Mouth ulcers: Chemotherapy can cause sores or inflammation in the mouth. Good oral hygiene and suitable mouth care can help reduce discomfort.
Loss of appetite: Changes in appetite or taste may occur during chemotherapy. Eating small, and frequent meals can help maintain adequate nutrition.
Tingling or numbness: Some chemotherapy medicines can affect the nerves, causing tingling, numbness, or a burning sensation in the hands and feet.

Targeted Therapy for ovarian cancer

Targeted drugs act on specific features of cancer cells rather than on every rapidly dividing cell, so their side effects differ from those of conventional chemotherapy.
The main targeted option alongside chemotherapy is the anti-angiogenic group, of which bevacizumab is the best known. Tumors need a blood supply to grow and create one by signaling nearby vessels to sprout new branches; bevacizumab blocks that signal and effectively starves the tumor.
It is given with chemotherapy and continued alone as maintenance treatment in selected patients with advanced disease, with blood pressure and kidney function monitored throughout.

PARP inhibitors

PARP inhibitors are a class of targeted cancer drugs. PARP (poly (ADP-ribose) polymerase) is an enzyme that helps cells repair damaged DNA. In ovarian cancer, PARP inhibitors block this repair pathway, reducing the ability of the cancer cells to survive. They may be especially helpful in some patients with tumors with BRCA1 or BRCA2 mutations or other DNA repair issues.
Typical PARP inhibitors are olaparib, niraparib and rucaparib. In selected patients after chemotherapy, they can be used as maintenance treatment to help delay the return or progression of the cancer. The particular PARP inhibitor used will depend on the genetic characteristics of the cancer, prior to treatment and general health.

Immunotherapy for ovarian cancer

Immunotherapy helps the body’s immune system recognise and attack cancer cells. It works differently from chemotherapy, which directly targets rapidly dividing cells. In ovarian cancer, immune checkpoint inhibitors are the main type of immunotherapy being studied and used in selected cases. These medicines block signals that prevent immune cells from attacking cancer cells, allowing the immune system to respond more effectively.
Immunotherapy may be considered for some patients with advanced or recurrent ovarian cancer, depending on the tumour type, previous treatments, and specific biomarkers. It is not suitable for everyone, and doctors may recommend tumour testing to determine whether a patient is likely to benefit.

Why Choose Narayana Health for Ovarian Cancer Treatment?

Outcomes depend heavily on where the first treatment is given. Complete debulking, accurate staging and the right sequence of chemotherapy are difficult to achieve outside a centre that treats these cancers regularly.
At Narayana Health, our oncologists review every case together, so no plan rests on a single opinion. Our hospitals offer advanced imaging, BRCA testing, complex debulking surgery, day-care chemotherapy and intensive care under one roof.

Key Takeaways for Ovarian Cancer Treatment

Surgery and chemotherapy remain the twin pillars of ovarian cancer treatment. Surgery removes the disease that can be seen, and chemotherapy clears what remains beyond sight. Targeted drugs, especially PARP inhibitors, have added a valuable third layer by keeping the cancer away for longer, and immunotherapy may widen the options further.

Frequently Asked Questions

Q. What happens if ovarian cancer comes back after treatment?
A. Recurrence is treated, and not simply watched. The choice of drug depends on how long it has been since your last platinum chemotherapy: a longer gap usually means the same platinum drug can be used again, while a short gap points to a different class. Surgery is considered a second time in selected cases, and a PARP inhibitor may be added or continued as maintenance.

Q. How long does ovarian cancer treatment take from start to finish?
A. For most patients, the active phase runs across four to six months, covering the operation and the chemotherapy cycles on either side of it. Maintenance treatment with a targeted drug, where your doctor advises it, can continue well beyond that. Follow-up visits and scans carry on for several years.

Q. How will I know whether the treatment is working?
A. Your response is tracked in three ways: imaging scans, a physical examination at each visit, and a blood test that measures CA-125, a protein that many ovarian tumours release. A falling CA-125 level during chemotherapy usually means the tumour is shrinking. Your doctor reads these results together rather than acting on any one of them alone.

Q. Can ovarian cancer be cured completely?
A. Ovarian cancer can be treated successfully, especially when it is diagnosed at an early stage. Treatment usually involves surgery and chemotherapy, with targeted or maintenance therapies considered for some patients. Even after treatment, regular follow-up is important to monitor recurrence and manage long-term health.

References

1. Gaillard S, Lacchetti C, Armstrong DK, Cliby WA, Edelson MI, Garcia AA, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: ASCO guideline update. J Clin Oncol. 2025 Mar;43(7):868-891. doi:10.1200/JCO-24-02589.