What’s Really Happening While You Wait On Ovarian Cancer Treatment Recommendations

It’s normal to wonder what’s going on in your body or worry that the cancer may be growing or progressing as you wait. “People often express concern about the possibility of their cancer spreading,” says Charles “Trey” Leath, MD, an obstetrician-gynecologist at UAB Medicine in Birmingham, Alabama. “We try to reassure them that we’re working on getting a plan in place.”

As hard as it can be, waiting is an expected part of the treatment process, not a sign that something is wrong or being overlooked. Developing the right treatment plan takes time. Understanding why these pauses happen and learning ways to cope with them can help you feel more grounded and better prepared for what comes next.

A few common scenarios lead up to an ovarian cancer diagnosis, as doctors take time to determine the type, stage, and spread of the cancer. That includes:

• Suspecting Ovarian Cancer Based on Imaging, Blood Work, or Symptoms If doctors find a concerning mass on imaging, get unexpected lab results, or have concerns about symptoms you’re having, surgery may be needed to biopsy or remove the tumor. Tissue samples are then sent to a lab for analysis by a pathologist to confirm if ovarian cancer is present and, if so, what type and stage it is.

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   Your doctor won’t know if you have ovarian cancer until the biopsy results are back from the lab, which can take up to a week or two. “We’re waiting [until then] to have those conversations,” says Dr. Leath.
• Ovarian Cancer Suspected But Not Fully Removable With Surgery Yet Sometimes, imaging shows that the tumor can’t safely be removed right away. In that case, doctors wait on the initial biopsy results to confirm ovarian cancer. They’ll plan for chemotherapy to shrink the tumor to make it more operable and then schedule surgery to remove the shrunken tumor later. Waiting on the next steps can occur after each stage.

After ovarian cancer is officially diagnosed, there is often additional waiting before treatment begins as your care team determines the best course of action, depending on the stage and spread of the cancer. Multiple specialists may be involved, including gynecologic oncologists, medical oncologists, pathologists, and radiologists, who all contribute to creating the safest and most effective treatment plan.

• Finalize staging and pathology details, including tumor subtype and grade
• Hold multidisciplinary tumor board meetings, where specialists come together to review your case
• Determine the best treatment plan for you, including recommendations and timing for surgery and/or chemotherapy
• Coordinate treatment scheduling
• Map out a recovery timeline and follow-up care recommendations

“I know you might want to talk about the implications of ovarian cancer sooner, but we can’t do that until we have all of the information we need,” says Leath.

In addition, some people who are diagnosed with early-stage ovarian cancer may not need further treatment. If the initial diagnostic surgery successfully removes all of the cancerous tissue, and the biopsy results show no evidence that the disease has spread, chemotherapy may be avoided.

Instead, your care team may recommend close monitoring with regular follow-up visits and imaging. While this approach helps prevent unnecessary treatment, it can still involve periods of waiting between appointments and scans while doctors watch carefully for any signs of recurrence.

In addition to planned waiting periods, unexpected factors can extend the timeline. Although it may add to the stress of the situation, an extension to your wait time isn’t a cause for concern in most cases. Rest assured that your ovarian cancer care team is trained to recognize when a prolonged wait time is a safe way to ensure the best possible course of treatment and if urgent action is needed.

Some reasons your estimated timeline may be pushed out include:

• Second Opinions Reviewing pathology reports, reinterpreting scans, or consulting another specialist can add time but may ultimately improve confidence in the treatment plan.

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• Insurance Approvals Authorizations for surgery, chemotherapy, or speciality referrals can take time. Limited access to an in-network gynecologic oncologist can also delay care.

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• Access to Specialized Care If there’s a lack of gynecologic oncologists in your area, you may need to travel for treatment. This can affect how long it takes to coordinate and schedule treatment.

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• Decide on your research comfort zone. Some people dive in and search for all of the information they can find about ovarian cancer, while others find this feeds into their anxiety, says Leath. Think about whether internet sleuthing might feel comforting or if you need to set limits on your googling.
• Focus on post-op recovery. If the tumor has been removed, you’ll likely need to go through several rounds of chemotherapy, starting four to six weeks after surgery, says Leath. In the meantime, use waiting periods to prioritize healing and regain strength with light movement, nutrition, and rest.
• Jot down questions. You may have a lot of thoughts swirling around. Write down all of the things you’d like to ask at your next follow-up appointment. Make note of which topics feel most pressing, so they don’t get lost in the shuffle.
• Ask your care team to clarify timelines. Knowing when you should expect updates from your care team can help set your expectations and ease unnecessary uncertainty, says Leath.
• Lean on your support system. Identifying a key group of family members and friends to lean on for emotional and practical support can make waiting feel more manageable. Also consider setting up an appointment with a mental health provider to help you navigate the road ahead.
• Make space for healthy distractions. Waiting doesn’t mean you have to sit with uncertainty all day long. This is a good time to get pulled into a TV series, lose yourself in a book or audiobook, pick up a craft, or try a new baking project. Small, comforting distractions can give your mind a much-needed break from worry.
• Create light structure in your day. Small routines or simple daily goals can help restore a sense of normalcy and control during an uncertain time. Even something as manageable as a short walk, a regular mealtime, or a daily playlist can offer grounding without demanding too much energy.

• Ovarian cancer care involves multiple waiting periods, both leading up to diagnosis and throughout the treatment process. Sometimes the wait is longer than initially planned, which adds to the stress of the situation.
• During these wait times, your care team is coordinating with specialists, gathering information, and mapping out the right treatment plan for you.
• Finding ways to stay grounded while you wait, including setting realistic timeline expectations, taking care of your physical and emotional health, and writing down questions, can help you navigate the uncertainty with greater confidence and support.