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Researchers estimate that between 70 percent and 80 percent of people treated for ovarian cancer have a recurrence, or a relapse, after initial treatment. Ovarian cancer is a type of gynecologic cancer that includes cancers of the ovary, fallopian tube, or peritoneum.
Ovarian cancer is hard to catch during exams and often doesn’t cause symptoms. Around 80 percent of ovarian cancers aren’t diagnosed until they’re already at a later stage.
If your ovarian cancer was initially diagnosed at an earlier stage, it’s less likely to come back. Here are the recurrence rates based on cancer stage at diagnosis:
The amount of time it takes for cancer to come back after being treated is referred to as progression-free survival (PFS). The average PFS for ovarian cancer is 16 to 21 months. Recurrent ovarian cancer is most likely to come back within this window of time, although it may also come back earlier or later.
If your ovarian cancer comes back, your doctor may estimate your prognosis, or outlook. Certain factors may indicate a better prognosis following a recurrence of ovarian cancer. Some of these factors include:
The term overall survival estimates how long people with cancer are likely to live. Overall survival rates depend on the type and stage of ovarian cancer. Researchers often use the term “five-year relative survival rate” to describe how long someone with cancer may live. This describes how likely the person is to still be alive five years after diagnosis, compared to someone without that cancer type.
The five-year relative survival rate for epithelial ovarian cancer is about 50 percent. For stromal cancer, the five-year relative survival rate is 89 percent, and for germ cell tumors, it’s 92 percent. Advanced-stage ovarian cancer (cancer that has spread) is also more likely to lead to a shorter overall survival.
Recurrent ovarian cancer has worse overall survival rates. The median time people live after having an ovarian cancer relapse is two years. However, these statistics don’t predict what your outcome will be. Your doctor can help you get a better understanding of your outlook based on your characteristics.
Recurrent ovarian cancer may cause the same symptoms as the original cancer, or these symptoms may be different. The most common symptoms that often cause the greatest amount of trouble for people living with ovarian cancer are:
Other symptoms are frequently found as well. These can include nausea, bowel changes, and bloating.
Once you’ve been treated for ovarian cancer, you’ll probably need regular follow-up appointments with your doctor to check for signs that the cancer has recurred. Your doctor will likely give you a physical exam and ask you questions to identify whether you’re having any advanced ovarian cancer symptoms. They may also have you undergo blood tests or imaging tests to identify possible cancer signs.
The first systemic treatment you receive after you’re initially diagnosed with ovarian cancer is called first-line therapy. For ovarian cancer, this often includes chemotherapy. First-line chemotherapy usually consists of a drug that contains platinum, such as cisplatin (Platinol) and carboplatin (Paraplatin), and possibly a type of chemotherapy drug called a taxane, such as paclitaxel. The goal of first-line therapy is to try to eliminate as many cancer cells from your body as possible, or it may be to slow the growth of an advanced tumor.
If first-line treatments have been successful, and your cancer has shrunk, your doctor will probably recommend that you start maintenance therapy. The goal of these treatments is to keep your cancer under control and prevent it from progressing.
There are a few types of maintenance therapy used for ovarian cancer. One of these is bevacizumab (Avastin). This drug stops tumors from using blood vessels to feed themselves and grow.
Another type of maintenance therapy is a category of drugs called poly (ADP-ribose) polymerase, or PARP, inhibitors. PARP inhibitors include olaparib (Lynparza), niraparib (Zejula), and rucaparib (Rubraca). PARP inhibitors make it harder for cancer cells to repair DNA damage, leaving them more vulnerable. These drugs are especially effective in treating cancers with mutations in the BRCA gene.
If your ovarian cancer comes back, the treatments you receive may be the same as they were the first time around, or they may be different. The treatment you receive may depend on factors like how well first-line treatments worked, how long ago you received those treatments, what side effects you experienced in the past, and how much your cancer has spread since it came back. The goals of treatment may also change. For recurrent disease, the goals are often to:
Chemotherapy is often used to treat ovarian cancer that has relapsed. If your cancer took more than six months to come back, it’s called platinum-sensitive. This means that the platinum-based drugs used the first time around, like carboplatin, will probably work again.
If cancer returns within six months after the first treatment, it’s called platinum-resistant or refractory. If you have platinum-resistant disease, you’ll probably receive a different chemotherapy regimen that includes other drugs like paclitaxel, pegylated liposomal doxorubicin, gemcitabine, and topotecan.
Chemotherapy isn’t the right choice for everyone. These drugs may do more harm than good for people who aren’t expected to benefit from them.
If you have recurrent ovarian cancer, you may have debulking surgery to remove the cancer. Whether or not you have surgery depends on:
Targeted therapy drugs can seek out and kill cancer cells. Some of these medications are also used in maintenance therapy, and may include:
Your oncology team may also recommend that you try an antibody-drug conjugate. This class of drugs identifies, targets, and destroys specific ovarian cancer cells. One drug in this category is called mirvetuximab soravtansine-gynx (Elahere). It was approved in 2024 to treat platinum-resistant epithelial ovarian cancer, peritoneal cancer, or fallopian tube cancer.
You may receive targeted therapy during treatment the first time around, or you may receive it later, if ovarian cancer recurs.
You may receive radiotherapy treatments to make tumors smaller. Radiotherapy uses high-energy beams to kill cancer cells. It may also help reduce symptoms or kill cancer that’s spread to other places in the body.
No matter the stage of your ovarian cancer, you can also consider palliative care. Palliative, or supportive, care is not the same as hospice care and doesn’t necessarily mean that you’re at the end of your life. It focuses on reducing cancer symptoms, such as pain, and it can be used along with any other treatments you may want to pursue. It can help people have a better quality of life and may even lead to better outcomes.
Fighting cancer is hard enough the first time around, and it can be even more challenging the next. Many people with recurrent ovarian cancer have a hard time managing tests, treatments, and an uncertain future. It’s common to feel depressed, sad, angry, or scared.
Ask your oncologist about support services available through your hospital or cancer care center, or for referrals. Social workers, therapists, and chaplains can help you manage the emotions and practical challenges of recurrent cancer. They can also help you cope with feelings of stress or anxiety that may result from living with advanced ovarian cancer.
On MyOvarianCancerTeam, the social network for people with ovarian cancer and their loved ones, more than 7,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.
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A MyOvarianCancerTeam Member
I was diagnosed January 2nd with 4th recurrence. I am going to beat the damn cancer again. I have a lot of living left to do!
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