Surgery is often the first step in treating most ovarian cancers. For some women, treatment may begin with chemotherapy to shrink the tumour before surgery.
Surgery is also important for staging the ovarian cancer. When the tumour is removed through surgery it will be examined by a pathologist and the stage and grade of the ovarian cancer will be determined. This will help the gynecologic oncologist determine the appropriate treatment.
“Epithelial cancer on the ovary is now known to consist of at least five different diseases. Treatment is dependent on a number of factors including tumor type (histology), burden of disease (stage and amount of cancer), physical health and genetic differences. Treatment generally involves both chemotherapy and surgery, the sequence of which is based on the overall clinical situation and is individualized to obtain optimal personalized care." The Society of Gynecologic Oncology of Canada
GOC Statement Regarding Neoadjuvant Chemotherapy vs. Upfront Debulking Surgery for Treatment of Advanced Stage Cancer of the Ovaries
How surgery is performed
Surgery for ovarian cancer should be performed by a gynecologic oncologist. A gynecologic specialist is a medical doctor with five years of postgraduate training in obstetrics and gynecology plus an additional two years of cancer training. He/she will manage the treatment (surgery and chemotherapy). When surgery is performed by a gynecologic oncologist the chances are improved for a longer time to possible recurrence and increased survival time.
The standard treatment for ovarian cancer is surgical removal or "debulking" of the cancer: the surgeon removes as much of the tumour as possible. Ideally the patient should be reduced to no visible residual disease as maximal debulking has been shown to improve a woman’s prognosis.
What is removed
Depending on how much the cancer has spread, one or both ovaries will be removed along with the fallopian tubes. The uterus, cervix and omentum (the thin tissue that surrounds the stomach and other organs in the abdomen) may also be removed along with lymph nodes.
After the surgery
Always ask your doctor or the nurse assigned to you to explain what has been removed and anything that is not clear about the surgery.
After surgery for ovarian cancer, your gynecologic oncologist is likely to recommend:
Chemotherapy and/or radiation; chemotherapy can also be given before surgery (neoadjuvant chemotherapy)
Wait and see, monitor your symptoms and be closely followed by your physician
Some women may not need chemotherapy because their cancer was either:
Low Malignant Potential (which is not as aggressive) or
It was caught at an early stage and chances are high that it is not likely to recur.
Recovery may take about 6-8 weeks, depending on a number of factors such as:
your general state of health prior to surgery
the extent and complexity of your surgery
how much rest you are getting
Assuming you have no serious complications such as infection, you will normally go home within a week after the surgery.
Some side effects of surgery may include:
Vaginal bleeding or discharge
Urinary tract frequency and urgency
Increased feelings of stress, anxiety or depression
Increased depressive symptoms
Pain and swelling
Rash or itching
These should be brought to your doctor’s attention.
For more information:
Recovering from ovarian cancer surgery (Cancer Research UK)