During the first two years after treatment, you should have follow-up visits every two to four months to ensure that changes in your health are monitored and problems are treated early. Your follow up visits will include physical exams, pelvic exams, and may include a CA-125 blood test, chest X-ray and CT scan if needed. After two years, follow up visits should continue every six months. If the cancer does not return within three to five years, visits can be scheduled less often.
If you are able to have children, your doctor will discuss fertility options with you. Since the first line of treatment for ovarian cancer is a hysterectomy with bilateral salpingo-oophorectomy, in which the uterus, fallopian tubes, and ovaries are removed, most women will not be able to have children after having ovarian cancer. For more information, see Preserving Fertility in Women.
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Issues that affect quality of life, such as sexual health, have become increasingly important, especially since cancer care has improved and survival rates have increased. Often patients are not sure what to expect from health care providers when talking about sexual health during cancer treatment.
Cancer treatment, such as surgery, chemotherapy, hormone therapy, or radiation therapy, may decrease your level of sexual desire by slowing down the production of sex hormones or affecting lubrication of the vagina. Side effects of treatment, such as nausea or fatigue, may also decrease your desire. Negative emotions like depression, anger, fear, or guilt, may keep you or your partner from wanting to have sex. Medicines for pain, nausea, anxiety, or depression, may also decrease desire. If you have experienced changes in your appearance because of treatment, you may feel self-conscious or unattractive. All of these factors affect your sexuality.
Surgery or radiation treatment to the abdomen or pelvis may cause physical changes in blood circulation or nerve supply to the sex organs. Women who experience vaginal dryness because of surgery or radiation may use water-soluble lubricants or moisturizing suppositories available at any drugstore without a prescription. Some women may experience shrinkage of the vagina because of radiation or surgery. A combination of learning to relax the vaginal muscles and gentle, gradual stretching of the vagina with dilators can overcome this problem. Finding positions that give the woman control over movement and minimize deep penetration also help.
Your doctor can give you additional advice about sexual activity after radiation treatment or surgery. For more detailed information about positioning and sexual techniques, refer to Sexuality for Women and Their Partners by the American Cancer Society.
During chemotherapy, you are also at greater risk for getting an infection. For this reason, practice good personal hygiene, and bathe daily. Wash your hands and genitals before and after sexual activity. If you are not in a monogamous sexual relationship (having only one partner) where you are not sure of your partner's faithfulness, you should practice safe sex, using latex condoms and dental dams to avoid contact with your partner's body fluids. If you use a lubricant with latex condoms, choose a water-based lubricant, and not a lubricant that contains oil, such as baby oil or petroleum jelly, since these products weaken condoms. Nonoxynol-9 does not help prevent HIV and is not recommended.
Cancer and cancer treatment may cause changes in your appearance that may distress you. Side effects, such as hair loss, weight changes, scars, or changes in skin color may leave you feeling unattractive and self-conscious. You may feel helpless and frustrated by changes beyond your control. The way you feel about your body and yourself may affect how you interact with others.
Classes to improve your appearance during treatment are available to help you look good and feel better. Contact your local chapter of the American Cancer Society to find out about classes near you.
Anxiety about cancer and cancer treatment may cause a strain on any relationship. Anxiety interferes with your ability to enjoy any activity, but it is a treatable condition. Worry and fear about the future may make it hard to share intimacy and affection. This commonly occurs when your need for closeness and intimacy are greater than ever. It is normal to experience these emotions during treatment, and it is healthy to talk about them.
Your doctor, nurse, social worker, or chaplain is available to listen to your concerns and give you advice. Many people do not talk to health care professionals about their sexual relationships because they feel embarrassed, ashamed, or afraid, but it is important to discuss your concerns with one of your health care providers. Choose a doctor, nurse, social worker, chaplain, or therapist whom you trust. He or she can give you information and advice to help you maintain your sexual and emotional health during and after treatment.
You carry out different roles every day. You may be a friend, a mother, a daughter, a wife, a lover, a sister, a boss, and a worker all at once. Each of these roles makes demands upon your time and energy. Fatigue and stress caused by your treatment may prevent you from duties that you once took for granted. If you are not able to meet these demands, you may feel guilty and become frustrated. You may not be able to do as much for your family as before, however, you still have a lot to offer through your love, your caring, and your friendship.
Because of your illness, your family and loved ones may try to protect you. Even though they mean well, you may feel like they are taking away your independence or your rights as an adult. After treatment, when you start feeling better, your loved ones may have become used to you in the role of a patient. You may need to sit down together and discuss how to switch from the caretaker and sick person roles into your usual, more balanced roles.
A diagnosis of cancer may raise questions and spiritual concerns. You may wonder, "Why did this happen to me?" or "Am I being punished?"
It is normal for people with cancer to have feelings of shame or guilt because of a cancer diagnosis, even though many factors cause cancer. Try to use your faith to inspire you and help you understand yourself. You may find it helpful to discuss your concerns with your physician, priest, rabbi, minister, or other spiritual person whom you trust.
When a patient's health care team determines that the cancer can no longer be controlled, medical testing and cancer treatment often stop. Some women with advanced disease may choose not to have treatment because of the time, cost, and side effects. However, the patient's care continues, with a focus on making the patient comfortable. This is called palliative care.
Patients receive medicines and treatment to control pain and other symptoms, such as constipation, nausea, and shortness of breath. Some patients remain at home, while others enter a hospital or other facility. Either way, services are available to help you and your family with the medical, psychological, and spiritual issues surrounding dying. A hospice program often provides such services.
The time at the end of life is different for each person. Each individual has unique needs for information and support. You and your family should discuss questions and concerns with the health care team as they arise.
Last reviewed on 7/22/09
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