After an ovarian cancer diagnosis, surgery is often the main treatment option. The type of surgery you have depends on your general health, what type of ovarian cancer you have, and how far the cancer has spread, which may not be known until surgery is performed. For ovarian cancer the goals of surgery are:
- To find out the cancer’s stage, or how far it has spread (staging surgery)
- To remove as much of the visible tumor as possible; this is called debulking or cytoreduction surgery. Ideally, all visible tumor is removed
What is staging surgery for ovarian cancer?
Staging surgery for ovarian cancer tells your doctor how far the cancer has spread from the ovary. Surgery is important to accurately diagnose and stage ovarian cancer, which is essential for determining the best treatment options.
Staging surgery for ovarian cancer can include:
- Inspection and biopsy: The surgeon inspects the abdominal and pelvic cavities visually and may take tissue samples (biopsies) from multiple areas.
- Removal of ovaries and fallopian tubes: Both the ovaries and fallopian tubes may be removed (bilateral salpingo-oophorectomy) to determine if the cancer is present in these tissues.
- Hysterectomy: The uterus may be removed to check for cancer spread.
- Omentectomy: The omentum, a layer of fatty tissue that covers the abdominal organs, may be removed because it is a common site for ovarian cancer spread.
Removal of the uterus
(hysterectomy)
Removal of one or both ovaries
(oophorectomy)
Removal of one or both ovaries and one or both fallopian tubes
(salpingo-oophorectomy)
Staging surgery can reveal if the cancer is confined to the ovaries or if it has spread to other parts of the body, determining the cancer stage, which ranges from Stage I (local to the ovary) to Stage IV (advanced spread to other locations). Staging surgery can be essential for tailoring treatments, such as chemotherapy or targeted therapy.
What is debulking surgery for ovarian cancer?
Debulking surgery for ovarian cancer aims to remove as much of the visible tumor as possible. This is important because ovarian cancer often spreads within the abdominal cavity by the time it is diagnosed, making it difficult to remove all the cancer cells with surgery alone.
Debulking surgery can improve the effectiveness of other treatments, such as chemotherapy or radiation therapy.
During debulking surgery, the surgeon will remove all visible tumors and any other tissues or organs where the cancer may have spread, including:
- Tumor tissue from the ovaries, fallopian tubes and uterus
- Other organs and tissues affected by cancer spread, such as parts of the colon, intestines, bladder, stomach, or liver.
- The omentum is a layer of fatty tissue that covers the abdominal organs if it is involved with the cancer.
Informative Video - What types of surgery are used for ovarian cancer?
Nita Lee, MD, MPH, a cancer and women’s health expert from the University of Chicago, talks about laparoscopic and traditional open surgery for ovarian cancer and the importance of finding a surgeon who specializes in women’s health. She explains different reasons for surgery and how surgery can affect the outlook for treatment.
Does ovarian cancer surgery affect fertility?
Yes, ovarian cancer surgery can affect fertility, but the extent of the impact depends on the type and extent of the surgery performed.
Many ovarian cancers can be surgically treated without removing the uterus and ovaries (fertility-sparing surgery). These are important considerations for those of childbearing age to discuss with a gynecologic oncologist or a specialist in cancers of the female reproductive organs.
For example, if the cancer is only in one ovary and you still want to have children naturally, your surgeon may be able to remove just the ovary with the tumor and the fallopian tube on the same side. This leaves one ovary and a fallopian tube on the other side.
Loss of fertility due to surgery for ovarian cancer can be one of the most challenging issues that women face. Women who have not finished having children or who have not yet begun to start their families may experience the loss of fertility in different ways. It is important to have strong support systems such as family members and counselors. For more information about fertility challenges and support, contact the National Infertility Association.
Can ovarian cancer surgery lead to menopause?
Yes, if you have not entered menopause, surgery that removes both of the ovaries will cause menopause. This is called surgical menopause. With both ovaries removed, the body no longer produces the female hormones in significant amounts, leading to surgical menopause. Unlike natural menopause, which happens gradually, surgical menopause occurs immediately after the surgery. Symptoms of surgical menopause can include hot flashes, night sweats, vaginal dryness, and mood swings.
Understanding the potential for surgical menopause and discussing the management options with your medical team can help you prepare for and cope with the changes that may follow ovarian cancer surgery.
Helpful Resource - Quality of Life Issues
Supportive and insightful, this resource addresses the key quality of life issues faced by ovarian cancer patients, offering guidance and comfort throughout their experience.
What are the side effects of ovarian cancer surgery?
Surgery comes with its own benefits, risks, and potential side effects. The severity of these side effects can differ from person to person, influenced by factors such as:
- The location and type of cancer
- The nature of the surgery
- Any treatments received before surgery (such as chemotherapy or radiation)
- Overall health
- Symptoms experienced prior to surgery
Some common side effects of ovarian cancer surgery may include:
Pain and tenderness
Pain is a common side effect of surgery. You should speak to your doctor to determine your personalized pain-management strategy.
Surgical menopause
Surgery can cause early or sudden menopause. This happens when surgery that removes the ovaries leads to a halt in menstruation and symptoms typical of menopause, such as hot flashes, vaginal dryness, and mood changes. If this happens, talk with your healthcare team about how to manage and help your body adjust.
Swelling (lymphedema)
If lymph nodes are removed during your surgery, the normal flow of lymphatic fluid in your body may be disrupted. In some, this can lead to a buildup of fluid in one or both legs. This can occur at any time after surgery, even years later. Your healthcare team will provide you with information on how to reduce the risk of developing lymphedema.
Bleeding and bruising
You may experience some blood loss during your surgery, and in some cases, a blood transfusion might be necessary. Although rare, there is a slight risk of internal bleeding after the procedure. If this occurs, a second surgery might be required. After your surgery, your nurse will monitor you closely for any signs of blood loss.
Constipation
After surgery, you may have trouble passing stool (constipation) or have loose stools (diarrhea). If you experience severe stomach pain, cramping, or diarrhea for more than a day, call your doctor.
Bowel obstruction
A bowel obstruction happens when scar tissue, often from surgery or sometimes because of a tumor, blocks your intestine. It can lead to problems like severe constipation, abdominal pain, nausea, and vomiting. If you have these symptoms, tell your doctor right away. They’ll check if simple diet changes can help or if you need additional surgery.
Ostomy
Advanced ovarian cancer can sometimes spread to the surface of the bowel (part of the digestive system), sometimes requiring surgery to remove some of the bowel. The affected bowel area can sometimes be removed, and the two ends joined back together. However, if not, the surgeon may need to create a new opening to eliminate waste, called an ostomy or stoma. Waste is then collected in a colostomy or stoma bag. This may be temporary or permanent.
Loss of fertility
Loss of fertility due to surgery for ovarian cancer can be one of the most challenging issues that women face. Women who have not finished having children or who have not yet begun to start their families may experience the loss of fertility in different ways. It is important to have strong support systems such as family members and counselors. For additional information and support, contact the The National Infertility Association.
It’s important to stay in touch with your care team right from the start of your treatment. Make sure to ask questions about side effects before, during, and after your treatment, so they can give you the best advice on how to handle them.
Patient Video - Ariana’s story: What was your experience with surgery for your ovarian cancer?
Ariana reflects on the experiences she had with surgery when she was diagnosed with ovarian cancer at the young age of 17. She had fertility-sparing surgery, to spare her uterus and one ovary. Now 20 years later, she shares her perspective in the hope that it will help other young women with ovarian cancer discuss surgical options with their doctors.
Questions to ask your doctor
It is important to ask your doctor comprehensive questions to fully understand the procedure, its risks, and how it may affect your health and treatment plan. Some questions you may want to ask:
- What type of surgery do you recommend for my ovarian cancer and why?
- What are the goals of this surgery (e.g., staging, debulking, or both)?
- What are the chances of achieving optimal debulking (removing most of the tumor) during the surgery?
- What are the potential risks and complications of this surgery?
- How will this surgery affect my daily activities, like eating, moving around, or going to the bathroom?
- How will this surgery affect my fertility and hormonal balance?
- What is the expected recovery time, and what side effects should I expect post-surgery?
- Will I need additional treatments, such as chemotherapy or radiation, after the surgery?
- How should I prepare for the surgery?
- How will my pain be managed after the surgery?
- What follow-up care will I need, and how will this surgery impact my overall prognosis and daily life?
- How soon can I return to my normal activities or work after surgery?
Ovarian cancer treatment resources
To find more information about ovarian cancer treatment and side effects, visit these helpful resources:
- American Cancer Society – Treatment Ovarian Cancer
- National Comprehensive Cancer Network – Ovarian Cancer Treatment Guidelines
- National Ovarian Cancer Coalition – Resource Guide for Those Newly Diagnosed
- National Ovarian Cancer Coalition – Resource Guide for Women With Recurrent Disease
- You and Ovarian Cancer – Animated Patient Guide
Medically reviewed and updated | August, 2024
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