Surgical procedure is the primary treatment for removal of cancerous tumor in the ovaries. The extent of ovarian cancer surgery depends on how far the cancer has spread and patient’s general health. Generally complete treatment process involves surgery and chemotherapy.
Depending on the type, stage and grade of the cancer, the surgery involves removing one or both the ovaries, fallopian tubes and uterus. For advanced stage cancer, the surgeon will first perform debulking (removing as much tumor as possible) and follow it with chemotherapy.
In case the cancer has spread outside the ovaries, the surgeon may have to perform other surgeries like
Hysterectomy (removal of the uterus)
Omentectomy (removal of the fat that covers the intestines)
Resection of bowel and/or other structures in the belly
Lymphadenectomy (elimination of one or more lymph glands)
Indications and symptoms of ovarian cancer are vague and non-specific. In most ovarian cancer cases, by the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.
Commonly known symptoms include
Bloating or swelling of the belly
Pelvic or abdominal pain
Constipation or loss of appetite or feeling full quickly
Changes in bladder habits including incontinence and increase in frequency
Lower back pain
Pain during sex
Abnormal changes in the menstrual cycle
Abdominal weight loss or gain
Women, who has a combination of above mentioned symptoms on daily basis for a few weeks, should consult a gynecologist.
To plan the course of treatment, the doctor will recommend following
Blood tests including complete hemogram, renal function tests, liver function tests, serum electrolytes and coagulation profile
Pelvic examination and pap-smear test
To ensure that the patient is fit for the surgery, the patient has to undergo the following tests before the surgery
For patients who had undertaken pre operative chemotherapy, the toxic effects of the chemotherapeutic drugs will also be considered before the surgery.
Ovarian cancer surgery is perfomed under general anesthesia by a surgical oncologist who specializes in gynecological cancer.
For early stage ovarian cancer, the surgery can be performed as minimally invasive procedure or open procedure. While for advance stage cancer, the surgery is performed using open technique.
For open procedure, a large incision of approximately 20 cms is made in the abdominal region. In minimal invasive procedure, several minor inicsions are made to insert the surgical instruments and a laparocope (a thin lighted tube with camera).
During the surgery for early stage cancer, samples are taken from several areas of abdomen, pelvis and lymph nodes to check the spread of tumor. A layer of fatty tissue that is close to the ovaries, called the omentum, is removed to find cancerous cells. Peritoneal or Abdominal washing is also done to by putting sterile fluid inside the abdomen and removing it. This fluid is also checked for cancer cells.
If cancer cells are found in the surrouding organs of the ovary, the surgeon will remove as much of the tumor as possible. This is called debulking. The surgeon may also have to perform hysterectomy, omentectomy, resection of bowel and/or other structures in the belly, appendectomy, cholecystectomy, splenectomy and elimination of one or more lymph glands.
Generally, the cather is removed in 3 to 6 days after the surgery and then the patient can go home.
If the patient had an advanced cancer, chemotherapy is used to attempt to eliminate any remaining cancer. With surgery and chemotherapy around 30% of women with advanced ovarian cancer are cured.
If both the ovaries are removed, the patient will undergo sudden menopause and may face symptoms of menopause for a few weeks. The doctor may recommend hormone replacement therapy to deal with these symptoms.
After discharging from the hospital, the doctor will suggest to
Do breating and leg exercises to prevent chest infect and clotting of blood in legs
Eat food or supplements, especially for calcium and vitamin D
Avoid driving for 1 to 2 weeks
Avoid any strenuous physical activity including sexual intercourse for 4 to 6 weeks
The patient can take upto 6 weeks to get back to normal routine.
Risk and Complication
Complications of ovarian cancer surgery may be
Post operative pain
Damage to surrounding organ - bladder, ureter or bowel may be damaged
Blood clots may develop in the veins of the legs or pelvis
If you have any additional questions, talk to our in-house doctors. Call 1800-1022-733 (toll free).
Credihealth is a medical assistance company that gives guidance to a patient from the first consultation through the entire hospitalization process. A team of in-house Credihealth doctors helps the patient find the right doctor, book appointment, request cost estimate for procedures and manage admission & discharge processes.