Surgery for ovarian cancer

Whether an ovarian cancer patient is a candidate for surgery depends on several factors, including pre-existing 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.

Surgical procedures for ovarian cancer may be performed in one of two ways: with a laparotomy, which uses an incision to open up the abdomen, or with a laparascopy, which uses small incisions in the abdomen. Your ovarian cancer surgical oncology team will discuss the recommended approach for you, which may include 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

HIPEC: Some patients be be candidates for hyperthermic intraperitoneal chemotherapy (HIPEC), a highly concentrated, heated chemotherapy treatment delivered directly to the abdomen during surgery. Unlike systemic chemotherapy delivery, which circulates throughout the body via the bloodstream, HIPEC delivers chemotherapy directly to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may also improve the absorption of chemotherapy drugs by tumors and destroy microscopic cancer cells that remain in the abdomen after surgery. 

Preventative options

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. You may be a candidate for preventive surgery to reduce your ovarian cancer risk if:

• You have a family history of ovarian or breast cancer.
• You have a syndrome linked with a high risk of ovarian cancer, such as Lynch syndrome or Peutz-Jeghers syndrome.
• You have a BRCA1 or BRCA2 mutation.
• You have a previous breast, colorectal or endometrial cancer diagnosis.

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).

Fertility preservation

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 diseases may not be candidates for this option. At Cancer Treatment Centers of America^® (CTCA), we will discuss a variety of fertility-sparing procedures with you, including retrieving and freezing your eggs.

Next topic: What are the statistics about ovarian cancer?