Surgery for ovarian cancer
The first line in the treatment and diagnosis of ovarian cancer at Cancer Treatment Centers of America® (CTCA) is often surgery. Our goal during ovarian cancer surgery is to locate and remove all visible signs of cancer in a process called debulking.
During surgery for ovarian cancer, our gynecologic oncologists may also collect samples from a variety of tissues to test for the presence of cancer in order to determine whether the cancer has spread, or metastasized. They also work with other members of your care team to anticipate and help manage side effects that may result from surgery.
Whether an ovarian cancer patient is a candidate for surgery depends on several factors, including preexisting medical conditions, nutritional status, whether the patient has undergone previous surgeries to treat the cancer, and, in the case of a recurrence, when the last cancer treatment was performed.
Ovarian cancer surgical procedures
During the initial debulking surgery, your gynecologic oncologist may perform a variety of procedures, depending on the type and stage of ovarian cancer, as well as your individual fertility concerns.
These procedures may be done in one of two ways: During a laparotomy, an incision is made to open up the abdomen. During a laparascopy, small incisions are made in the abdomen. Your ovarian cancer surgical oncology team will discuss the best approach for you, which may include any of the following:
- Unilateral salpingo-oophorectomy: Surgical removal of one ovary and one fallopian tube
- Bilateral salpingo-oophorectomy: Surgical removal of both ovaries and both fallopian tubes
- Total hysterectomy: Surgical removal of the uterus, including the cervix
- Omentectomy: Surgical removal of part or all of the omentum, a fold of fatty tissue inside the abdomen
- Bowel resection: Surgical removal of part of the small or large intestine
- Diaphragm surgery: Surgical removal of part of the diaphragm
- Appendix surgery: Surgical removal of the appendix
- Lymph node dissection: Surgical removal of multiple lymph nodes in the abdominal cavity
Ovarian cancer surgery may be followed by chemotherapy. Often the chemotherapy will be administered directly into the abdominal cavity, known as intraperitoneal chemotherapy. If you are a candidate for this type of chemotherapy, your oncologist will put a thin tube in the abdomen during surgery. Once it heals, chemotherapy treatment will begin.
Addressing fertility concerns
If you want to preserve your fertility, your ovarian cancer surgical oncology team may be able to remove only the affected ovary. Patients battling more complex disease may not be candidates for this option. At CTCA®, we will discuss a variety of fertility-sparing procedures with you, including retrieving and freezing your eggs.
Preventive surgery for ovarian cancer
If you're concerned about your risk of ovarian cancer, you may wish to talk to your doctor about whether preventive surgery may be an option for you. If you have a family history of ovarian or breast cancer; a syndrome linked with a high risk of ovarian cancer, such as Lynch syndrome or Peutz-Jeghers syndrome; a BRCA1 or BRCA2 mutation; or a previous breast, colorectal or endometrial cancer diagnosis, you may be a candidate for preventive surgery to reduce your ovarian cancer risk.
Preventive surgical procedures performed to reduce the risk of ovarian cancer include a tubal ligation (tying the fallopian tubes) and a hysterectomy (removing the uterus but not the ovaries).