Ovarian Cancer

Quick Reference Guide

Open a 2-page quick reference summary of the therapies best supported by evidence for use with ovarian cancer:

Our goal is to help you live as well as you can for as long as you can using an optimal integrative combination of conventional and complementary therapies and approaches.

Key Points

  • Early detection, prompt and appropriate treatment, and general health support may greatly increase your success in treating the cancer and in maintaining quality of life.
  • We summarize a protocol used at the Bastyr University Integrative Oncology Research Center for treating ovarian cancer.
  • The 7 Healing Practices are the beginning point for bringing your body to health and wellness.
  • Complementary therapies can be useful to enhance conventional treatment effects, improve quality of life and possibly even extend life for those with ovarian cancer.
  • A number of natural products, off-label and overlooked novel cancer approaches (we call them ONCAs) and other types of therapies show benefits in three domains:
    • Treating the cancer
    • Managing side effects and promoting wellness
    • Reducing risk of both cancer onset and recurrence

Many women with ovarian cancer are interested in going beyond conventional cancer therapies—that is, having an integrative approach to care that blends the best of conventional and complementary therapies. Your reading this indicates that you are likely one of these women.

Perhaps you have just been diagnosed with ovarian cancer or with a recurrence of your cancer. Now you may be embarking on surgery, chemotherapy, radiation therapy or some combination of these—maybe even all three. You are curious to see if complementary therapies or healing practices could help your treatment be more effective or bolster your resilience or prevent or manage treatment side effects.

Or maybe you’ve completed your treatments and you want to know what else you can do to keep the cancer from coming back or keep it at bay. Perhaps living with ovarian cancer has brought on difficult emotions, or made it hard to sleep well or challenged your relationships. Is there help for that?

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Laura Pole

Integrative Care in Ovarian Cancer

No matter where you are in your experience with ovarian cancer, there’s good reason to seek integrative care: Women with ovarian cancer who followed a weekly individualized integrative medicine program during chemotherapy or palliative care had improved quality of life. They saw improvements in appetite, general well-being and ability to complete their conventional treatments. They also noted better control of symptoms such as fatigue, pain, anxiety, sleep disruption, nausea and cognitive impairment (see at right).1

Our goal is to help you live as well as you can for as long as you can using an optimal integrative combination of conventional and complementary therapies and approaches. Before investigating integrative care in ovarian cancer, we recommend reviewing integrative cancer care in general. For cancer care to be considered truly integrative, patients and their cancer treatment teams work together to find the best blend of conventional and complementary therapies that have been shown to be effective and safe.

We also recommend that you learn about your body terrain, which is your internal environment that is influenced by external factors such as the foods you eat, the chemicals around you, and the light and radiation you’re exposed to. It’s also influenced by internal factors such as stress hormones, sex hormones, your fitness level, your feelings of being loved, and your sense of purpose. This body terrain can influence the tumor microenvironment—the biochemical and physical interaction of cancer cancers and normal cells—in which the cancer exists, making it either more or less likely to spread. You can sometimes improve your body terrain with integrative practices. See Body Terrain and the Tumor Microenvironment.

Symptoms of Ovarian Cancer

  • Abdominal pain or cramps
  • Pain in the lower back or pelvis
  • Abnormal vaginal bleeding or discharge
  • Pain or bleeding during intercourse
  • Nausea
  • Loss of appetite or weight loss
  • Bloating or gas
  • Ascites (excess abdominal fluid)
  • Fatigue
  • Constipation or diarrhea
  • Change in urinary frequency or urgency
  • Obesity and unusual weight g

Clinical Practice Guidelines

Examples: Treatment Approaches from Noted Specialists and Researchers

Bastyr Integrative Oncology Care—A Naturopathic Oncology Approach

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Integrative Oncology Program, The Oncology Service, Lin and Carmel Medical Centers, Clalit Health Services Israel

Patient Expectations in Using Complementary Approaches

One study found that patients using complementary medicine expected their gynecologic oncologist to be actively involved in the process of integration within supportive care and that complementary medicine consultations would focus on improving well-being.5

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Integrative Programs, Protocols and Medical Systems

For more information about protocols and programs, see our Integrative Protocols and Programs page.

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Integrative Therapies in Ovarian Cancer

7 Healing Practices: The Foundation

Let your intuition guide you in choosing where to start with these healing practices.

Any of the 7 Healing Practices are a good beginning. Eating well and moving more pack a powerful one-two punch in potentially improving treatment outcomes, enhancing quality of life and/or reducing risk of recurrence in ovarian cancer. Moreover, evidence shows that managing stress, sleeping well, creating a healing environment, sharing love and support and exploring what matters now can help women with ovarian cancer. Ultimately, let your intuition guide you in choosing where to start with these healing practices.

Eating Well

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Moving More

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Managing Stress

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Sleeping Well

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Creating a Healing Environment

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Sharing Love and Support

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Exploring What Matters Now

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Chemosensitivity Testing

In many ways, each case of cancer is unique. Your personal body terrain and tumor microenvironment, which is a combination of genes, nutritional status, stress response, circadian rhythms, fitness, microbiome, history of infectious disease, hormone levels and much more, is as unique to you as your fingerprints are. Your body and tumor may not respond exactly like others to any given treatment.

If feasible, your healthcare team can collect a live sample of tumor tissue and send it for chemosensitivity testing to identify your cancer’s responses to both standard and complementary therapies. Test results can identify which chemotherapies and natural products are likely to be either most effective or ineffective or in treating the tumor.

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Beyond the 7 Healing Practices: Further Integrative Therapies

Complementary Approaches in Ovarian Cancer: Involving Conventional Healthcare Providers

A 2018 review of complementary treatments for gynecologic cancer found these rates of use and communication between patients and healthcare providers:56

  • Fewer than 25 percent of patients in the US received any information about complementary or alternative therapies from their physicians, nurses or other conventional medical providers.

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Conventional treatments are readily available and are discussed below. Complementary therapies can be useful to enhance conventional treatment effects, improve quality of life and possibly even extend life for those with ovarian cancer. Many complementary therapies―when chosen thoughtfully, reviewed with your oncology treatment team and used alongside conventional therapies—can become part of your integrative cancer care approach.

Therapies are grouped according to their effects:

  • Treating the cancer
  • Managing side effects and promoting wellness
  • Reducing risk
  • Optimizing your terrain

We present natural products in six groups:

  1. Good clinical evidence of efficacy & safety, easy access
  2. Good clinical evidence of efficacy & safety, limited access
  3. Limited clinical evidence of efficacy but good safety, used in leading integrative programs
  4. Limited clinical evidence of efficacy, or significant cautions, but potential significant benefit
  5. Especially promising preclinical or emerging clinical evidence of efficacy and safety
  6. Evidence of no efficacy or may be dangerous

Off-label, overlooked and novel cancer approaches (ONCAs) are grouped separately:

  • Group A: Good clinical evidence of efficacy
  • Group B: Limited clinical evidence of efficacy
  • Group C: Promising preclinical evidence only
  • Group D: Evidence of no efficacy or may be dangerous

 

Other integrative therapies and approaches are described but not categorized. See the full summaries as linked for more information on each of these therapies.

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Conventional Treatments

Integrative Approaches and Surgery

Surgery may be part of the recommended treatment for this cancer type. We provide helpful information about how integrative approaches can coordinate with surgery on our Integrative Approaches and Surgery page.

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Natural Products

Traditional Medicine Therapies

Throughout this summary, you will find examples of therapies used by and in many cases created by traditional medical systems.

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“While many herbals have been shown to have anticancer properties, the research to date has been largely preclinical (in vitro), without clinical evidence of their effectiveness.”59 Here we make clear the level of evidence behind natural products.

Group 1: Good clinical evidence of efficacy & safety, easy access

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Group 3: Limited clinical evidence of efficacy but good safety, used in leading integrative programs

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Group 4: Potential significant benefit, but either limited clinical evidence of efficacy or significant cautions

May be used in leading integrative oncology programs. Therapies in this group may need more medical oversight and surveillance.

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Other therapies with preclinical evidence only for treating the cancer

Group 5: Especially promising preclinical or emerging clinical evidence of efficacy and safety

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Group 6: Evidence of no efficacy or may be dangerous

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Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

These therapies have exciting potential and/or proven benefits. However, some carry higher risks of side effects, interactions with other treatments and other adverse medical events than other therapies we review. Cautions are noted with each therapy, and we strongly urge you consult your doctor before using these therapies—even over-the-counter drugs—for cancer treatment. We also note whether a prescription is needed or if a therapy is not widely available. 

Group A: Good clinical evidence of efficacy

May be used in integrative protocols and programs

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Group B: Limited clinical evidence of efficacy

May be used in integrative protocols and programs

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Group C: Promising preclinical evidence only

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Therapies using heat, sound or light

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Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Sexual Activity, Depression and Ovarian Cancer

A number of sexual difficulties can arise if ovarian cancer treatment causes hormonal changes:

  • Vaginal dryness leading to painful intercourse
  • Vulvodynia (pain and/or burning in the vulvar area)
  • Decreased libido

Focus on survival can lead to a lack of interest in sex. Symptoms, including depression, anxiety and fatigue can also lead to sexual difficulties.

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Conventional Treatments

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Natural Products

Group 1: Good clinical evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

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Group 2: Good clinical evidence of efficacy & safety, limited access

Some may require a prescription, for example.

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Group 3: Limited clinical evidence of efficacy but good safety, used in leading integrative programs

Read more

Group 4: Potential significant benefit, but either limited clinical evidence of efficacy or significant cautions

May be used in leading integrative oncology programs. Therapies in this group may need more medical oversight and surveillance.

Read more

Group 5: Especially promising preclinical or emerging clinical evidence of efficacy and safety

Read more

Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

These therapies have exciting potential and/or proven benefits. However, some carry higher risks of side effects, interactions with other treatments and other adverse medical events than other therapies we review. Cautions are noted with each therapy, and we strongly urge you consult your doctor before using these therapies—even over-the-counter drugs—for cancer treatment. We also note whether a prescription is needed or if a therapy is not widely available. 

Group C: Promising preclinical evidence only

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Energy Therapies

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Mind-Body, Spiritual and Consciousness-changing Approaches

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Manipulative and Body-Based Methods

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Diets and Metabolic Therapies

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Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Managing Thrombosis

Ovarian cancer brings a high risk of formation of blood clots (thrombosis).194 For prevention, Keith Block provides information on modifying the terrain factor he calls hypercoagulation.195 He discusses testing, lifestyle approaches and supplements to reduce risks. For more information see chapter 17, “Blood Circulation and Cancer: The Thick and the Thin.”

Risk Factors

Risk factors for ovarian cancer that are generally not under a woman’s control:196

  • Family history of ovarian cancer or BRCA1 and BRCA2 mutation (these mutations are responsible for most family history incidence)
  • Age and menopause status
  • Greater genetically predicted adult height
  • Greater number of menstrual cycles, influenced by early menarche, late menopause, fewer pregnancies or periods of lactation or contraceptive use
  • Infertility
  • Personal history of breast cancer

Lifestyle Associations

Risk factors that may be influenced by a woman’s lifestyle choices and behaviors:197

  • Smoking tobacco with (borderline) mucinous cancers
  • Use of hormone replacement therapy (estrogen plus progesterone) for serous and endometrioid ovarian cancers
  • Breastfeeding is modestly associated with a decreased risk of premenopausal ovarian cancer for the mother, likely related to fewer menstrual cycles.
  • Inactivity (limited evidence)
  • Being overweight or obese (inconsistent evidence)
  • A rotating work schedule (conflicting evidence)

Some initial evidence shows that the microbiome in the cervix and vagina may relate to or indicate ovarian cancer risk. Lower levels of the protective bacteria Lactobacillus in the microbiota in the cervix was associated with higher incidence of ovarian cancer or BRCA1 mutation status, especially in younger women. The research is too preliminary to draw a causal relationship, and no evidence yet shows that restoring the Lactobacillus microbiota in the cervix/vagina might lower the risk.198

Natural Products

Group 1: Good clinical evidence of efficacy & safety, easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Read more

Group 3: Limited clinical evidence of efficacy but good safety, used in leading integrative programs

Read more

Group 4: Potential significant benefit, but either limited clinical evidence of efficacy or significant cautions

May be used in leading integrative oncology programs. Therapies in this group may need more medical oversight and surveillance.

Read more

Group 5: Especially promising preclinical or emerging clinical evidence of efficacy and safety

Other therapies with preclinical evidence only for reducing risk

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Group 6: Evidence of no efficacy or may be dangerous

Read more

Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

These therapies have exciting potential and/or proven benefits. However, some carry higher risks of side effects, interactions with other treatments and other adverse medical events than other therapies we review. Cautions are noted with each therapy, and we strongly urge you consult your doctor before using these therapies—even over-the-counter drugs—for cancer treatment. We also note whether a prescription is needed or if a therapy is not widely available. 

Group B: Limited clinical evidence of efficacy

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Optimizing Your Terrain

Creating an environment within your body that does not support cancer development, growth or spread

Natural Products

Group 1: Good clinical evidence of efficacy & safety, easy access

Read more

Group 3: Limited clinical evidence of efficacy but good safety, used in leading integrative programs

Read more

Group 4: Potential significant benefit, but either limited clinical evidence of efficacy or significant cautions

May be used in leading integrative oncology programs. Therapies in this group may need more medical oversight and surveillance.

Read more

Group 5: Especially promising preclinical or emerging clinical evidence of efficacy and safety

Read more

Energy Therapies

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Manipulative and Body-Based Methods

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Mind-Body, Spiritual and Consciousness-changing Approaches

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Commentary

Naturopathic oncologist and BCCT advisor Lise Alschuler recommends for people having significant side effects, especially gastrointestinal, from chemo, fasting for 48 hours—from after dinner on the day before chemo, through the day of chemo and the day following chemotherapy. The chemo fast can be a water fast (which includes coconut water and vegetable broths), or you can eat up to 600 calories per day of vegetable soup and/or low-carb vegetables. She stresses the importance of your being motivated to fast, and also that fasting during chemotherapy should be cleared with your treating oncologist. You should modify or stop the fast if you become dizzy or weak (try adding boiled eggs or nuts), or if you feel worse than if you had eaten.

Written by Laura Pole, RN, MSN, OCNS, and Nancy Hepp, MS, and reviewed by Maria Williams; most recent update on September 21, 2020.

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More Information

General Information on Ovarian Cancer Treatments

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Advocacy and Support Groups

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