Ovarian Cancer

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Questions to Ask Your Doctor about Ovarian Cancer
(Free Handout)

Ovarian Cancer Follow-Up

Continuous follow-up is essential for all ovarian cancer patients. This includes patients whose disease is in remission after treatment. Although most women who develop a recurrence do so within the first 2 years after treatment, ovarian cancer can reappear up to 20 years later.

Most patients are examined by their physicians every 3 months for the first 2 years. Thereafter, follow-up visits may be scheduled every 4 to 6 months.

During each visit, the physician will check the CA125 level in the patient's blood. If the CA125 level is increased, tests such as CT scan, biopsy, and peritoneal lavage may be performed to locate the new cancer site. Recurrent cancer may require additional chemotherapy and, possibly, secondary debulking surgery (see also Treatment of Ovarian Cancer).

Sexual Concerns
The surgery that is performed to treat ovarian cancer will result in sexual changes. Hysterectomy—removal of the uterus—causes cessation of the menstrual periods and loss of the ability to bear children. In young women, oophorectomy—removal of the ovaries —causes symptoms of menopause, such as hot flashes, night sweats, and altered moods.

Menopausal symptoms can be treated hormonally; however, hormone replacement therapy (HRT) has both risks and benefits (see also Hormone Therapy). Therefore, thorough consideration must be given to the patient's particular situation, including her age, stage and type of cancer, and the severity of her symptoms. If the woman suffers from extreme menopausal symptoms, some physicians give progestin injections (medroxprogesterone) every 3 months. This drug—which is estrogen-free and therefore may not be as risky for cancer recurrence as other hormonal medications—often can remedy hot flashes.

Sexual intercourse may be painful after hysterectomy because the vagina has been shortened. In addition, painful intercourse may be caused by vaginal dryness due to estrogen deficiency after ovary removal or irritation of the vagina's mucous membranes by chemotherapy. Vaginal moisturizers and lubricants - such as Astroglide, K-Y Jelly, Surgilube, and Replens - are available to relieve this condition.

The more complicated problems of diminished libido (sexual desire) and poor self image after cancer therapy may be helped by psychological and/or sexual counseling.

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