Life after treatment

After treatment ends, you will have regular appointments to monitor your health, manage any  long-term side effects and look for any signs that the cancer has come back or spread. These are known as follow-up appointments.

In most cases, follow-up appointments will be with your gynaecological oncologist and medical oncologist. They may perform a physical examination, which may include an internal examination, and arrange blood tests or scans such as ultrasounds and CT scans. You will also be able to discuss any concerns you may have.

There is no set follow-up schedule for ovarian cancer, but it’s common to see a specialist every three months for the first few years, and then every four to six months for up to five years. Some people prefer not to follow a schedule but to see their specialist if they experience symptoms. Check with your doctor if you are unsure of your follow-up plan.

Your check-ups will become less frequent if you have no further problems. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.

Having CA125 blood tests

Your specialist will also talk to you about the advantages and disadvantages of having regular
blood tests for the tumour marker CA125. This test is optional.

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

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

When a follow-up appointment or test is approaching, you may find that you think more about the cancer and feel anxious. Talk to your treatment team or call Cancer Council
13 11 20 if you are finding it hard to manage this anxiety.

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

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

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

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

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

Tips for living with ovarian cancer

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

Listen to our podcast episode ‘Living Well with Advanced Cancer’

Listen to our podcast episode ‘Managing Fear’

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

Talk to your GP, because counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible.

Cancer Council SA offers a free counselling service, call Cancer Council 13 11 20 for more information.

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