For many people living with ovarian cancer, the possibility of the cancer growing despite treatment (progression) or coming back (recurrence) can feel overwhelming. Preparing for both scenarios can help you feel empowered to make the best decisions for your own care.
What do recurrence and progression mean?
- Recurrence means the cancer has returned after a period where it was undetectable or under control.
- Progression means the cancer is growing or spreading despite current treatment.
Both situations are common in ovarian cancer and are not a sign that you did anything wrong. Ovarian cancer can be a chronic condition for some patients, meaning it may be managed over time with different therapies.
How does your care team detect if the cancer has spread or returned?
Your care team may identify recurrence or progression through:
- Rising CA-125 blood levels (a tumor marker)
- Imaging scans (such as CT or PET scans)
- New or returning symptoms, like:
- Abdominal bloating or discomfort
- Changes in appetite
- Fatigue
- Changes in bowel or bladder habits
If you notice new symptoms, it’s always worth discussing them with your doctor—even if they seem minor.
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What happens next?
If recurrence or progression is confirmed, your oncology team will reassess your treatment plan. This decision is highly individualized and depends on factors such as:
- Time elapsed since your last course of treatment
- How your cancer responded to previous therapies
- Your overall health and preferences
- Genetic factors (such as BRCA status or other tumor markers)
Treatment options after progression or recurrence
The good news is that there are multiple treatment pathways available. Many patients go on to receive several lines of therapy over time.
- Chemotherapy: you may receive a different chemotherapy regimen than before, or sometimes the same one if it was previously effective.
- Targeted therapy: these treatments focus on specific features of cancer cells. For example PARP inhibitors are often used in patients with BRCA mutations or certain tumor profiles, or oncologists rely on anti-angiogenic drugs, which block blood supply to tumors.
- Hormone therapy: in select cases, hormonal treatments may help slow cancer growth with fewer side effects.
- 4. Clinical trials: Clinical trials can provide access to promising new therapies. Many patients find them to be an empowering option worth exploring.
- Surgery: in some situations, additional surgery may be recommended, depending on where and how the cancer has returned.
Emotional and mental health matters
Hearing that cancer has returned or progressed can bring up a wide range of emotions, including fear, frustration, sadness, even anger. These feelings are completely valid. Ask your care team about access to an oncology social worker. An oncology social worker can be a great start for accessing support group referrals, mental health professionals, and connecting you with other peers. Outcomes4Me also has a virtual peer community.
Living with ovarian cancer as a chronic condition
For many patients, ovarian cancer becomes something that is treated and managed over time—similar to other chronic illnesses. This can include periods of treatment followed by periods of monitoring. During this time, it’s helpful to focus on:
- Maintaining strength and nutrition
- Managing side effects proactively
- Staying connected to your care team
- Continuing activities that bring meaning and joy
Questions to ask your care team
Being informed can help you feel more in control. Consider asking:
- What are my treatment options right now?
- What are the goals of this treatment (control vs. remission)?
- What side effects should I expect?
- Am I a candidate for a clinical trial?
- How will this treatment affect my quality of life?
While recurrence or progression can feel like a setback, advances in ovarian cancer treatment continue to expand options and improve outcomes. Most importantly, your care plan should reflect your goals, values, and priorities. Open communication with your healthcare team can help ensure that your treatment journey aligns with what matters most to you.
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