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Types of Surgery for Ovarian Cancer

Surgery
A diagnosis of ovarian cancer usually requires surgery. Surgery allows the doctor to take a biopsy and check for cancer cells.

There are different types of surgery for ovarian cancer. The type of surgery you have depends mainly on these factors.

  • The type of ovarian cancer you have

  • Whether the cancer is confined to your ovary or has spread

  • Whether you plan to become pregnant

  • Whether your general health is good

  • Your age

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 and may need hormone replacement medications.

You may have more than one type of surgery--either as part of the same procedure, or as separate procedures. Depending on the type and stage of the cancer, you may or may not have another type of treatment, such as chemotherapy, before or after surgery.

No matter what type of surgery you have, it is important for the cancer to be staged to determine the extent of the disease. To do this, a pathologist checks tissue samples (called biopsies) removed from your reproductive organs. The surgeon may also remove one or more lymph nodes. This is called a lymph node biopsy. The surgeon may also take tissue samples from other areas within the abdomen. 

These are the types of surgery used to treat ovarian cancer.

Total hysterectomy

This surgery is the one most commonly done for ovarian cancer. For it, the surgeon takes out the following:

  • Your two ovaries

  • Your two fallopian tubes

  • Your uterus

  • Your cervix, which is the narrow end of the uterus.

The surgeon may also remove your omentum. This is a membrane that supports your abdominal structures.

Oophorectomy

In an oophorectomy, the surgeon removes one or both of the ovaries, depending on the likelihood that the cancer will spread. Another consideration may be whether or not you desire to have children. If the cancer has not spread to more than one ovary, it may be possible for the surgeon to treat you by removing only one ovary and one fallopian tube. This is called salpingo-oophorectomy. This procedure would enable you to attempt pregnancy.

Lymph node biopsy

Your doctor may remove one or more lymph nodes at the same time as an oophorectomy or hysterectomy. These small glands are part of your immune system and help your body fight infections. The surgeon removes nodes and checks them right away for signs of cancer.

Cytoreduction

This surgery is also called debulking. For it, the surgeon removes as much of the cancer as possible. Your doctor may recommend this surgery when cancer cells are stuck to other organs and can't be removed. Or your surgeon may decide to do it during the surgery to remove the cancerous ovary. If you have a debulking surgery and cancer has spread to your colon, you may need to have part of the colon removed as well. Then you may need a colostomy. This means that the surgeon diverts a piece of your bowel through your abdomen to allow the remaining intestines to heal. Your stool will then drain into a pouch. This is usually temporary. Later on, it may be reversed by another surgery.

Debulking can also be done after some initial chemotherapy was given. This is called interim debulking. 

FYH

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