If you have ovarian cancer, you’ll want to find the best care you can. If it’s within your means and ability, that may mean looking past the nearest hospital to one with plenty of experience with your cancer type.
Many studies have found that people with ovarian cancer live longer when they are treated at hospitals that regularly handle those cancers, called “high-volume centers” (HVCs). There are several possible reasons why:
- At these specialty centers, patients have a better chance of being treated by a gynecologic oncologist. That’s a doctor with training and experience in treating cancers of the female reproductive organs.
- These healthcare providers (HCPs) may also be more likely to stick to treatment guidelines issued by the National Comprehensive Cancer Network (NCCN).
- Patients may receive more careful surgery to remove as much of the tumor as possible, plus better postoperative care.
- Staff may be better at coordinating care for these complex cancers.
The centers can also more easily participate in clinical trials or studies that test the latest treatment options.
How race may play a role in treatment
In general, Black women develop ovarian cancer at somewhat lower rates than other women of other backgrounds. But the five-year survival rate for Black women is significantly lower than for white or Hispanic women. This is particularly true for Black women living in an area with a low socioeconomic status.
One potential reason for this discrepancy is that treatment plans for Black women may not line up with the recommended treatment guidelines. This may be due to racial bias, as well as risk factors like lack of sufficient insurance and a higher likelihood of the presence of other serious health conditions (comorbidities).
The type of treatment facility makes a difference, as does access to a wealthier area. Black women in high socioeconomic status neighborhoods have between a 25 and 56 percent better chance of survival, according to a 2023 study published in Annals of Epidemiology.
Practical advice to consider
If you or someone you love has been diagnosed with ovarian cancer, take the following steps to get the best care possible.
Ask to see a specialist
To access a specialist, you may need to advocate for yourself. This may especially be true for certain groups. For example, evidence suggests that women who are Black or who live in rural areas are less likely to get a referral to a specialist. Though it is not and should not be a patient’s responsibility to obtain the care they require, this is often the unfortunate reality.
Research suggests that taking steps to advocate for yourself when you visit your HCP can help offset racial bias. The most important thing to keep in mind is clear communication.
Be sure to write down questions in a list form that you can easily reference while speaking with them. Ask each of these questions. If an HCP says something that you don’t understand, ask them to clarify. Be persistent and firm. If the HCP doesn’t communicate well, doesn’t give you a chance to speak, or doesn’t appear to listen to your concerns, it’s okay to ask for another HCP to treat you.
If you need support, it may help to bring a trusted friend or loved one with you to the appointment.
Choose a hospital wisely
If you can, travel to a facility where more than 20 ovarian cancer cases are treated per year, which makes for an HVC. These hospitals are usually academic or research centers with top-notch experts. The National Cancer Institute offers tips on its website about finding a treatment facility that specializes in cancer care.
You’ll also want to do some digging online. Look for information on a hospital’s patient experience, mortality and complications data, and other statistics. Compare it to other nearby hospitals using Medicare’s online service, Hospital Compare. You can also check a hospital’s patient safety score with Hospital Safety Grade, run by the nonprofit organization The Leapfrog Group.
Understand your treatment options
Be sure you know what treatment options make sense for your type of cancer, such as surgery, chemotherapy, radiation therapy, or immunotherapy. Ask questions and choose HCPs who take the time to answer those questions. Here are some sample questions you can ask:
- What important things should I know about my ovarian cancer diagnosis?
- What treatment do you recommend?
- Why do you recommend this treatment?
- How does this treatment work?
- What are the side effects of the treatment?
- How will treatment affect my daily life?
- What is the goal of this treatment?
- How will I know if this treatment is or isn’t working?
- Where can I learn more about ovarian cancer and how it is treated?
- While being treated, what can I do to keep myself as healthy as possible?
It’s also wise to ask about other HCPs you might consult during treatment and who you can reach about cost questions.
Sources: Bristow RE, Chang J, Villanueva C, et al... + 13
- Bristow RE, Chang J, Villanueva C, et al. A Risk-Adjusted Model for Ovarian Cancer Care and Disparities in Access to High-Performing Hospitals. Obstet Gynecol. 2020 Feb;135(2):328-339.
- Millert-Kalińska S, Pruski D, Przybylski M, et al. High-Volume Hospitals' Ovarian Cancer Care-Less Individual Approach or Better Treatment Results? Curr Oncol. 2022 Jul 26;29(8):5278-5294.
- U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2022 submission data (1999-2020): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; released in November 2023.
- National Cancer Institute. Ovarian Cancer Studies Aim to Reduce Racial Disparities, Improve Outcomes. July 16, 2020.
- Cowan R, Shuk E, Byrne M, et al. Factors Associated With Use of a High-Volume Cancer Center by Black Women With Ovarian Cancer. JOP 15, e769-e776(2019).
- Washington CJ, Karanth SD, Wheeler M, Aduse-Poku L, et al. Racial and socioeconomic disparities in survival among women with advanced-stage ovarian cancer who received systemic therapy. Cancer Causes Control. 2024 Mar;35(3):487-496.
- Lawson AB, Kim J, Johnson C, et al. Deprivation and segregation in ovarian cancer survival among African American women: a mediation analysis. Ann Epidemiol. 2023 Oct;86:57-64.
- Chen F, Bailey CE, Alvarez RD, et al. Adherence to treatment guidelines as a major determinant of survival disparities between black and white patients with ovarian cancer. Gynecol Oncol. 2021 Jan;160(1):10-15.
- Fischer, Mary Claire. “Coaching patients to advocate for themselves can offset the effects of doctors’ racial bias.” Michigan Medicine. August 2, 2022.
- Landon BE, Onnela JP, Meneades L, et al. Assessment of Racial Disparities in Primary Care Physician Specialty Referrals. JAMA Netw Open. 2021 Jan 4;4(1):e2029238.
- Geissler KH. Differences in referral patterns for rural primary care physicians from 2005 to 2016. Health Serv Res. 2020 Feb;55(1):94-102.
- Agency for Healthcare Research and Quality. Comparative Reports on Hospitals. Page last reviewed December 2022.
- Bristow R, Chang J, Villanueva C, et al. A Risk-Adjusted Model for Ovarian Cancer Care and Disparities in Access to High-Performing Hospitals. Obstetrics & Gynecology. 2020 Feb;135(2):p 328-339.
- Centers for Disease Control and Prevention. How Is Ovarian Cancer Treated? Page last reviewed June 14, 2023.
