Surgery is the most common treatment for ovarian cancer. The main goal of surgery is to remove the tumors and, if necessary, some surrounding tissue. The surgeon removes as much of the cancer as possible to attempt a cure. The surgeon may also remove tissue and have it examined. This helps to see how far the cancer has spread.
There are different types of surgery for ovarian cancer. The type of surgery you have depends mainly on these factors.
If your cancer was found at an early stage and has not spread, your surgeon may be able to leave your uterus and one ovary and fallopian tube intact. Then you may be able to have children. If you have both your ovaries and uterus removed, you will no longer be able to have children. You will enter sudden menopause if you have not already reached it. That means you will no longer have menstrual periods.
You may have more than one type of surgery. They may be done as one procedure or as separate procedures. Depending on the type and stage of the cancer, you may or may not have another type of treatment. For example, you could have chemotherapy, before or after surgery.
No matter what type of surgery you have, it is important for the cancer to be staged to see the extent of the disease. To do this, a pathologist checks the removed tissue samples (called biopsies) from your reproductive organs. In addition, the surgeon will usually remove specific lymph nodes. The surgeon will also usually take multiple biopsies in the abdomen and pelvis and remove the omentum. That is a fatty apron that hangs off of your stomach.
These are the types of surgery used to treat ovarian cancer.
Total Hysterectomy
This surgery is the most common surgery done for ovarian cancer. For it, the surgeon takes out all of these parts:
Oophorectomy
This surgery removes an ovary. The surgeon may remove one or both of the ovaries. It depends on the likelihood of the cancer spreading. Another consideration may be whether or not you want to have children. If the cancer has not spread to more than one ovary, it may be possible for the surgeon to only remove one ovary and one fallopian tube. This is called salpingo-oopherectomy. This procedure would let you attempt pregnancy. If conservative surgery is performed, it is very important that staging be done (pelvic paraaortic lymph nodes, omentectomy) to be sure that the cancer is in an early stage.
Lymph Node Biopsy/Omentectomy
Your doctor will usually remove lymph nodes and the omentum at the same time as an oophorectomy or hysterectomy. Lymph nodes are small glands that are part of your immune system. They help your body fight infections. The surgeon removes nodes and has the pathologist checks them for signs of cancer. The omentum, which is a fatty structure that hangs off of your stomach, can also frequently be involved with cancer. So it also should be removed as part of the staging process.
Cytoreduction
This surgery is also called debulking. It involves the surgeon removing as much of the cancer as possible. Often this is a very extensive surgery and other organs such as a portion of the small bowel, colon, diaphragm or spleen are removed. Having a surgeon who can do cytoreduction is extremely important. That’s because ovarian cancer often has spread to multiple areas in the abdomen and pelvis at the time of diagnosis. Women in whom all of the cancer can be removed have cure rates that are twice as high as women in whom large amounts of tumor are left behind.
SOURCE CONTENT: Women's Cancer Network (https://www.wcn.org/articles/types_of_cancer/ovarian/treatment/surgery.html)
