Treatments for germ cell ovarian cancer

The following are treatment options for stages of germ cell ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

The stages, grades and types of germ cell ovarian cancer are treated the same except for stage 1 dysgerminoma and grade 1 immature teratomas.

Surgery is the first treatment for all stages of germ cell ovarian cancer. The types of surgery are :

• removing only the ovary with cancer and the fallopian tube on the same side (unilateral salpingo-oophorectomy)

• removing as much of the cancer as possible (surgical debulking) may be done for stage 1C and higher

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging..

Most people with germ cell ovarian cancer will have chemotherapy after surgery. The types of chemotherapy commonly used are:

• PEB (or BEP), which is a combination of cisplatin, etoposide (Vepesid) and bleomycin

• carboplatin and etoposide

Stage 1 dysgerminoma is treated with surgery alone to remove the ovary with cancer and the fallopian tube on the same side. You will be watched closely to see if the cancer comes back. If it does, you will be given chemotherapy or radiation. Most women with stage 1 dysgerminoma never need chemotherapy.

A stage 1 grade 1 immature teratoma is found in one or both ovaries. It is treated by removing the ovary or ovaries with the cancer and the fallopian tube or tubes. Other tissues are removed for testing during the surgery. Grade 1 immature teratomas rarely come back after surgery and chemotherapy is rarely needed.

Recurrent ovarian cancer means that the cancer has come back after it has been treated. Persistent ovarian cancer never went away completely after treatment.

Treatments for recurrent or persistent germ cell ovarian cancer include:

Chemotherapy with a combination of drugs is the main treatment for recurrent or persistent germ cell cancer.

PEB may be used if you haven't had this combination of drugs before. If these drugs were used before, another combination of chemotherapy drugs will be used such as:

• VAC – vincristine, dactinomycin (Cosmegen), cyclophosphamide (Procytox)

• VeIP – vinblastine, ifosfamide (Ifex), cisplatin

Radiation therapy is often given for dysgerminoma. It is not used very often for other types of germ cell ovarian cancer.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don't work anymore, they're not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can't have or don't want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Some clinical trials are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.