Preparing for Ovarian Cancer Debulking Surgery

Surgery is the main treatment for most ovarian cancers, and the goal is to remove as much of the tumor as possible. This is called debulking surgery. The approach has good outcomes, especially when the surgeon can remove all visible traces of the cancer.

Ovarian cancer surgery is considered a major operation and it can be complex. Just before your surgery, you might be worried, says Dr. Adam ElNaggar,  a gynecologic oncologist at West Cancer Center in Memphis, Tennessee. “The night before surgery is always a scary time, because there’s so much unknown that’s approaching, especially when cancer is now thrown into the picture.”

Your doctor will give you instructions about how to prepare for surgery, but think of it as getting ready for a race.  If you were preparing to run a race,  you would need to build up your stamina, keep your energy level high, and your body well nourished and well hydrated. The same holds true for preparing to have surgery. While doctors’ specific recommendations can vary, the goal is to improve your nutritional status by boosting your and intake of both carbohydrates and protein in the days or weeks leading up to your surgery.

“You wouldn’t starve yourself, walking into a race,” says Dr. EINaggar. “And so we don’t want you to starve yourself walking into surgery.”

The night before surgery, your doctor may recommend specific drinks or meals that you should eat, or you might be asked to fast for a specific number of hours. On the morning of your surgery, you will either be asked not to take anything by mouth, or just to have a special drink.

Preventing Pain

Pain after surgery is normal, and most patients will experience varying degrees of discomfort. But now different procedures can be done to help prevent pain before it ever happens.

One procedure, known as a tap block, involves injecting a local anesthetic directly into your abdomen once you are already asleep for the surgery. The injection numbs the skin and muscles. “The injection is placed on either side of your abdomen, which will be to the left and right of the incision,” says Dr. EINaggar.

You may also get what is called either a spinal or an epidural. These  injections are given in your back, and are very similar to what women may receive during childbirth, when they are in labor and delivery. The main difference between the injections given before ovarian cancer surgery and the ones given during childbirth is that the injections given before cancer surgery don’t paralyze you from the waist down, says Dr. EINaggar.

“These are designed to numb those pain fibers before the pain hits them,” Dr. EINaggar says, “So that after the surgery, hopefully the pain is much better controlled.”

The upside of acting proactively, meaning before the surgery even begins, is that it reduces the need for pain medication after the operation is over. These “blocks” will continue to help prevent pain as you recover. If your need for pain medication is lower, you can probably go home sooner, will need less pain medication as you recover, and will be able to get back to a normal diet much more quickly.

Using Blood Thinners

Unfortunately, undergoing major surgery can make you more susceptible to developing a blood clot, which is a potentially serious complication. To prevent that from happening, you may be given blood thinner medication before the operation. “That’s designed to decrease the risk of developing a blood clot during the surgery,” explains Dr. ElNaggar. He adds that to prevent a blood clot after surgery, you may be asked to take a blood thinner shot for the next several weeks while you recover.

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