Ovarian Germ Cell Tumors

General Information | Treatment Options | Screening | Prevention
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Treatment
  • Overview
  • Standard Treatment
  • Clinical Trials
  • Treatment By Stage

There are different types of treatment for patients with ovarian germ cell tumors.

Different types of treatment are available for patients with ovarian germ cell tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. 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.

Three types of standard treatment are used:

Surgery

Surgery is the most common treatment of ovarian germ cell tumor. A doctor may take out the cancer using one of the following types of surgery.

  • Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
  • Total hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
  • Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
  • Tumor debulking: A surgical procedure in which as much of the tumor as possible is removed. Some tumors may not be able to be completely removed.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be offered chemotherapy or radiation after surgery to kill any cancer cells that are left. Treatment given after the surgery to increase the chances of a cure is called adjuvant therapy.

Following radiation or chemotherapy, an operation called a second-look laparotomy is sometimes done. This is similar to the laparotomy that is done to determine the stage of the cancer. During the second-look operation, the doctor will take samples of lymph nodes and other tissues in the abdomen to see if any cancer is left.

New types of treatment are being tested in clinical trials.

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 NCI Web site.

High-dose chemotherapy with bone marrow transplant

High-dose chemotherapy with bone marrow transplant is a method of giving very high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

New treatment options

Combination chemotherapy (the use of more than one chemotherapy drug to fight cancer) is being tested in clinical trials.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial 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 standard treatment.

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.

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.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

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 recurring (coming back) or reduce the side effects of cancer treatment.

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 NCI's clinical trials database.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage 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. This is sometimes called re-staging.

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 condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Stage I Ovarian Germ Cell Tumors

Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.

Treatment of dysgerminoma may include the following:

  • Unilateral salpingo-oophorectomy with or without lymphangiography (an x-ray study of the lymph system, the tissues and organs that filter and destroy harmful substances and help fight infection and disease) or CT scan (a series of detailed pictures of areas inside the body, created by a computer linked to an x-ray machine).
  • Unilateral salpingo-oophorectomy followed by observation (closely monitoring a patient's condition without giving any treatment until symptoms appear or change).
  • Unilateral salpingo-oophorectomy followed by radiation therapy.
  • Unilateral salpingo-oophorectomy followed by chemotherapy.

Treatment of other germ cell tumors may be either:

  • unilateral salpingo-oophorectomy followed by careful observation; or
  • unilateral salpingo-oophorectomy, sometimes followed by combination chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I ovarian germ cell tumor.

Stage II Ovarian Germ Cell Tumors

Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.

Treatment of dysgerminoma may be either:

  • total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiation therapy or combination chemotherapy; or
  • unilateral salpingo-oophorectomy followed by chemotherapy.

Treatment of other germ cell tumors may include the following:

  • Unilateral salpingo-oophorectomy followed by combination chemotherapy.
  • Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
  • A clinical trial of new treatment options.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II ovarian germ cell tumor.

Stage III Ovarian Germ Cell Tumors

Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.

Treatment of dysgerminoma may include the following:

  • Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible.
  • Unilateral salpingo-oophorectomy followed by chemotherapy.

Treatment of other germ cell tumors may include the following:

  • Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible. Chemotherapy will be given before and/or after surgery.
  • Unilateral salpingo-oophorectomy followed by chemotherapy.
  • Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
  • A clinical trial of new treatment options.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III ovarian germ cell tumor.

Stage IV Ovarian Germ Cell Tumors

Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.

Treatment of dysgerminoma may include the following:

  • Total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy, with removal of as much of the cancer in the pelvis and abdomen as possible.
  • Unilateral salpingo-oophorectomy followed by chemotherapy.

Treatment of other germ cell tumors may include the following:

  • Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with removal of as much of the cancer in the pelvis and abdomen as possible. Chemotherapy will be given before and/or after surgery.
  • Unilateral salpingo-oophorectomy followed by chemotherapy.
  • Second-look surgery (surgery performed after primary treatment to determine whether tumor cells remain).
  • A clinical trial of new treatment options.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV ovarian germ cell tumor.

Treatment Options for Recurrent Ovarian Germ Cell Tumors

Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.

Treatment of dysgerminoma may be:

  • Chemotherapy with or without radiation therapy.

Treatment of other germ cell tumors may include the following:

  • Chemotherapy.
  • Surgery with or without chemotherapy.
  • A clinical trial of high-dose chemotherapy followed by bone marrow transplant.
  • A clinical trial of new treatment options.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent ovarian germ cell tumor.

Cancer information from the NCI PDQ service