Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. The side effects from the chemotherapy come from the fact that it also destroys normal cells.
Chemotherapy is usually injected or infused into a vein, but some forms can be given by mouth. Your medical oncologist will tell you how many cycles or courses of chemotherapy are best for you. In most cases, chemotherapy is given after surgery for six cycles, although recent data suggests that as few as three cycles of chemotherapy may be as good as six cycles, which means fewer side effects. Sometimes, the cancer is too large to remove surgically, and the doctor may give you chemotherapy first to make the cancer smaller so that it can all be removed during surgery. There is still some debate about whether it is better to have chemotherapy before or after surgery, but the standard at this time is to receive chemotherapy after surgery.
The side effects and amount of time required in your doctor’s office depend on the type of chemotherapy you receive, as well as how many cycles you receive and how often. The most common chemotherapy-associated side effects are:
Nausea and vomiting
Fatigue or tiredness
Decreased blood counts
First line agents, used separately or in combination, include:
Paclitaxel combined with cisplatin or carboplatin is a favored regimen for treating epithelial cell ovarian cancer. It produces complete disease regression in about a quarter of patients with Stage III disease.
Cisplatin is used alone for certain ovarian cancers and in combination with either cyclophosphamide or paclitaxel to treat advanced disease. Cisplatin is also a member of the standard BEP regimen for germ cell cancers (with bleomycin and etoposide). Due to its lower toxicity, carboplatin is being tested as a substitute for cisplatin in this combination.
Possible side effects of platinum coordination complexes include:
The second member of BEP treatment for germ cell cancers, epipodophyllotoxin may be given on days 1-5 of each 21-day cycle.
Possible side effects of epipodophyllotoxin include:
Severe bone marrow damage
Severe allergic reactions
Heart muscle injury
Common names include:
Cyclophosphamide interferes with the growth of cancer cells, which are eventually destroyed. Since cyclophosphamide may also affect the growth of normal body cells, other effects will also occur. Cyclophosphamide is given either by mouth or by injection.
Possible side effects of cyclophosphamide include:
Cough or hoarseness
Fever or chills
Lower back or side pain
Missed menstrual periods
Painful or difficult urination
Darkening of skin and fingernails
Loss of appetite
Nausea or vomiting
Sterility in men
Bone marrow damage and risk of leukemias
Doxorubicin seems to interfere with the growth of cancer cells, which are then eventually destroyed by the body. Since the growth of normal body cells may also be affected by doxorubicin, other effects will also occur. Doxorubicin is given as an injection.
Possible side effects of doxorubicin include:
Sores in mouth and on lips
Fast or irregular heartbeat
Damage to the heart muscle
Pain at place of injection
Shortness of breath
Swelling of feet and lower legs
Topotecan inhibits an enzyme topoisomerase I, causing DNA damage to tumor cells. It is commonly given intravenously daily for five days every three weeks.
Docetaxel is similar to paclitaxel and is a semisynthetic compound derived from yew plants. It is commonly given intravenously every three weeks, often with corticosteroids to prevent problems with sensitivity to the medication.
Possible side effects of docetaxel include:
Weakness and nerve damage
Diarrhea, nausea, vomiting
Bone marrow damage
Detailed guide: ovarian cancer. American Cancer Society
website. Available at:
Accessed April 8, 2009.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a