Surgery is the main treatment for most ovarian cancers. How much and what type of surgery you have depends on how far the cancer has spread, your health (other than the cancer), and whether or not you still hope to have children. For women of childbearing age who have certain kinds of tumors and whose cancer is in a very early stage, it may be possible to treat the disease without taking out both ovaries and the uterus.
Surgery for epithelial ovarian cancer has 2 main goals: finding out how far the cancer has spread (staging) and removing as much of the cancer as possible (debulking). Because only gynecologic oncologists are trained to do these, it’s important that surgery for ovarian cancer be done by this specialist and not a regular gynecologist or general surgeon. If the cancer isn’t staged and debulked properly the first time, you might have to have a second surgery.
The most common operation for ovarian cancer includes removing the uterus, both ovaries, and both fallopian tubes. The omentum (a layer of fatty tissue that covers the stomach area like an apron) is also removed. Some lymph nodes in the pelvis and belly (abdomen) are taken out to see if they contain cancer. If there is fluid in the belly (abdominal area), it will also be removed. The surgeon may also remove tissue samples from different places inside the abdomen and pelvis. All the tissue and fluid samples taken during the operation are sent to a lab and checked for cancer cells.
If the cancer has spread to the tissue inside the abdomen and pelvis, the surgeon will remove as much of it as possible. The goal of this surgery is to leave behind no tumors larger than 1 cm. If this surgery is successful, the patient is considered optimally debulked. This is important because patients who have had optimal debulking surgery have a better outlook than those left with larger tumors after surgery.
To debulk the cancer, the surgeon may need to remove part of the colon, bladder, stomach, liver, and/or pancreas. The spleen and/or gallbladder may also need to be removed. This leads to more side effects.
Taking out both ovaries and/or the uterus means that you will not be able to become pregnant. It also means that you will go into menopause if you have not done so already.
For more information about surgery for ovarian cancer, including possible side effects, see our Ovarian Cancer.
Last Revised: 02/03/2016