There Are Options to Help
- The goal of ovarian cancer surgery is to remove all, or as much of the tumor as possible. This is called debulking
- Debulking is very important when ovarian cancer has spread beyond the ovaries throughout the abdomen
- Debulking surgery may include hysterectomy, removal of ovaries, lymph node biopsies, and possibly portions of other structures or organs
- Following surgery, non-narcotic medications are usually enough to control pain
- Movement also helps alleviate post-surgery pain, so the sooner you're up and walking the better
What Is Debulking Surgery?
"[We do] debulking surgery when we have evidence preoperatively that the cancer may have already spread to other organs," explains Dr. Amanda Fader, vice chair of gynecologic surgical operations at Johns Hopkins University. "We’re not really doing a staging procedure, because we know that the cancer is at a more advanced stage. [Our goal] is to try to remove all or most all of that visible disease, which sometimes involves a hysterectomy, removal of the ovaries, lymph node biopsies, and may also involve removing bulky tumors in the other parts of the abdomen or pelvis as well.Read More
Data shows that patients whose cancer has been “optimally debulked,” meaning no tumors larger than 1 cm (less than half an inch) are left behind, have a better prognosis than those left with larger tumors after surgery. Also, says Dr. Fader, "chemotherapy, the complement to surgery that many women with ovarian cancer also receive, works much better on smaller or microscopic tumors than on larger masses. So, if we can debulk most or all of those tumors, we’re apt to see a much better response to chemotherapy."
Debulking surgery is typically an open surgery, which means it's done through an incision on the abdomen, from the pubic bone to above the belly button. The operation, whether it’s before chemotherapy or after, is extensive, and can take up to seven hours. And though it's a big procedure, it gives doctors all the exposure they need in order to get all of the cancer out.
For the most part, doctors say, surgery for ovarian cancer is a safe surgical procedure, especially when it's done with skilled hands and in institutions that know how to care for cancer patients.
Recovery from Ovarian Cancer Surgery
Understandably, many women are concerned about how much pain they will be in after their operation. Though there's no such thing as painless surgery there are many ways to decrease discomfort. Doctors will often use TAP blocks, a numbing medication to decrease incisional pain.
After surgery, doctors say that generally speaking, pain can usually be managed with non-narcotic medications. "We're using a lot of different types of medications to improve pain control without doping women up on heavy doses of narcotics, because we know that opioids and narcotics are not only habit-forming, they can also really slow down the gut and cause constipation," Dr. Fader says. They can make patients feel fuzzy and sleepy, which means they may not be up and walking around as much as doctors would like.
Patients are encouraged to get up and move around as soon as possible after surgery. Though it may be a little difficult at first, it’s been shown that the sooner patients are moving the better they'll usually feel, and the faster they tend to recover and enjoy a better quality of life. According to the American Cancer Society, most women will stay in the hospital for 3 to 7 days after the operation and can resume their usual activities within 4 to 6 weeks.