Since the end of June, I have officially been in complete remission, which basically means that right now, no cancer can be seen on any scans. At the beginning of July, I started maintenance treatment, which I am still getting used to.

I haven’t posted an update all summer, so I guess I should start by explaining what “maintenance treatment” actually means. After my main treatment, which in my case consisted of two major abdominal surgeries and six rounds of chemotherapy, my doctor prescribed pills containing olaparib, a drug that belongs to a group called PARP inhibitors. Olaparib blocks PARP enzymes, which help cells repair damaged DNA.

The purpose of these pills isn’t really to “finish off” the treatment. The idea is to keep the response we’ve already achieved for as long as possible and reduce or delay the risk of the cancer becoming active again. If my tests continue to look good, I’ll be taking olaparib for two years. We are all hoping that this is enough time for it to find and sufficiently damage any cancer cells that might have survived chemotherapy but are too small to show up on scans.

Obviously, I went looking for numbers.

I found a study from 2023 (SOLO1 study, DiSilvestro et al., 2023) that followed women with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation who had achieved either a complete or partial response after surgery and platinum-based chemotherapy. In the study, 260 women received olaparib (Lynparza) as maintenance treatment for a maximum of two years, while 131 women received a placebo.

And the results are actually pretty encouraging.

Seven years later, 67% of the women who had received olaparib were still alive, compared with 46.5% of those who hadn’t received it. Even more interesting to me, 45.3% of the women treated with olaparib were still alive after seven years and had not needed any further anti-cancer treatment. Without olaparib, that number was only 20.6%.

The study even says that olaparib may increase the possibility of a cure. Unfortunately, we still can’t say that those 45.3% of women were actually “cured.” We can “only” say that seven years later they were alive and hadn’t needed any more cancer treatment. I’ll take that.

Another thing I liked about this study is that it wasn’t some tiny study done in one hospital. It was an international study carried out at hospitals and medical centers across 15 countries.

Unfortunately, they don’t tell us very much about the women whose cancer did come back—where exactly it came back, what the recurrence looked like, how extensive it was, etc. They mainly tell us how long it took before the cancer progressed and what treatment the women received afterwards. And obviously, that was exactly the information I wanted to know.

I did find another interesting number, though. Out of the 260 women who received olaparib, 14 developed a new primary cancer—so not a recurrence of their ovarian cancer, but a completely new cancer. Ten of those 14 developed breast cancer. To put that into perspective, that’s 10 out of all 260 women, so around 4%, not 10 out of 14 women in the study.

It’s only one study, but together with everything I already know about my genetic risk, it has made me even more certain that once I’m done with olaparib, I want to ask for a preventive mastectomy—removing the breast tissue to reduce my chances of developing breast cancer as much as possible. I’m definitely not going to make cancer’s job any easier.

A preventive mastectomy can reduce the risk of breast cancer by approximately 90–95%. They apparently keep that last few percent because it’s basically impossible to remove every single bit of breast tissue. If there is no cancer present, it should also be possible to preserve the external appearance of the breasts and have reconstruction done at the same time. And because in my case this would be done for medical reasons rather than cosmetic ones, it should be covered by health insurance.

Of course, after reading SOLO1, I wasn’t done. I wanted to know where ovarian cancer actually goes when it comes back.

From other studies, I found that in one study, around 75% of women who experienced recurrence had cancer involving the peritoneum. The peritoneum is basically the membrane lining the inside of the abdomen and covering many of the organs there. Only about 8% had an isolated distant metastasis without anything showing up in the abdominal area.

Some ovarian cancers apparently also like to hang around in the lymph nodes, and when the recurrence stays confined to the lymph nodes, it can sometimes progress more slowly. If ovarian cancer decides to pick a distant organ instead, the liver is one of its more common choices.

And then I found one more piece of information that I consider pretty important:

The longer you stay cancer-free after platinum-based chemotherapy, the greater the chance that the cancer will respond well to platinum chemotherapy again if it ever comes back.

So every month without cancer matters.

For now, though, there is nothing visible on my scans. I’m taking my pills, getting my blood tests done, trying to get used to the side effects, and hoping those little olaparib pills are somewhere inside me making life extremely unpleasant for anything that shouldn’t still be there.

So… I guess we have a plan.