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Maintenance

Maintenance therapy is a type of treatment some people can take for ovarian cancer. Maintenance therapy is different from other types of cancer treatments. The main goal of maintenance therapy is to delay the return of the cancer. Use this page to learn more about maintenance therapy. Your doctor will help you decide what to do after treatment for ovarian cancer.

Explore Maintenance

Maintenance therapy is a type of treatment some people can take for ovarian cancer. Maintenance therapy is different from other types of cancer treatments. The main goal of maintenance therapy is to delay the return of the cancer. Use this page to learn more about maintenance therapy. Your doctor will help you decide what to do after treatment for ovarian cancer.

About Maintenance Therapy and Surveillance

Maintenance Therapies are given via:

An intravenous drug (through an IV)

Once or twice daily pills

What is Maintenance Therapy?

Maintenance therapy is additional treatment after primary treatment or platinum-based chemotherapy after recurrence. The goal of maintenance therapy is to delay the return of the cancer.

Your doctor may have you consider maintenance therapy after you complete your treatment and have no evidence of disease or a small volume of residual disease.

Usually, maintenance therapy is given for a longer period of time than chemotherapy but has fewer side effects. Maintenance therapy may increase the time a woman is cancer-free. However, it is not known whether maintenance therapy will help a woman live longer.

Maintenance therapy is intended for women whose cancers are responding to chemotherapy containing platinum. Women who want to take maintenance therapy must start it soon after finishing chemotherapy.

Maintenance therapy can either be:

  • An intravenous drug (through an IV)
  • Once or twice daily pills

Knowledge Check

Women with advanced ovarian cancer can start maintenance therapy at any time after finishing chemotherapy.

True
Incorrect. A woman who decides to take maintenance therapy must start it soon after finishing chemotherapy.
False
Correct. A woman who decides to take maintenance therapy must start it soon after finishing chemotherapy.

Medical Visits While on Maintenance Therapy

Medical visits while on maintenance therapy are similar to follow-up visits for women on surveillance. Imaging may occur every 3-6 months. Usually, medical visits are scheduled every 3-4 weeks. These visits may include:

  • Blood tests
  • Physical examination
  • Taking care of any other health issues related to cancer and treatment

Women who take maintenance therapy will need to see their doctors more often than women on surveillance. Consider the impact such visits and treatments might have on time away from your daily activities, the need for caregiver assistance, the financial impact of missing work (if applicable), as well as any expenses associated with transportation or lodging associated with the medical visits and treatment.

What is Surveillance?

Surveillance refers to follow-up visits with a heath care team after completing chemotherapy. The purpose of these visits is to check to see if the cancer has come back. Follow-up visits are also used to take care of any other health issues related to cancer and cancer treatment. These visits can include a physical examination and a CA-125 blood test. They usually do not include routine tests like CT scans or PET CT scans. However, these may be ordered if your healthcare provider thinks they are right for you.

For patients on surveillance, follow-up visits should generally be scheduled:

  • Every 3-4 months for years 1-2
  • Every 4-6 months for years 2-3
  • Every 6 months for years 3-5
  • Once per year after year 5

This schedule is recommended by the Society of Gynecologic Oncology. Your schedule may differ based on your individual situation.

Comparing Therapies

Below are some benefits and harms of maintenance therapy and surveillance. Please keep in mind that each person’s experience is different. You should talk with your doctor about the benefits and harms that are most important to you.
Maintenance Therapy Surveillance
Benefits
  • Doctors can’t tell how much a treatment may help, but for some women maintenance therapy may extend the time they are cancer-free or the time before having to go back on chemotherapy.
  • Some maintenance therapies work better in women who have certain germline genetic mutations, mutations in their tumor (somatic), or HRD+ tumors. (Visit Section One to learn more about biomarkers.)
  • Time off active treatment with no additional toxicity from additional cancer treatments
  • Time to recover from finishing chemotherapy
  • Generally fewer short-term financial costs
Harms
  • Potential Side Effects (see table below)
    Maintenance therapy may have side effects. Not everyone on maintenance therapy has the same side effects. Different types of therapies may have different types of side effects. Doctors might modify a woman’s treatment based on the side effects she experiences.
  • A lower or delayed dose can be as effective.
  • There are often treatments or medications to help manage the side effects.
  • Women may choose to stop taking maintenance therapy.
  • Women should stop maintenance therapy when their cancer comes back or when they have completed the recommended length of treatment.
  • None

Options Summary

You can read more information about maintenance therapy and surveillance below. More information about maintenance therapy options are included in the Consider Your Options section of this website.

Maintenance Therapy Surveillance
Time commitment for follow-up visits
  • Every 3-4 weeks
  • Every 3-4 months for years 1-2
  • Every 4-6 months for years 2-3
  • Every 6 months for years 3-5
  • Once per year after year 5
Drug treatment
  • Once or twice daily pills and/or IV infusions lasting 30 minutes every 3-4 weeks
  • None
Time on treatment
  • Until completion of maintenance therapy or progression
  • No therapy unless your cancer returns
Side Effects Common side effects may include:
  • Fatigue
  • Nausea
  • Abdominal pain
  • Anemia
  • Low blood cell counts
  • High blood pressure
  • Kidney problems
  • Bleeding
  • Lung inflammation
Rare but serious side effects may include:
  • Fatal blood cancers
  • Development of a hole in the intestine causing infection or death
  • None