Supportive care for ovarian cancer

Supportive care helps women meet the physical, practical, emotional and spiritual challenges of ovarian cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from ovarian cancer and adjusting to life after treatment is different for each woman, depending on the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A woman who has been treated for ovarian cancer may have the following concerns.

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Ovarian cancer and its treatments can affect a woman’s self-esteem and body image. Often this is because cancer or cancer treatments may result in body changes, such as:

• scars
• hair loss
• changes in body weight
• sexual problems

Some of these changes can be temporary. Others can last for a long time or be permanent.

For many women, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may be afraid to go out, be afraid others will reject them, or feel angry or upset, even if the effects of treatment may not show on the outside of the body.

Find out more about how to cope with problems of self-esteem and body image.

Lymphedema is a type of swelling that occurs when lymph fluid builds up in tissues. It usually occurs in parts of the body where large numbers of lymph nodes have been removed.

You may have lymphedema in your legs if lymph nodes were removed from your pelvis or groin. Lymphedema is more likely to occur if you were also given radiation therapy to the pelvis.

If you develop lymphedema, your healthcare team can suggest ways to reduce swelling and pain as much as possible and to help prevent more fluid from building up. Ways to manage lymphedema include propping the limb up so that fluid can drain more easily, exercise, compression stockings and regular physiotherapy. You can also ask for a referral to a healthcare professional who specializes in managing lymphedema.

Find out more about lymphedema.

Ascites is a buildup of fluid in the abdomen (peritoneal cavity). It occurs when the body produces fluid faster than it can remove it. Many women with ovarian cancer will develop ascites, especially as the cancer progresses.

Find out more about ascites.

A bowel obstruction occurs when the large or small intestine (also called the bowel or the colon) becomes blocked or kinked and the contents cannot pass through the intestine easily. People who have abdominal surgery are at greater risk of developing a bowel obstruction.

Ovarian cancer commonly causes a bowel obstruction because the ovarian tumour or ascites puts pressure on the intestines. Bowel obstruction from ovarian cancer develops slowly over a period of weeks or months.

Find out more about a bowel obstruction.

A pleural effusion is a buildup of fluid in the space between the outside covering of the lung and the inside lining of the chest wall (called the pleura). It is more common with cancer that has spread to the lung area.

Find out more about a pleural effusion.

Menopause occurs naturally as women age, usually when a woman reaches her early 50s. Menopause is caused when the ovaries produce lower levels of hormones. Women treated for ovarian cancer may experience early menopause as a side effect of cancer treatment.

Find out more about treatment-induced menopause.

Most ovarian cancers occur in women who are past their child-bearing years, but younger women with ovarian cancer may have concerns about fertility after the diagnosis.

Fertility problems can occur after radiation therapy or chemotherapy for ovarian cancer. Most women who have had surgery for ovarian cancer will not be able to become pregnant because their ovaries have been removed.

Treatments for early stage ovarian cancer may be considered to preserve fertility in women who still wish to have children. Before you start any treatment for ovarian cancer, talk to your healthcare team about side effects that may affect your ability to have children after treatment and what you can do about them.

Find out more about how you can manage fertility problems.

Many women continue to have strong, supportive relationships and a satisfying sex life after ovarian cancer treatment. If sexual problems occur because of ovarian cancer treatment, there are ways to manage them.

Some of the side effects of cancer treatment that can make sex painful or difficult include:

• Vaginal dryness caused by cancer treatments, such as radiation therapy or surgery.
• Vaginal narrowing caused by scarring after radiation therapy to the pelvic area or some vaginal cancer surgeries.
• Treatment-induced menopause caused by cancer treatments such as radiation therapy or surgery.

Some women lose interest in having sex. It is common to have a decreased interest in sex around the time of diagnosis and treatment.

When a woman first starts having sex after treatment, she may be afraid that it will be painful or that she may will not have an orgasm. The first attempts at being intimate with a partner may be disappointing. It may take time for the couple to feel comfortable with each other again. Some women and their partners may need counselling to help them cope with these feelings and the effects of cancer treatments on their ability to have sex.

Find out more about sexuality and cancer and sexual problems for women.

Many women who are treated for ovarian cancer worry that the cancer will come back. It is important to learn how to deal with these fears to maintain a good quality of life.

In addition to the support offered by the treatment team, a mental health professional, such as a social worker or counsellor, can help you learn how to cope and live with a diagnosis of ovarian cancer.

Some women with ovarian cancer are very anxious or depressed during or after treatment. Levels of anxiety and depression appear to be related to physical symptoms and how much support you think you have from people close to you, including your caregivers.

You may need help from your healthcare team. You can also ask to be referred to a mental health professional, such as a social worker or counsellor.

To make decisions that are right for you, ask your healthcare team questions about supportive care.