Ovarian Cancer Overview

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Treating Ovarian Cancer TOPICS

Surgery for ovarian cancer

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.

For epithelial ovarian cancer, surgery has 2 main goals: staging and debulking (these are discussed in detail further on). It’s important that this surgery be done by someone who’s experienced in ovarian cancer surgery. Many gynecologists and surgeons are not trained to do the staging and debulking that are needed in treating ovarian cancer. For this reason, experts recommend that patients see a gynecologic oncologist for surgery.

Staging

Surgery for ovarian cancer has 2 main goals. The first goal is to stage the cancer − to see how far the cancer has spread from the ovary. Staging is very important because ovarian cancers at different stages are treated differently. If the staging isn’t done right, the doctor might not be able to give the right treatment.

Most often, staging means taking out 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 to be looked at for cancer cells.

Debulking

The other goal of surgery is to remove as much of the tumor as possible. This is called debulking. The aim of this surgery is to leave behind no tumors larger than 1 cm. Patients who have had successful debulking surgery have a better outlook than those left with larger tumors after surgery.

In order 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.

Sometimes when a piece of colon is removed, the 2 ends that remain can simply be sewn back together. In other cases, though, the ends can’t be sewn back together right away. Instead, the top end of the colon is attached to an opening (stoma) in the skin of the belly to allow body wastes to get out. This is known as a colostomy. Most often, this is only temporary, and the ends of the colon can be reattached later in another operation. For more information, refer to our document, Colostomy: A Guide.

If part of the bladder needs to be removed, a catheter (to empty the bladder) will be placed during surgery. This will be left in place after surgery until the bladder recovers enough to be able to empty on its own. Then, the catheter can be removed.

Most women will stay in the hospital for 3 to 7 days after the operation and can go back to their usual activities in 4 to 6 weeks. 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.


Last Medical Review: 04/22/2013
Last Revised: 02/06/2014