Life after treatment for ovarian cancer

Adjusting to life after treatment

For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.

Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.

Cancer Connect on 13 11 20 can help you connect with other people who have had ovarian cancer, and provide you with information about the emotional and practical aspects of living well after cancer.

Dealing with feelings of sadness

If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.

Talk to your GP, because counselling or medication, even for a short time, may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.

For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636. For 24-hour crisis support, call Lifeline on 13 11 14.

Follow-up appointments

After your treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back or spread. These are known as follow-up appointments and are times for you to discuss any concerns you may have.

In most cases, follow-up appointments will be with your gynaecological oncologist and sometimes the medical oncologist. They will usually perform a physical examination, which may include an internal examination, and arrange blood tests before each visit.

Scans such as CT or PET–CT may be arranged if you develop symptoms, your blood test detects a rise in the tumour marker or your doctor wants more information.

There is no set follow-up schedule for ovarian cancer, but it’s common to see a specialist every 3 months for the first few years, and then every 4–6 months for up to 5 years. Some people prefer not to follow a schedule but to see their specialist if they experience symptoms. Talk with your doctor about the right follow-up plan for you.

Your check-ups will become less frequent if you have no further problems, and the cancer has not come back. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.

What if ovarian cancer returns?

If ovarian cancer is advanced at diagnosis, it often does come back after treatment and a period of improvement (remission). This is known as a recurrence and it is why regular follow-up appointments are important. In some cases, there may be a number of recurrences, with long gaps in between when cancer treatment is not needed. Early-stage ovarian cancer is less likely to come back than advanced ovarian cancer.

The most common treatment for epithelial ovarian cancer that has come back is more chemotherapy or targeted therapy. The drugs used will depend on what drugs you had initially, the length of remission, and the aim of the treatment, as well as your general health and any side effects from previous treatments. The drugs used the first time may be given again if you have a good response to them and the cancer stays away for 6 months or more.

New drugs are constantly being developed and tested. Genetic tests and targeted therapy are offering new treatment options for people with ovarian cancer. Talk with your doctor about the latest developments in the treatment of ovarian cancer, and whether a clinical trial may be right for you.

Having CA125 blood tests

Talk to your doctor about the pros and cons of having regular blood tests that check for the tumour marker CA125. It is your choice whether to have this test.

There is research to suggest that waiting until new symptoms develop before starting treatment is just as effective as starting treatment earlier because of a rise in CA125. Not having treatment until you have new symptoms may mean that your quality of life is better for longer because you are not having the side effects of further treatment.

For germ cell or stromal tumours, you may have blood tests for tumour markers other than CA125.

Living with ovarian cancer

One of the challenges of a cancer diagnosis is dealing with uncertainty. When first diagnosed, many people want to know what’s going to happen and when it will be over. But living with uncertainty is part of having cancer, especially if the cancer is advanced.

There will be some questions that will have no answers. Learning as much as you can about the cancer and its treatment may make you feel more in control.

Tips for living with ovarian cancer

• Talk with other people who have had ovarian cancer. You may find it reassuring to hear about their experiences. 
• Explore different ways to relax, such as meditation or yoga. 
• Talk to a psychologist or counsellor about how you are feeling – they may be able to teach you some strategies to help you manage your fears.
• Keep a diary to track how you’re feeling.
• Set yourself some achievable goals.
• Practise letting your thoughts come and go without getting caught up in them.
• Try to exercise regularly. Research shows that exercise can help people cope with the side effects of treatment.
• Focus on making healthy choices in areas of your life that you can control, such as eating well and getting regular exercise.
• See Living with advanced cancer and listen to Cancer Council's Managing Fear and Living Well with Advanced Cancer podcast episodes.