Coping With the Emotional Challenges of Platinum-Resistant Ovarian Cancer

To help, we spoke with experts and people living with platinum-resistant ovarian cancer about coping strategies.

Pause to Process the Situation

Many people describe fear as their first reaction to learning that their cancer is platinum-resistant, says Amy Raedeker, an advanced practice provider and the program director at Mission Cancer + Blood, part of University of Iowa Health Care. Platinum chemotherapy is a go-to treatment for ovarian cancer, so if the tumor returns, it may feel like the “best” treatment didn’t work, she says.

For Amanda Widro, an Ovarian Cancer Research Alliance (OCRA) community member in Baltimore, hearing the news was like a maelstrom. Widro, who was 45 when she was diagnosed with stage 3C ovarian cancer in 2023, experienced a recurrence just six weeks after finishing platinum-based chemotherapy. “I felt like I was in this whirlwind of everything that was going on,” she says.

Manage Emotional Fatigue

It helps to pace yourself, says Raedeker. That means being deliberate about where your energy goes and reducing unnecessary stress.

Pedreira calls it “energy budgeting.” If you only have 60 percent of your usual capacity, she says, you get to allocate where that 60 percent goes. This often means saving your energy for the people, activities, and moments that are most important to you. Remember that choosing to rest is a form of self-care. “Your body and mind are doing enormous work just managing the illness and treatment,” she says.

Dorr shared a few things that helped her along the way.

• It’s okay to say no. If you don’t feel up to social plans, decline or take a rain check on the offer.
• Keep a journal. Writing down your thoughts or tracking your good hours can help you see patterns in your energy and provide a private space to vent.
• Focus on your own path. Your journey with platinum-resistant ovarian cancer is entirely your own, and your experience will likely look very different from someone else’s.
• Take care of yourself first. Be gentle with yourself on difficult days instead of comparing yourself to how you felt before cancer.

Recognize and Address Depression and Anxiety

Feeling sad after learning your ovarian cancer is platinum-resistant is normal, says Rahul Gosain, MD, a medical oncologist at Wilmot Cancer Institute in Webster, New York, and a cohost of the Oncology Brothers podcast. But when sadness or worry starts affecting your emotional well-being, it may be a sign of depression or anxiety, and it’s important to let your care team know early so you can get appropriate support, he says.

What are the signs to watch for? Pedreira says to pay attention to how long the feelings last, how intense they are, and how much they’re affecting your ability to function.

• Sadness that does not go away, even briefly
• Losing interest in things that once brought you comfort or enjoyment
• Feelings of hopelessness
• Difficulty sleeping or sleeping too much
• Significant changes in appetite
• Thoughts of self-harm

• Constant worry that’s hard to control
• Physical symptoms like chest tightness or difficulty breathing
• Avoiding medical appointments or scan results out of fear
• Feeling like you’re in a near-constant state of panic

“If any of these feel familiar, reach out to your oncology team and ask for a referral to a psychologist or psychiatrist,” Pedreira says. “Mental health care is part of comprehensive cancer care.”

Build a Support System

Going through this alone is a lot to ask of yourself. Treating and fighting cancer is a team effort, says Dr. Gosain, and a support system can help you feel more connected and cared for.

• An oncology nurse navigator to help coordinate care
• A social worker to help connect you with financial, transportation, and community resources
• A psychologist or therapist to help you process emotions and develop coping strategies
• Friends and family to help with daily needs and emotional support

Your oncology team can help you access many of these resources, so call them and ask.

“Support does not need to come from one person alone,” says Raedeker. One friend may be the person you vent to, while another helps distract you for a while. Some people may help with rides, meals, childcare, or keeping you company during treatment. Your support system can also change as your needs change, she adds.

Accept help when it’s offered and ask for it, too, Dorr says, and be specific about what you need. Connecting with others through support groups became a valuable source of comfort and information for her.

Widro also found leaning into support groups helpful. She belongs to several online communities, including ones specific to her treatment, where people share experiences, side effects, and coping tips.

You can find peer support groups through organizations like OCRA and NOCC.

Set Boundaries Around Draining Conversations

Pedreira shares the following examples to help you set boundaries around those conversations:

• “I know you’re trying to help, but right now I need you to just sit with me in this hard moment rather than trying to fix it or find the silver lining.”
• “I don’t have the energy for updates right now. Can we just watch a show together instead?”
• “I have a great medical team helping me navigate this. I’d appreciate support from you, not solutions.”

At the same time, choosing to hold onto hope for yourself is different from feeling pressured to stay positive for other people. Dorr says staying hopeful and leaning on her faith after her recurrence has been a great help, and it was something she chose for herself.

Another difficult part of navigating cancer conversations is feeling like you have to protect other people from the reality of what’s happening. Widro says that she softened the truth about her diagnosis and disease progression to spare friends and family from worry. She eventually realized she could share updates honestly and let loved ones process that information in their own way. You can practice this by saying what you need to say and allowing others to respond however they need to. Doing so is part of caring for yourself.

Find Comfort in New Treatment Breakthroughs

Some of the newer treatments approved by the U.S. Food and Drug Administration include:

• pembrolizumab (Keytruda) plus weekly paclitaxel (Taxol), with or without bevacizumab (Avastin), an immunotherapy-based combination that helps the immune system recognize and attack cancer cells

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• relacorilant (Lifyorli) combined with nab-paclitaxel (Abraxane), a treatment that blocks the stress hormone cortisol, potentially making cancer cells more vulnerable to chemotherapy

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• mirvetuximab soravtansine-gynx (Elahere), an antibody-drug conjugate (ADC) that delivers chemotherapy more directly to certain ovarian cancer cells that carry the folate receptor-alpha (FR-α) protein

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These treatments won’t be appropriate for everyone, but they represent meaningful progress, and they provide more tools for your care team.

Staying informed can help you feel more like a partner in your care rather than a bystander. Ask your oncology team to explain the treatment options available to you, the benefits each one might offer, and the risks to consider.

Research into platinum-resistant ovarian cancer continues to grow, and more treatments are being studied in clinical trials. If you’re interested in clinical trials, your team can help you understand whether you may be a candidate and how to enroll.

You can also search for studies through ClinicalTrials.gov or the National Cancer Institute.

The Takeaway

• After a platinum-resistant ovarian cancer diagnosis, it’s normal to experience difficult emotions. They’re valid, so give yourself time to process them.
• Along with physical fatigue, emotional fatigue can occur, so pace yourself and discuss symptoms of depression or anxiety with your care team early on to get connected with appropriate support.
• A support system, whether through your care team, loved ones, or peer communities, is often helpful, and you are allowed to set boundaries around conversations that drain you.
• New treatments and clinical trials continue to expand options for platinum-resistant ovarian cancer. Learn about those options, and talk to your care team about whether you might be eligible for a clinical trial or newer targeted treatment.