Treatment Is Over: How Often Will I Be Seen, and What Does a Rising CA-125 Mean?
Last updated: 10 October 2026
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Ovary Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota, Ahmedabad · 18 years of experience
★★★★★ 5.0 · 18 Google reviews
IN SHORT
After treatment, you are seen every three months for two years, then every four to six months up to year five, then once a year.
Each visit checks your symptoms, weight and fitness, with an internal examination and a CA-125 test. Scans are not routine while you are well and the CA-125 is normal.
A rising CA-125 while you feel well is not, alone, a reason to restart chemotherapy. A CT scan is done, and the next step depends on you, not the number.
The first visit, two weeks after the operation
Follow-up begins before chemotherapy does. About two weeks after the operation, the wound is checked, and the stoma if there is one. The final pathology report is gone through with you. You are referred to the medical oncologist for chemotherapy. This visit also confirms two things. The BRCA and HRD result is back. The decision on maintenance treatment has been made.
Two problems can appear in the weeks after you go home. Both need a call, not a wait for the next appointment. Leg swelling, chest pain or breathlessness can mean a clot. This cancer carries a high clot risk. That is why the blood-thinning injections continue for 28 days after discharge. A watery discharge from the vagina weeks after surgery is not normal healing. It needs to be seen. What is normal in the first weeks is covered in our page on recovery after ovarian cancer surgery.
The follow-up calendar
Once treatment is complete, the visits settle into a fixed pattern. The gaps between visits lengthen as the years pass, but the checks stay the same.
| When | How often | What happens |
|---|---|---|
| Two weeks after surgery. | Once. | Wound or stoma check. Pathology discussed. Referral for chemotherapy. BRCA/HRD result and maintenance decision confirmed. |
| First two years. | Every three months. | Symptoms, examination including the internal check, weight, fitness, CA-125. |
| Years three to five. | Every four to six months. | The same checks. |
| After five years. | Once a year. | Clinical review. When to stop regular visits is decided for each woman. |
What is checked at each visit
- How you have been. You are asked every time about bloating, a swollen abdomen and feeling full after a little food. You are also asked about pain in the abdomen or pelvis, and weight loss.
- Examination. The abdomen is felt. An internal check looks at the pelvis and the vaginal vault. This is the closed end of the vagina where the uterus used to be.
- Weight and fitness. Your weight, and how active you are day to day, are recorded at each visit.
- CA-125. A blood test taken at every visit in the first five years.
Why a scan is not part of every visit
With no symptoms and a normal CA-125, scans are not done on a timetable. A CT scan is ordered when the CA-125 rises or a new symptom appears.
A PET-CT is kept for a doubtful finding or a suspected spread outside the abdomen. Many families expect a scan every few months and worry when it is not ordered. The schedule is deliberate. The visit, the examination and the CA-125 together tell the team when a scan is needed.
When the CA-125 goes up
A rising CA-125 is the moment most women fear. It is a signal to look more closely, not an automatic restart of chemotherapy. If you feel well, starting treatment on the number alone is not advised. The guiding rule is to treat the patient, not the number.
- A CT scan is done. The scan shows whether, and where, the disease has come back.
- The case goes to the tumour board. Every recurrence that might be operated on again is discussed there.
- The time since the last platinum chemotherapy is counted. Whether that gap is six months or more shapes which drugs are used next.
- A second operation is considered for some. This applies when the disease returns six months or more after platinum. It must also pass the tumour board’s test for complete removal. Then a second cytoreduction may be offered.
- Support for symptoms starts early. The palliative care team is brought in at every recurrence, not only at the end. They help control symptoms alongside treatment.
How a recurrence is treated is set out on our page on recurrent ovarian cancer.
Do not wait for the next appointment if you notice:
- Swelling of the abdomen that is new or growing, or bloating that does not settle.
- Vomiting with a swollen, tight abdomen, or no passage of stool or wind.
- Leg swelling, chest pain or sudden breathlessness.
- A watery discharge from the vagina in the weeks after surgery.
- Pain in the abdomen or pelvis that is new and does not go away.
Maintenance treatment alongside follow-up
For many women, maintenance treatment runs alongside follow-up. Which one, if any, depends on the BRCA and HRD result. It should start within twelve weeks of the last chemotherapy cycle.
| Test result | Maintenance usually discussed |
|---|---|
| BRCA1 or BRCA2 change. | Olaparib tablets for two years. |
| HRD positive, BRCA normal. | Olaparib with bevacizumab, or niraparib. |
| HRD negative or not known. | Niraparib, or bevacizumab alone. The expected benefit is smaller. |
Maintenance is given and monitored with the medical oncologist. Your follow-up visits continue on the same calendar. Cost and access are raised at the first counselling, not when the prescription is due. Maintenance should not be held up waiting for a genetic report that was not sent at diagnosis. That delay can be avoided, which is why the test is sent at the first visit.
Life after treatment: menopause, bones and family
If both ovaries were removed, menopause came on at once. For most epithelial ovarian cancers, hormone replacement is fine after discussion. Bone health is looked after during follow-up. Leg swelling after node removal is referred to the lymphoedema service. Support for intimacy and sexual health is part of the visits. If you carry a BRCA change, your mother, sisters and daughters should be offered the test. This is tracked until it is done, because it is often forgotten.
Frequently asked questions
Why is CA-125 checked at every visit?
Together with your symptoms and the examination, it tells the team when a scan is needed. In the first five years it is taken at every follow-up visit; after five years the review is clinical.
My CA-125 has gone up a little. Will chemotherapy start again?
Not on that number alone. If you feel well, a rising CA-125 is a reason for a CT scan and a tumour board discussion, not for restarting chemotherapy automatically. The team treats you, not the number.
I feel fine. Why am I not scanned every three months?
Scans are not routine while you have no symptoms and the CA-125 is normal. A CT scan is ordered when the CA-125 rises or a new symptom appears.
Which symptoms mean I should not wait for my next visit?
New or growing swelling of the abdomen, vomiting with a tight abdomen or no passage of stool or wind, leg swelling, chest pain or breathlessness, a watery vaginal discharge in the weeks after surgery, and new pain that does not settle.
I have a BRCA change. Does my daughter need the test?
Your first-degree relatives, including your mother, sisters and daughters, should be offered the test. Follow-up keeps track of it until it is done, because it is often forgotten.
Related pages
For an overview of how ovarian cancer is treated at the institute, read our ovarian cancer page. It brings the stages, surgery and chemotherapy together.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Ovary Cancer Surgeon
Indian Ovary Cancer Institute I Ovary cyst & tumour treatment — SF-203, 2nd Floor, Olive Greens, Gota, S G Highway, Ahmedabad, Gujarat 382481
Dr Swati Shah Gynec Oncologist I Uterus, Cervix, Ovary Cancer I Robotic & CRS HIPEC — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat 382428
Call: +91-63590-11009 · WhatsApp: +91-63590-11009
Finished surgery and chemotherapy, and not sure what the next few years of check-ups involve? You can send your latest CA-125, scan report and discharge summary ahead on WhatsApp. Then the visit starts with them already read. Any change in treatment is decided at the visit, after an examination. Call +91-63590-11009 Send reports before your visit
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