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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65718_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65718_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65718_"><span class="title" itemprop="name">Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: October 1, 2015.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062963__321">This PDQ cancer information summary has current information about the treatment of ovarian epithelial, fallopian tube, and primary peritoneal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062963__322">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062963__104"><h2 id="_CDR0000062963__104_">General Information About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062963__105">Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which malignant (cancer) cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__313">Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are treated the same way.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__109">Women who have a family history of ovarian cancer are at an
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increased risk of ovarian cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__112">Some ovarian, fallopian tube, and primary peritoneal cancers are caused by inherited gene mutations
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(changes).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__116">Women with an increased risk of ovarian cancer may consider
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surgery to lessen the risk.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__217">Signs and symptoms of ovarian, fallopian tube, or peritoneal cancer include pain or swelling in the abdomen.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__123">Tests that examine the ovaries and pelvic area are used to detect (find) and diagnose ovarian, fallopian tube, and peritoneal cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__127">Certain factors affect treatment options and prognosis
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(chance of recovery).</a></div></li></ul></div><div id="CDR0000062963__105"><h3>Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are diseases in which malignant (cancer) cells form in the tissue covering the ovary or lining the fallopian tube or peritoneum. </h3><p id="CDR0000062963__107">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> are a pair
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of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the female <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046564/" class="def">reproductive
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system</a>. They are in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>, one on each side of the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a> (the hollow, pear-shaped
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organ where a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046400/" class="def">fetus</a> grows). Each
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ovary is about the size and shape of an almond. The ovaries make eggs and
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female <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a> (chemicals that
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control the way certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> or
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organs work). </p><p id="CDR0000062963__311">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a> are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary.</p><p id="CDR0000062963__312">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> is the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> that lines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> wall and covers organs in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">Primary peritoneal cancer</a> is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary. <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963251" co-legend-rid="figlgndCDR0000062963251"><a href="/books/NBK65718.2/figure/CDR0000062963__251/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963251" rid-ob="figobCDR0000062963251"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000609921.gif" src-large="/books/NBK65718.2/bin/CDR0000609921.jpg" alt="Anatomy of the female reproductive system" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963251"><h4 id="CDR0000062963__251"><a href="/books/NBK65718.2/figure/CDR0000062963__251/?report=objectonly" target="object" rid-ob="figobCDR0000062963251">Figure</a></h4><p class="float-caption no_bottom_margin">Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium. <a href="/books/NBK65718.2/figure/CDR0000062963__251/?report=objectonly" target="object" rid-ob="figobCDR0000062963251">(more...)</a></p></div></div></p><p id="CDR0000062963__108"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">Ovarian epithelial cancer</a>
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is one type of cancer that affects the
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ovary. See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> treatment summaries for information about other types of ovarian <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>:</p><ul id="CDR0000062963__264"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062967/">Ovarian Germ Cell Tumors</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062968/">Ovarian Low Malignant Potential Tumors</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062878/#CDR0000062878__128">Unusual Cancers of Childhood Treatment</a> (<a href="/books/n/pdqcis/CDR0000062878/#CDR0000062878__128">Ovarian Cancer</a> section)</div></li></ul></div><div id="CDR0000062963__313"><h3>Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer are treated the same way.</h3></div><div id="CDR0000062963__109"><h3>Women who have a family history of ovarian cancer are at an
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increased risk of ovarian cancer.</h3><p id="CDR0000062963__111">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk.</p><p id="CDR0000062963__320">Women who have one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000460150/" class="def">first-degree relative</a> (mother, daughter, or
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sister) with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642021/" class="def">history</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445074/" class="def">ovarian cancer</a> have an increased risk of ovarian
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cancer. This risk is higher in women who have one first-degree relative and one
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second-degree relative (grandmother or aunt) with a history of ovarian cancer. This risk is
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even higher in women who have two or more first-degree relatives with a history of ovarian
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cancer.</p></div><div id="CDR0000062963__112"><h3>Some ovarian, fallopian tube, and primary peritoneal cancers are caused by inherited gene mutations
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(changes).</h3><p id="CDR0000062963__114">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> in cells carry the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045983/" class="def">hereditary</a> information
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that is received from a person’s parents. Hereditary ovarian cancer makes up about
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5% to 10% of all cases of ovarian cancer. Three hereditary patterns have been
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identified: ovarian cancer alone, ovarian and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast cancers</a>, and ovarian and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044237/" class="def">colon cancers</a>.</p><p id="CDR0000062963__315"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">Fallopian tube cancer</a> and peritoneal cancer may also be caused by certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045098/" class="def">inherited</a> gene <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutations</a>.</p><p id="CDR0000062963__115">There are tests that can detect <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044133/" class="def">mutated</a> genes. These
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046128/" class="def">genetic tests</a> are sometimes done for
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members of families with a high risk of cancer. See the following PDQ summaries for
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more information: </p><ul id="CDR0000062963__265"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258027/">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062822/">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062855/">Genetics of Breast and Gynecologic Cancers</a></div></li></ul></div><div id="CDR0000062963__116"><h3>Women with an increased risk of ovarian cancer may consider
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surgery to lessen the risk.</h3><p id="CDR0000062963__118">Some women who have an increased risk of ovarian
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cancer may choose to have a risk-reducing
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045438/" class="def">oophorectomy</a> (the removal of healthy ovaries so that cancer
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cannot grow in them). In high-risk women, this procedure has been shown to greatly decrease the risk of ovarian cancer. (See the PDQ summary on <a href="/books/n/pdqcis/CDR0000062822/">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention</a> for more information.)</p></div><div id="CDR0000062963__217"><h3>Signs and symptoms of ovarian, fallopian tube, or peritoneal cancer include pain or swelling in the abdomen.</h3><p id="CDR0000062963__219">Ovarian, fallopian tube, or peritoneal cancer may not cause early <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. When signs or symptoms do appear, the cancer is often <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a>. Signs and symptoms may include the following:</p><ul id="CDR0000062963__220"><li class="half_rhythm"><div>Pain, swelling, or a feeling of pressure in the abdomen or pelvis.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044308/" class="def">Vaginal</a> bleeding that is heavy or irregular, especially after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046296/" class="def">menopause</a>.</div></li><li class="half_rhythm"><div>Vaginal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443583/" class="def">discharge</a> that is clear, white, or colored with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>.</div></li><li class="half_rhythm"><div>A lump in the pelvic area.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045692/" class="def">Gastrointestinal</a> problems, such as gas, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476585/" class="def">bloating</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a>.</div></li></ul><p id="CDR0000062963__221">These signs and symptoms also may be caused by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> and not by ovarian, fallopian tube, or peritoneal cancer. If the signs or symptoms get worse or do not go away on their own, check with your doctor so that any problem can be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> and treated as early as possible.</p><p id="CDR0000062963__222">Women with ovarian cancer should think about taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a>. Information about ongoing clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062963__123"><h3><div class="milestone-start" id="CDR0000062963__124"></div>Tests that examine the ovaries and pelvic area are used to detect (find) and diagnose ovarian, fallopian tube, and peritoneal cancer.<div class="milestone-end"></div></h3><p id="CDR0000062963__125"> The following tests and procedures may be used:</p><ul id="CDR0000062963__284"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322873/" class="def">Pelvic exam</a></b>: An exam of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a>, uterus, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>, ovaries, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046588/" class="def">speculum</a> is inserted into the vagina and the doctor or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">nurse</a> looks at the vagina and cervix for signs of disease. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045978/" class="def">Pap test</a> of the cervix is usually done. The doctor or nurse also inserts one or two <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046302/" class="def">lubricated</a>, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963285" co-legend-rid="figlgndCDR0000062963285"><a href="/books/NBK65718.2/figure/CDR0000062963__285/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963285" rid-ob="figobCDR0000062963285"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000609924.gif" src-large="/books/NBK65718.2/bin/CDR0000609924.jpg" alt="Pelvic exam" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963285"><h4 id="CDR0000062963__285"><a href="/books/NBK65718.2/figure/CDR0000062963__285/?report=objectonly" target="object" rid-ob="figobCDR0000062963285">Figure</a></h4><p class="float-caption no_bottom_margin">Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, <a href="/books/NBK65718.2/figure/CDR0000062963__285/?report=objectonly" target="object" rid-ob="figobCDR0000062963285">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> or organs in the abdomen, and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. The picture can be printed to be looked at later.
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<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963286" co-legend-rid="figlgndCDR0000062963286"><a href="/books/NBK65718.2/figure/CDR0000062963__286/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963286" rid-ob="figobCDR0000062963286"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000618022.gif" src-large="/books/NBK65718.2/bin/CDR0000618022.jpg" alt="Abdominal ultrasound" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963286"><h4 id="CDR0000062963__286"><a href="/books/NBK65718.2/figure/CDR0000062963__286/?report=objectonly" target="object" rid-ob="figobCDR0000062963286">Figure</a></h4><p class="float-caption no_bottom_margin">Abdominal ultrasound. An ultrasound transducer connected to a computer is passed over the surface of the abdomen. The ultrasound transducer bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture). </p></div></div>Some patients may have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046633/" class="def">transvaginal ultrasound</a>.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963287" co-legend-rid="figlgndCDR0000062963287"><a href="/books/NBK65718.2/figure/CDR0000062963__287/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963287" rid-ob="figobCDR0000062963287"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000618018.gif" src-large="/books/NBK65718.2/bin/CDR0000618018.jpg" alt="Transvaginal ultrasound" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963287"><h4 id="CDR0000062963__287"><a href="/books/NBK65718.2/figure/CDR0000062963__287/?report=objectonly" target="object" rid-ob="figobCDR0000062963287">Figure</a></h4><p class="float-caption no_bottom_margin">Transvaginal ultrasound. An ultrasound probe connected to a computer is inserted into the vagina and is gently moved to show different organs. The probe bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer <a href="/books/NBK65718.2/figure/CDR0000062963__287/?report=objectonly" target="object" rid-ob="figobCDR0000062963287">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046490/" class="def">CA 125</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044528/" class="def">assay</a></b>: A test that measures the level of CA 125 in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA 125 level can be a sign of cancer or another <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046427/" class="def">endometriosis</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> tumor cells in the body. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: The removal of cells or tissues so they can be viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. The tissue is usually removed during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove the tumor.</div></li></ul></div><div id="CDR0000062963__127"><h3><div class="milestone-start" id="CDR0000062963__128"></div>Certain factors affect treatment options and prognosis
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(chance of recovery).<div class="milestone-end"></div></h3><p id="CDR0000062963__214">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000062963__215"><li class="half_rhythm"><div>The
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of the cancer.</div></li><li class="half_rhythm"><div>The type and size of the tumor.</div></li><li class="half_rhythm"><div>Whether all of the tumor can be removed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Whether the patient has swelling of the abdomen.</div></li><li class="half_rhythm"><div>The
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patient’s age and general health.</div></li><li class="half_rhythm"><div>Whether the cancer has just been <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurred</a> (come back).</div></li></ul></div></div><div id="CDR0000062963__130"><h2 id="_CDR0000062963__130_">Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062963__131">After ovarian, fallopian tube, or peritoneal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__242">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__288">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__135">The following stages are used for ovarian epithelial, fallopian tube, and primary peritoneal
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cancer:</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__316">Ovarian epithelial, fallopian tube, and primary peritoneal cancers are grouped for treatment as early or advanced cancer. </a></div></li></ul></div><div id="CDR0000062963__131"><h3>After ovarian, fallopian tube, or peritoneal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body. </h3><p id="CDR0000062963__133">The process used to find out whether <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> or to other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> cancer are often also used to stage the disease. (See the <a href="#CDR0000062963__124">General Information</a> section.)</p></div><div id="CDR0000062963__242"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000062963__242_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000062963__242_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000062963__288"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000062963__288_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000062963__288_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000062963__290">The metastatic tumor is the same type of cancer as the primary tumor. For example, if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian epithelial cancer</a> spreads to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, the cancer cells in the lung are actually ovarian epithelial cancer cells. The disease is metastatic ovarian epithelial cancer, not lung cancer.</p></div><div id="CDR0000062963__135"><h3>The following stages are used for ovarian epithelial, fallopian tube, and primary peritoneal
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cancer:</h3><div id="CDR0000062963__137"><h4>Stage I </h4><p id="CDR0000062963__139">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045899/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is
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found in one or both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>. Stage I is divided into stage IA, stage IB, and stage IC.</p><ul id="CDR0000062963__140"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045899/" class="def">Stage IA</a>: Cancer is found inside a single <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovary</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tube</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045899/" class="def">Stage IB</a>: Cancer is found inside both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045899/" class="def">Stage IC</a>: Cancer is found inside one or both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a> and one of
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the following is true:
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<dl id="CDR0000062963__141" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">cancer is also found on the outside surface of one or both
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ovaries or fallopian tubes; or</p></dd><dt>-</dt><dd><p class="no_top_margin">the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455334/" class="def">capsule</a> (outer covering) of the ovary
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has ruptured (broken open); or</p></dd><dt>-</dt><dd><p class="no_top_margin">cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>
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are found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046125/" class="def">peritoneal cavity</a> (the body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> that contains
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most of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>) or in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000700145/" class="def">washings</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> lining the peritoneal
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cavity).</p></dd></dl></div></li></ul></div><div id="CDR0000062963__142"><h4>Stage II </h4><p id="CDR0000062963__144">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045900/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is
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found in one or both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a> and has spread into other areas of the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a> is found within the pelvis. Stage II ovarian epithelial and fallopian tube cancers are divided
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into stage IIA and stage IIB.</p><ul id="CDR0000062963__145"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045900/" class="def">Stage IIA</a>: Cancer has spread from where it first formed to the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a> and/or the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a> and/or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045900/" class="def">Stage IIB</a>: Cancer has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovary</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tube</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046125/" class="def">peritoneal cavity</a> (the space that contains the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> organs).</div></li></ul><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963235" co-legend-rid="figlgndCDR0000062963235"><a href="/books/NBK65718.2/figure/CDR0000062963__235/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963235" rid-ob="figobCDR0000062963235"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000415526.gif" src-large="/books/NBK65718.2/bin/CDR0000415526.jpg" alt="Pea, peanut, walnut, and lime show tumor sizes" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963235"><h4 id="CDR0000062963__235"><a href="/books/NBK65718.2/figure/CDR0000062963__235/?report=objectonly" target="object" rid-ob="figobCDR0000062963235">Figure</a></h4><p class="float-caption no_bottom_margin">Pea, peanut, walnut, and lime show tumor sizes. </p></div></div></div><div id="CDR0000062963__147"><h4>Stage III </h4><p id="CDR0000062963__149">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045901/" class="def">stage III</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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is found in one or both <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tubes</a>, or is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a>, and has spread outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> to other parts of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> and/or to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.
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Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.</p><ul id="CDR0000062963__150"><li class="half_rhythm"><div>In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045901/" class="def">stage IIIA</a>, one of the following is true:<dl id="CDR0000062963__307" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the area outside or behind the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> only; or</p></dd><dt>-</dt><dd><p class="no_top_margin">Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that can be seen only with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> have spread to the surface of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>. Cancer may have spread to nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. </p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045901/" class="def">Stage IIIB</a>: Cancer has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> and the cancer in the peritoneum is 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller. Cancer may have spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> behind the peritoneum.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045901/" class="def">Stage IIIC</a>: Cancer has spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> and the cancer in the peritoneum is
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larger than 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>. Cancer may have spread to
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> behind the peritoneum or to the surface of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>. </div></li></ul></div><div id="CDR0000062963__151"><h4>Stage IV </h4><p id="CDR0000062963__153">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045902/" class="def">stage IV</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread beyond the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> to other
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parts of the body. Stage IV is divided into stage IVA and stage IVB.</p><ul id="CDR0000062963__306"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045902/" class="def">Stage IVA</a>: Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in extra <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> that builds up around the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045902/" class="def">Stage IVB</a>: Cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> outside the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a>.</div></li></ul></div></div><div id="CDR0000062963__316"><h3>Ovarian epithelial, fallopian tube, and primary peritoneal cancers are grouped for treatment as early or advanced cancer. </h3><p id="CDR0000062963__318">Stage I ovarian epithelial and fallopian tube cancers are treated as early cancers.</p><p id="CDR0000062963__319">Stages II, III, and IV ovarian epithelial, fallopian tube, and primary peritoneal cancers are treated as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced cancers</a>.</p></div></div><div id="CDR0000062963__154"><h2 id="_CDR0000062963__154_">Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h2><p id="CDR0000062963__155"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian
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epithelial cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">fallopian tube cancer</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> that has recurred (come back) after it has been
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treated. Persistent cancer is cancer that does not go away with treatment.</p></div><div id="CDR0000062963__156"><h2 id="_CDR0000062963__156_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062963__157">There are different types of treatment for patients with ovarian epithelial
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cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__161">Four kinds of standard treatment are used.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__174">New types of treatment are being tested in clinical
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trials. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__244">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__246">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062963__248">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062963__157"><h3>There are different types of treatment for patients with ovarian epithelial
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cancer.</h3><p id="CDR0000062963__159">Different types of treatment are available for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian epithelial cancer</a>. Some
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treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a>, and some are being tested in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A
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treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current
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treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>.
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When clinical trials show that a new treatment is better than the treatment
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currently used as standard
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treatment, the new treatment may become the standard treatment.
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Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062963__161"><h3>Four kinds of standard treatment are used.</h3><div id="CDR0000062963__163"><h4>Surgery </h4><p id="CDR0000062963__165">Most patients have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove as much of the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> as possible. Different types
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of surgery may include:</p><ul id="CDR0000062963__166"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045718/" class="def">Hysterectomy</a>: Surgery to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a> and, sometimes, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046133/" class="def">cervix</a>. When only the uterus is removed, it is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000410676/" class="def">partial hysterectomy</a>. When both the uterus and the cervix are removed, it is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045929/" class="def">total hysterectomy</a>. If the uterus and cervix are taken out through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>, the operation is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044308/" class="def">vaginal</a> hysterectomy. If the uterus and cervix are taken out through a large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (cut) in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the operation is called a total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a> hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044360/" class="def">laparoscope</a>, the operation is called a total laparoscopic hysterectomy.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062963255" co-legend-rid="figlgndCDR0000062963255"><a href="/books/NBK65718.2/figure/CDR0000062963__255/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062963255" rid-ob="figobCDR0000062963255"><img class="small-thumb" src="/books/NBK65718.2/bin/CDR0000612116.gif" src-large="/books/NBK65718.2/bin/CDR0000612116.jpg" alt="Hysterectomy" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062963255"><h4 id="CDR0000062963__255"><a href="/books/NBK65718.2/figure/CDR0000062963__255/?report=objectonly" target="object" rid-ob="figobCDR0000062963255">Figure</a></h4><p class="float-caption no_bottom_margin">Hysterectomy. The uterus is surgically removed with or without other organs or tissues. In a total hysterectomy, the uterus and cervix are removed. In a total hysterectomy with salpingo-oophorectomy, (a) the uterus plus one (unilateral) ovary and fallopian <a href="/books/NBK65718.2/figure/CDR0000062963__255/?report=objectonly" target="object" rid-ob="figobCDR0000062963255">(more...)</a></p></div></div></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322894/" class="def">Unilateral salpingo-oophorectomy</a>: A surgical procedure to remove one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovary</a> and one <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045687/" class="def">fallopian tube</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322852/" class="def">Bilateral salpingo-oophorectomy</a>: A surgical procedure to remove both ovaries and both fallopian tubes.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045053/" class="def">Omentectomy</a>: A surgical procedure to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044935/" class="def">omentum</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> that contains <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>). </div></li><li class="half_rhythm"><div>Lymph
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node <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a>: The removal of all or part of a lymph node. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>.</div></li></ul></div><div id="CDR0000062963__167"><h4>Radiation therapy</h4><p id="CDR0000062963__169"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated.
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</p><p id="CDR0000062963__170">Some women receive a treatment called
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044942/" class="def">intraperitoneal radiation therapy</a>,
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in which radioactive liquid is put directly in the abdomen through a catheter.</p></div><div id="CDR0000062963__171"><h4>Chemotherapy</h4><p id="CDR0000062963__173"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the abdomen, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). </p><p id="CDR0000062963__226">A type of regional chemotherapy used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian cancer</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046331/" class="def">intraperitoneal (IP) chemotherapy</a>. In IP chemotherapy, the anticancer drugs are carried directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046125/" class="def">peritoneal cavity</a> (the space that contains the abdominal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a>) through a thin tube. </p><p id="CDR0000062963__231">Treatment with more than one anticancer drug is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">combination chemotherapy</a>.</p><p id="CDR0000062963__227">The way the chemotherapy is given depends on the type and stage of the cancer being treated.</p><p id="CDR0000062963__267">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/ovarian" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer</a> for more information.</p></div><div id="CDR0000062963__293"><h4>Targeted therapy</h4><p id="CDR0000062963__295"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.</p><p id="CDR0000062963__296"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibody</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> is a type of targeted therapy that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory, from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</p><p id="CDR0000062963__297"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> is a monoclonal antibody that may be used with chemotherapy to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian epithelial cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">fallopian tube cancer</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a> that has recurred (come back).</p><p id="CDR0000062963__301"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658053/" class="def">Poly (ADP-ribose) polymerase inhibitors</a> (PARP inhibitors) are targeted therapy drugs that block <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> repair and may cause cancer cells to die. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000657862/" class="def">Olaparib</a> is a PARP inhibitor that may be used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced</a> ovarian cancer caused by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutations</a> (changes) in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046047/" class="def">BRCA1</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046742/" class="def">BRCA2 genes</a>. </p><p id="CDR0000062963__308">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/ovarian" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer</a> for more information.</p></div></div><div id="CDR0000062963__174"><h3>New types of treatment are being tested in clinical
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trials. </h3><p id="CDR0000062963__241">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000062963__176"><h4>Biologic therapy</h4><p id="CDR0000062963__178"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.</p></div></div><div id="CDR0000062963__244"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062963__244_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062963__244_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062963__244_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062963__246"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062963__246_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062963__246_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000062963__248"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062963__248_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062963__248_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p></div></div><div id="CDR0000062963__184"><h2 id="_CDR0000062963__184_">Treatment Options by Stage</h2><div id="CDR0000062963__185"><h3>Early Ovarian Epithelial and Fallopian Tube Cancer</h3><p id="CDR0000062963__186">Treatment of early <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian epithelial
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cancer</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">fallopian tube cancer</a> may include the following:</p><ul id="CDR0000062963__187"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045718/" class="def">Hysterectomy</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322852/" class="def">bilateral
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salpingo-oophorectomy</a>, and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045053/" class="def">omentectomy</a>.
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> and other
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> in the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> are removed and checked
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under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> may be given after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322894/" class="def">Unilateral salpingo-oophorectomy</a> may be done in certain women who wish to have children. Chemotherapy may be given after surgery.</div></li></ul><p id="CDR0000062963__TrialSearch_185_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=43702&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage I ovarian epithelial cancer</a> and <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40968&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">fallopian tube cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062963__195"><h3>Advanced Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h3><p id="CDR0000062963__196">Treatment of advanced <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian
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epithelial cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">fallopian tube cancer</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a> may include the following:</p><ul id="CDR0000062963__309"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045718/" class="def">hysterectomy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322852/" class="def">bilateral salpingo-oophorectomy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045053/" class="def">omentectomy</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">Lymph nodes</a> and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> are removed and checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>.</div></li><li class="half_rhythm"><div>Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and checked under a microscope to look for cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046682/" class="def">Intravenous</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046331/" class="def">intraperitoneal chemotherapy</a> is given after surgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000660869/" class="def">PARP inhibitor</a> for certain patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046047/" class="def">BRCA1</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046742/" class="def">BRCA2</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutations</a>. </div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of combination chemotherapy with or without other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> either before or after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> (hysterectomy, bilateral salpingo-oophorectomy, omentectomy).</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>.</div></li></ul><p id="CDR0000062963__TrialSearch_195_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=43703&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage II ovarian epithelial cancer</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=43704&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage III ovarian epithelial cancer</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=43705&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">stage IV ovarian epithelial cancer</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40968&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">fallopian tube cancer</a> and <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40969&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">primary peritoneal cavity cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062963__203"><h2 id="_CDR0000062963__203_">Treatment Options for Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h2><p id="CDR0000062963__204">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046768/" class="def">ovarian epithelial cancer</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000755773/" class="def">fallopian tube cancer</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386215/" class="def">primary peritoneal cancer</a> may include the following:</p><ul id="CDR0000062963__205"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> using one or more anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>, with or
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without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">bevacizumab</a> combined with chemotherapy. </div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of surgery.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment.</div></li></ul><p id="CDR0000062963__TrialSearch_203_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=43706&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent ovarian epithelial cancer</a>, <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40968&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">fallopian tube cancer</a> and <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40969&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">primary peritoneal cavity cancer</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062963__236"><h2 id="_CDR0000062963__236_">To Learn More About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</h2><p id="CDR0000062963__237">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about ovarian epithelial, fallopian tube, and primary peritoneal cancer, see the following:</p><ul id="CDR0000062963__238"><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/ovarian" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
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Home Page</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062822/">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258027/">Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062878/#CDR0000062878__128">Unusual Cancers of Childhood Treatment</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/drugs/ovarian" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">BRCA1 and BRCA2: Cancer Risk and Genetic Testing</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Genetic Testing for Hereditary Cancer Syndromes</a></div></li></ul><p id="CDR0000062963__236_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062963__236_41"><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/diagnosis-staging/staging/staging-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="http://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062963__AboutThis_1"><h2 id="_CDR0000062963__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062963__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062963__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="http://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062963__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062963__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062963__AboutThis_6">This PDQ cancer information summary has current information about the treatment of ovarian epithelial, fallopian tube, and primary peritoneal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062963__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062963__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000062963__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062963__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062963__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062963__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062963__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062963__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062963__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062963__AboutThis_21">National Cancer Institute: PDQ® Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000062963__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000062963__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062963__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="http://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062963__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062963__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="http://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65718.2/?report=reader">PubReader</a></li><li><a href="/books/NBK65718.2/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65718" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65718" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®): Patient Version. 2015 Oct 1. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65718.24/">NBK65718.24</a></span> November 22, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65718.23/">NBK65718.23</a></span> August 23, 2024</li><li><span class="bk_col_itm"><a 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class="bk_col_itm"><a href="/books/NBK65718.12/">NBK65718.12</a></span> August 23, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65718.11/">NBK65718.11</a></span> July 27, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65718.10/">NBK65718.10</a></span> February 20, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65718.9/">NBK65718.9</a></span> October 13, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65718.8/">NBK65718.8</a></span> May 1, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65718.7/">NBK65718.7</a></span> April 28, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65718.6/">NBK65718.6</a></span> December 30, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65718.5/">NBK65718.5</a></span> November 3, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65718.4/">NBK65718.4</a></span> July 14, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65718.3/">NBK65718.3</a></span> January 28, 2016</li><li><span class="bk_col_itm">NBK65718.2</span> October 1, 2015 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65718.1/">NBK65718.1</a></span> July 2, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062963__104" ref="log$=inpage&link_id=inpage">General Information About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</a></li><li><a href="#CDR0000062963__130" ref="log$=inpage&link_id=inpage">Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</a></li><li><a href="#CDR0000062963__154" ref="log$=inpage&link_id=inpage">Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</a></li><li><a href="#CDR0000062963__156" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062963__184" ref="log$=inpage&link_id=inpage">Treatment Options by Stage</a></li><li><a href="#CDR0000062963__203" ref="log$=inpage&link_id=inpage">Treatment Options for Recurrent or Persistent Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</a></li><li><a href="#CDR0000062963__236" ref="log$=inpage&link_id=inpage">To Learn More About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer</a></li><li><a href="#CDR0000062963__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" 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