What are the disadvantages of radiation for ovarian cancer?

When I started my residency a long time ago, radiation therapy was one of the main treatments for ovarian cancer. Doctors used to radiate the entire abdomen. But chemotherapy became more effective than radiation therapy. The complications from radiation therapy, treating the whole abdomen, are very high.

Ovarian cancer spreads into the abdominal cavity, so doctors need to treat the entire abdominal cavity. Where there are wider organs like the liver and kidneys whose radiation tolerance is very low, the amount of radiation you can give these organs is not adequate to control the microscopic disease. So with effective chemotherapy, radiation therapy is not used anymore in a general fashion. But doctors do use radiation therapy for some targeted local problems where indicated -- if there’s a painful mass, a tumor that is not respondent to chemotherapy and is causing an obstruction, or some problematic areas.

As a rule of thumb, there is no standard role for radiation in patients with ovarian cancer. Because ovary cancer is a systemic disease, chemotherapy which treats the entire body is more effective therapy.