Surgery is the main treatment and diagnostic tool for most ovarian cancers. The goal is to see how far your cancer has spread, and to remove as much of the tumor as possible.
The type of operation you’ll have depends on the stage of your cancer and your health. Usually the surgeon will remove your uterus, ovaries, and both fallopian tubes. They may also need to remove other tissue in your abdomen if the cancer has spread. Your surgeon will do the procedure that will give you the best result with the fewest side effects.
Preparation
A week or two before surgery, your doctor will do some tests to make sure you are healthy enough for the procedure. These might include:
- Blood and urine tests
- Chest X-ray of your heart and lungs
- Electrocardiogram (EKG or ECG) to check your baseline heart rhythm
Ask your doctor if you need to stop taking any medicines, supplements, or herbal products before your surgery. The doctor will tell you not to eat or drink anything after midnight on the night before your procedure.
What Happens
A gynecologic oncologist does ovarian cancer surgery. This doctor specializes in treating cancers of a woman's reproductive tract.
During surgery, the doctor will check to see how far your cancer has spread and remove as much of it as possible. You'll get medicine before the surgery to make you sleep, and to prevent pain.
Ovarian cancer surgery includes a few different procedures:
- Partial hysterectomy removes the upper part of your uterus.
- Total hysterectomy removes both your uterus and cervix.
- Bilateral salpingo-oophorectomy (BSO) removes your ovaries and both fallopian tubes
- Unilateral salpingo-oophorectomy removes just one ovary and one fallopian tube.
- Omentectomy removes the layer of tissue that covers your stomach and large intestine
- Lymph node dissection removes some of the lymph nodes in your pelvis and abdomen
Your surgeon may use the drug pafolacianine (Cytalux), which illuminates cancerous tissue and can help locate otherwise hard to detect lesions. The surgeon will send your tissue samples to a lab to find out how far your cancer has spread. This can help your doctor plan the rest of your treatment.
During the surgery, you might also get a peritoneal wash. The surgeon will put sterile fluid in your abdomen and then remove it. The fluid will go to a lab to be checked for cancer cells.
If the cancer has spread to your pelvis or abdomen, the surgeon will try to remove as much of it as possible. This is called “debulking.” The doctor may remove a piece of your colon, bladder, stomach, liver, spleen, appendix, and/or pancreas. You might have chemotherapy after surgery to get rid of any cancer cells that are left behind.
Recovery
You'll stay in the hospital for 3 to 7 days after your surgery. You'll be in some pain, but your doctor will give you medicine to control it. You might also have some nausea and bleeding from your vagina.
You'll want to avoid heavy lifting, exercise, and sex for a few weeks after your surgery. You should be able to go back to your normal activities in 4 to 6 weeks. Your surgeon will tell you when different activities are safe to resume.
If your surgeon removed part of your colon during surgery, you may need to wear a colostomy bag on your belly to collect stool. In most cases this is temporary.
If part of your bladder is removed, you'll have a thin tube called a catheter placed in your bladder to remove urine until your bladder starts to work again.
Risks from surgery include:
- Bleeding
- Infection
- Damage to nearby organs like the bladder or ureters
When to Call the Doctor
Call the doctor if you have any of these symptoms after your surgery:
- Fever higher than 100.4 F
- Redness, swelling, or liquid oozing from the surgery site
- Severe nausea, vomiting, or belly pain
- Heavy bleeding (soaking through more than two pads an hour)
Life After Surgery
If both of your ovaries are removed, you'll go into menopause. You won’t be able to get pregnant, and you might also have:
- Hot flashes
- Night sweats
- Dry vagina
- Fatigue
- Mood shifts
Ask your doctor for ways to manage these symptoms.
If only one ovary was removed and you weren’t in menopause before the operation, you may be able to get pregnant later. Talk to your doctor about your fertility options before your surgery.
You might also want to see a therapist or counselor to talk about the emotional changes ovarian cancer surgery can cause. You might also want to consider joining a support group for women with ovarian cancer.
After your surgery, you'll meet with your doctor regularly. The doctor will examine you and do tests to make sure your cancer hasn't come back.
