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WAYS TO MANAGE OVARIAN
CANCER TREATMENT SIDE EFFECTS
Courtney Arn, APRN-CNP
The Ohio State University
AGENDA
• Ovarian Cancer
• Treatment Options
• Most Common Side Effects
• Management of Side Effects
• Questions
OVARIAN CANCER
• Carcinosarcoma (Malignant Mixed Müllerian Tumors)
• Clear Cell Carcinoma of the Ovary
• Epithelial Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer
• Grade 1 Endometrioid Carcinoma
• Low-Grade Serous Carcinoma
• Malignant Germ Cell Tumors
• Malignant Sex Cord-Stromal Tumors
• Mucinous Neoplasms of the Ovary
• Ovarian Borderline Epithelial Tumors (Low Malignant Potential)
TREATMENT
• Surgery (Hysterectomy, BSO, Staging)
• Chemotherapy
• Platinums (Carboplatin, Cisplatin)
• Taxanes (Paclitaxel, Docetaxel)
• Doxil
• Targeted Therapy (Bevacizumab, Mirvetuximab)
• Immunotherapy
• Clinical Trials
• Maintenance Therapy
• Supportive Care
PLATINUM AGENTS
• Nausea and Vomiting
• Anemia, Leukopenia, Neutropenia, Thrombocytopenia
• Peripheral neuropathy (dose and duration dependent)
• Nephrotoxicity (acute renal failure and chronic renal insufficiency)
• Ototoxicity (tinnitus, high frequency hearing loss)
• Hypersensitivity reaction
TAXANES
• Alopecia
• Diarrhea, Nausea and Vomiting
• Anemia, Neutropenia, Thrombocytopenia
• Hypersensitivity Reaction
• Joint Pain
TARGETED THERAPY
• Abdominal pain, constipation, decreased appetite, diarrhea, nausea, vomiting
• Anemia, Increased liver function tests
• Fatigue
• Neuropathy
• Joint Pain
• Hypertension
• Cataract, keratitis, dry eye syndrome, photophobia, visual impairment (blurred
vision, decreased visual acuity)
NAUSEA/
VOMITING
• Prevention (Pre-medications)
• Anti-nausea and Anti-emetic medications
• Supportive Care (IV fluids, breathing exercises,
meditation, diet, small frequent meals,
hydration)
• Referral to dietician
NEUROPATHY
• Medications
• Physical Therapy
• Modify dose of chemotherapy
FATIGUE
• Exercise/Physical Activity
• Diet
• Physical Therapy
• Integrative Therapy (yoga, acupuncture,
meditation and tai chi)
• Treat other causes (pain, nausea, abnormal lab
values)
• Medications
HEMATOLOGIC
• Anemia (low red blood cells) – Blood Transfusion
• Neutropenia (low white blood cells) – G-CSF
(Granulocyte colony-stimulating factor)
• Thrombocytopenia (low platelets) – Platelet
Transfusion
OCULAR
• Referral to ophthalmology
• Eye drops
• Patient education
THANK YOU!
QUESTIONS?

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Ways to Manage Ovarian Cancer Treatment Side Effects

  • 1. WAYS TO MANAGE OVARIAN CANCER TREATMENT SIDE EFFECTS Courtney Arn, APRN-CNP The Ohio State University
  • 2. AGENDA • Ovarian Cancer • Treatment Options • Most Common Side Effects • Management of Side Effects • Questions
  • 3. OVARIAN CANCER • Carcinosarcoma (Malignant Mixed Müllerian Tumors) • Clear Cell Carcinoma of the Ovary • Epithelial Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer • Grade 1 Endometrioid Carcinoma • Low-Grade Serous Carcinoma • Malignant Germ Cell Tumors • Malignant Sex Cord-Stromal Tumors • Mucinous Neoplasms of the Ovary • Ovarian Borderline Epithelial Tumors (Low Malignant Potential)
  • 4. TREATMENT • Surgery (Hysterectomy, BSO, Staging) • Chemotherapy • Platinums (Carboplatin, Cisplatin) • Taxanes (Paclitaxel, Docetaxel) • Doxil • Targeted Therapy (Bevacizumab, Mirvetuximab) • Immunotherapy • Clinical Trials • Maintenance Therapy • Supportive Care
  • 5. PLATINUM AGENTS • Nausea and Vomiting • Anemia, Leukopenia, Neutropenia, Thrombocytopenia • Peripheral neuropathy (dose and duration dependent) • Nephrotoxicity (acute renal failure and chronic renal insufficiency) • Ototoxicity (tinnitus, high frequency hearing loss) • Hypersensitivity reaction
  • 6. TAXANES • Alopecia • Diarrhea, Nausea and Vomiting • Anemia, Neutropenia, Thrombocytopenia • Hypersensitivity Reaction • Joint Pain
  • 7. TARGETED THERAPY • Abdominal pain, constipation, decreased appetite, diarrhea, nausea, vomiting • Anemia, Increased liver function tests • Fatigue • Neuropathy • Joint Pain • Hypertension • Cataract, keratitis, dry eye syndrome, photophobia, visual impairment (blurred vision, decreased visual acuity)
  • 8. NAUSEA/ VOMITING • Prevention (Pre-medications) • Anti-nausea and Anti-emetic medications • Supportive Care (IV fluids, breathing exercises, meditation, diet, small frequent meals, hydration) • Referral to dietician
  • 9. NEUROPATHY • Medications • Physical Therapy • Modify dose of chemotherapy
  • 10. FATIGUE • Exercise/Physical Activity • Diet • Physical Therapy • Integrative Therapy (yoga, acupuncture, meditation and tai chi) • Treat other causes (pain, nausea, abnormal lab values) • Medications
  • 11. HEMATOLOGIC • Anemia (low red blood cells) – Blood Transfusion • Neutropenia (low white blood cells) – G-CSF (Granulocyte colony-stimulating factor) • Thrombocytopenia (low platelets) – Platelet Transfusion
  • 12. OCULAR • Referral to ophthalmology • Eye drops • Patient education