Minimize the Chances of a Recurrence After Ovarian Cancer Treatment

Ovarian cancer begins in the ovaries, two almond-sized female organs on either side of the uterus that release eggs, or ova, which produce the hormones estrogen and progesterone. Ovarian cancer is most common in older women and those with a family history of breast cancer, ovarian cancer and/or related genetic mutations. Hormone risk factors play a role as well.

Approximately 1.2 percent of women will be diagnosed with ovarian cancer in their lifetime, and more than 14,000 American women will die from it this year. Treatment is most effective when the disease is caught early, while still confined to one or both ovaries, but a lack of noticeable symptoms can delay diagnosis. Treatments depend upon the individual and the type of cancer, but they can include surgery and/or chemotherapy and targeted therapies (often in recurrent cases).

Outcomes for ovarian cancer depend on the stage, the grade and the patient's characteristics. Early stages have good outcomes: 9 in 10 women live five years or more when their cancer is detected and treated in stage I.

Defining recurrence

Recurrence describes cancer that comes back, in the same place as the original tumor or elsewhere, typically months or years following prior treatment. Believing you’re cancer-free and suddenly facing it again is a huge emotional blow, and just the threat of recurrence can have a significant toll on a woman’s mental health and well-being. The likelihood of recurrence depends on the type of cancer, as well as the stage, grade and other patient factors.

Likelihood of a recurrence

Recurrence has a higher likelihood with cancers caught in later stages, because increased spread makes it more likely cancerous cells will have escaped treatment and that they may grow and multiply again later. Unfortunately, a majority of ovarian cancer cases—70 percent is the current estimate—are not caught until later stages (III and IV), and about 80 percent of those will recur, most often in the abdominal cavity. This frightening fact leaves a lot of patients on edge, constantly worried their cancer will return.

No surefire way exists to prevent this, but you can increase your chances by sticking to post-cancer screenings, follow-up schedules and guidelines, and by knowing the signs of a recurrence: abdominal pain and bloating, nausea, vomiting, bowel and bladder changes.

Preventing recurrence

Along with staying vigilant, making some lifestyle adjustments can help prevent a recurrence. Eat a balanced, nutrient-dense diet, high in leafy greens, fruits, vegetables and whole grains, with less (or no) red meat, processed foods and sugars. Exercise regularly, stay active throughout the day and maintain a healthy body weight. Reduce your alcohol consumption, don’t use tobacco products or other drugs and avoid carcinogen exposure (this includes everyday products such as talcum powder and vaginal deodorant).

When it comes to supplements, only take those approved by your physician. Most supplements are not tested or approved by the Food and Drug Administration, so their ingredients and efficacy aren't always clear. If you’re on oral contraceptives, they can help reduce the risk of ovarian cancer. And while radical, surgical removal of both ovaries, the fallopian tubes and/or the uterus may be recommended to minimize recurrence odds, your doctor can explain the benefits and downsides of the procedure, including implications for fertility.

New research has identified cutting-edge methods that may help reduce the chance of recurrence and improve outcomes, including the use of PARP inhibitors to prevent cancer cells from repairing DNA after treatment. A new compound called 673A, which, in a study using mice, inhibited the ALDHA pathway, blocking cancer stem cells (untouched by chemotherapy) from turning into a new tumor. There’s also a new vaccine in development meant to prevent the recurrence of ovarian cancer by training the body’s immune system to recognize, attack and kill ovarian cancer cells.

These treatments are still in trials, but in a few years, the threat of ovarian cancer recurrence could be greatly diminished.