Surgery for Ovarian Cancer

Ovarian cancer is a disease that starts in the ovaries. Part of the female reproductive system, the ovaries are responsible for producing eggs as well as the hormones estrogen and progesterone. Surgery and chemotherapy are frequently used approaches to treating ovarian cancer.¹

Goals of surgery

The 2 main goals of surgery for ovarian cancer are:²

• Staging – Staging means finding out the size of the tumor and if it has spread to other parts of the body. This helps doctors plan the best treatment.
• Debulking – Debulking means removing as much of the cancer as possible. This step is vital if the cancer has spread to other areas of the body. For example, this may mean removing a section of the colon, a piece of the bladder, or removing the spleen and/or gallbladder if the cancer has spread to those areas.

Types of surgery

There are different types of surgery for ovarian cancer. The type of surgery you have will depend on the specific form of ovarian cancer being treated, as well as the stage of your cancer and your overall health.^2,3

• Unilateral salpingo-oophorectomy – Surgery to remove 1 ovary and its associated fallopian tube. This is usually done with early-stage cancer that has not spread beyond that ovary. This can also be a fertility-sparing option if you are still wanting to become pregnant and only 1 ovary is impacted.
• Bilateral salpingo-oophorectomy – Surgery to remove both ovaries and both fallopian tubes. This surgery alone does not remove the uterus. So, using frozen embryos or donor eggs could be an option following surgery if you want to become pregnant.
• Hysterectomy – Surgery to remove the uterus, and may be done in combination with a bilateral salpingo-oophorectomy. This surgery is an option if you do not wish to become pregnant.
• Omentectomy – This surgery removes the omentum, a layer of fatty tissue in the abdomen.
• Lymph node removal – This surgery removes certain lymph nodes to see if the cancer has spread.
• Debulking surgery – This is a more extensive surgery that removes as much of the cancer as possible. It may involve removing parts of other organs, like the bowel or spleen. This is usually done for more advanced forms of ovarian cancer.

What is involved with surgery?

Surgery for ovarian cancer is typically done under general anesthesia. This means you will be asleep during the procedure. The surgeon will generally make a vertical (up and down) cut from your belly button to the pelvic bone. This is called a laparotomy. It is the most common method used for ovarian cancer surgery. This procedure allows the surgeon to see all the areas where the cancer is present so that it can be safely removed.⁴

Sometimes, surgeons use minimally invasive techniques, called a laparoscopy. This involves making a few small cuts in the abdomen and using special tools. This method is typically used for cases where the cancer has not spread beyond the ovaries.⁴

After surgery, you can often expect to stay in the hospital for about 3 to 7 days, depending on the type of surgery. It is normal to have some pain after surgery, but your doctors will give you medicine to help with that. You will also need time to recover at home. You should be able to resume normal activities after about 4 to 6 weeks.²

Benefits and risks of surgery

Surgery can have many benefits. It can remove the cancer and help you live longer. It can also improve your quality of life by relieving symptoms. However, like any surgery, it comes with some risks.⁵

These risks can include:⁵

• Infection
• Swelling of the legs
• Bleeding and bruising
• Damage to other organs
• Constipation or diarrhea
• Side effects from anesthesia, like nausea or vomiting
• Early menopause

At times, depending on the extent of surgery, a person might have part of the bowel removed. This may require the need for a temporary or permanent ostomy bag to remove waste from the body.⁵

Talk to your doctor

You may need other treatments, like chemotherapy or radiation therapy, after surgery to ensure all the cancer is gone. Talk to your doctor about all your treatment options.^2,3

You will need regular checkups after surgery and during treatment, to make sure the cancer has not returned and that treatment is working. Consider joining a support group or getting counseling to help you cope with the emotional and physical effects of ovarian cancer.