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Ovarian cancer originates in the ovaries, a pair of small, oval-shaped glands in the female reproductive system that produce and store eggs and female hormones. Because the symptoms are often subtle and nonspecific—such as abdominal bloating, pelvic pain, indigestion, frequent urination and unusual vaginal bleeding—early detection can be a challenge.

While ovarian cancer can occur at any age, it is most frequently diagnosed in women 50 and older. Approximately 10-15% of cases are linked to an inherited mutation of breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2). The diagnostic process for ovarian cancer typically involves imaging, lab work (including a CA-125 blood test) and biopsy. Treatment may involve a combination of surgery, radiation therapy and/or chemotherapy.

Why is ovarian cancer surgery performed?

Surgery is the main form of treatment for ovarian cancer. The goal is two-fold: to stage the cancer and to remove as much of the tumor as possible. Proper staging is an important first step because ovarian cancer treatment can vary based on how far the cancer has spread beyond the ovaries. The most accurate way to stage ovarian cancer is to evaluate tissue samples under a microscope. Therefore, in addition to debulking a tumor, ovarian cancer surgery is often performed to obtain tissue samples for staging purposes. From there, a gynecologic oncologist can determine which types of treatment would potentially be most effective.

Who is a good candidate for ovarian cancer surgery?

When determining whether a patient may be a good candidate for ovarian cancer surgery, a physician will consider several factors, such as the location and stage of the tumor and the patient’s age and overall health. Surgery is often an essential step in both staging and treating the tumor. Surgical treatment can be particularly effective for cancer that is localized to the ovaries.

How to prepare for ovarian cancer surgery

To help ensure thorough preparation for ovarian cancer surgery, the patient should undergo all recommended preoperative evaluations, including imaging tests and blood work, so the surgical team can fully assess the extent of the cancer and the patient’s overall health. During a meeting with the surgeon, anesthesiologist and possibly a nutritionist, the patient can gain a thorough understanding of the procedure, anesthesia and postoperative care.

The patient will be provided with preoperative fasting guidelines and instructions on medication usage and adjustments, such as stopping blood thinners. Lifestyle modifications, such as quitting smoking and improving nutrition, can enhance the patient’s capacity to heal and hasten their recovery. Finally, the patient should arrange for postoperative support at home and pack a bag for their hospital stay to help ensure a smooth surgical experience and recovery.

What happens during ovarian cancer surgery?

Before ovarian cancer surgery, the patient will be placed under general anesthesia to ensure they will remain unconscious throughout the procedure. The surgeon will then make an incision in the abdomen to access the pelvic organs. Depending on the extent of the cancer, the surgeon may perform:

  • Unilateral salpingo-oophorectomy – Removal of one ovary and one fallopian tube
  • Bilateral salpingo-oophorectomy – Removal of both ovaries and both fallopian tubes
  • Hysterectomy – Removal of the uterus and cervix, some surrounding tissues, the ovaries and the upper part of the vagina
  • Lymph node dissection – Removal of the lymph nodes in the pelvic and para-aortic areas
  • Omentectomy – Removal of the thin tissue that covers the stomach and large intestine
  • Cytoreductive debulking surgery – Complete removal of the ovarian tumor, which might include removal of tissues from surrounding organs, such as the stomach, gallbladder, spleen, bladder and/or colon
  • Pelvic exenteration – Removal of some or all of the female reproductive organs, such as the ovaries, fallopian tubes, uterus, cervix and vagina, and possibly the rectum, bladder, pelvic lymph nodes, anus and colon, followed by reconstructive surgery

After ovarian cancer surgery, chemotherapy may be administered to destroy any remaining microscopic cancer cells. Chemo may be given intravenously or intraperitoneally, which involves placing a catheter in the abdomen to deliver the chemotherapeutic drugs directly into the pelvic area.

What are the risks and possible complications of ovarian cancer surgery?

Ovarian cancer surgery, like any major surgical procedure, carries several risks and potential complications, such as infection at the surgical site, excessive bleeding and adverse reaction to anesthesia. Afterward, some patients experience temporary urinary or bowel changes and mild swelling due to lymphatic fluid buildup. With careful surgical planning and attentive postoperative care, these risks can be effectively managed to ensure a smooth recovery.

What to expect during recovery from ovarian cancer surgery

After ovarian cancer surgery, the patient can expect to spend several days in the hospital, where they will receive pain management, nutritional support and monitoring for any immediate postoperative complications. The patient may have a catheter in place for urine drainage and might have some general discomfort and fatigue, which should gradually improve.

Once home, the patient should closely follow their surgeon’s postoperative guidelines, including any restrictions on physical activities and lifting, to promote full and proper healing. During regular follow-up appointments, the surgical team will continue to monitor the patient’s recovery and plan any additional treatments, such as chemotherapy, if needed. They can also provide supportive care to help the patient manage any side effects and adjust to changes in their daily routine. Full recovery can take several weeks to a few months, depending on the extent of the surgery and the patient’s health.

How effective is ovarian cancer surgery?

Ovarian cancer surgery can be effective, especially when the cancer is detected early and confined to the ovaries. However, the effectiveness can vary based on individual factors, such as the location and stage of the tumor, the patient’s overall health and whether additional treatment, such as chemotherapy, is used. When performed as part of a comprehensive treatment plan, ovarian cancer surgery can help the patient achieve the best possible outcome and quality of life.

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in the gynecological clinic at Moffitt takes an individualized approach to ovarian cancer treatment, and our patients benefit from multiple expert opinions in a single location. In addition to the latest advances in ovarian cancer surgery, we offer a robust portfolio of clinical trials.

This novel treatment is a significant milestone that will advance how we detect cancer. We hope to see more patients when they are first diagnosed and need surgery so we can offer this novel treatment. A patient’s best chance is her first chance.
Robert Wenham, MD
Gynecologic Ocology Program Chair

Moffitt was a trial site for Cytalux, an FDA-approved drug that can help a surgeon detect ovarian tumors during surgery. The drug is administered to the patient through intravenous infusion as part of their preoperative care. A significant milestone in the detection of cancer, Cytalux contains:

  • A folic acid analog that identifies and binds to the folate receptors on ovarian cancer cells
  • A dye that glows when exposed to fluorescent light from a special camera

When used during surgery, this novel treatment can help the surgeon identify cancerous tissues that were not previously detected by touch or white light. 

If you would like to learn more about ovarian cancer surgery or Cytalux, you can request an appointment with a specialist in Moffitt’s gynecological oncology clinic by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

 

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