Preparing for Ovarian Cancer Surgery

If you have ovarian cancer, you’ll probably need to undergo surgery to see how far the cancer has spread and remove as much of it as possible. In fact, surgery is usually the first line of treatment for patients with ovarian cancer. (There are instances, though, when surgery for ovarian cancer is postponed in favor of chemotherapy treatment first. That can happen because of the patient’s medical condition, or during the pandemic because some hospitals are trying to wait to perform some procedures until they are safer.)

Maybe doctors have already confirmed your diagnosis. Or maybe you require additional testing to confirm that you have ovarian cancer. In either case, several factors converge to determine how quickly a patient can undergo surgery for ovarian cancer.

“With patients who are diagnosed with ovarian cancers, or quite honestly most cancers, we try to coordinate surgery quickly,” says Dr. Kimberly Levinson, Director of Johns Hopkins Gynecologic Oncology at Greater Baltimore Medical Center. The type of operation you’ll have depends on the stage of your cancer and your overall health and well-being.

There are instances, though, when surgery for ovarian cancer is postponed in favor of chemotherapy treatment first. That can happen because of the patient’s medical condition, or during the pandemic because some hospitals are trying to wait to perform some procedures until they are safer.

Pre-Surgical Protocols for Ovarian Cancer Surgery

In recent years, doctors have implemented several changes to pre-surgical protocols based on new research. Called ERAS, or Enhanced Recovery After Surgery, these new protocols focus on optimizing care before, during and after surgery to help streamline recovery.

“With ERAS, you prepare yourself in advance of surgery by eating well, staying hydrated and increasing stamina,” Dr. Levinson says. “All of those things help patients recover more quickly.”

Here’s how to best prepare:

• Eat: In the past, doctors told patients not to eat anything before surgery. They even did bowel preps to clean out the intestines. So patients came in for surgery in a depleted state. Now research suggests that doctors should be preparing patients for a marathon — and that requires good nutrition. The key, Dr. Levinson says, is trying to make sure that you’re eating appropriately, getting enough protein, and not losing weight. While patients used to be told not to eat or drink for as many as 18 hours before surgery, that time frame has now shrunk to as little as six hours for many doctors.
• Drink: Adequate hydration is critical not only to support your body’s organs, joints, and tissues but also to flush out toxins after surgery. “In the past, we encouraged patients not to drink anything before surgery. When they came in for surgery, they were already dehydrated,” Dr. Levinson says. That’s not the case anymore. To stick with the marathon analogy, you need to stay hydrated to make it through that final mile.
• Move: When you’re facing surgery for ovarian cancer, exercise is probably the last thing on your mind. But there’s good evidence to suggest that building stamina through exercise, even just walking, can help patients recover more quickly after surgery.

Pre-Op Preparedness

Surgery for ovarian cancer typically involves removing the uterus, ovaries and both fallopian tubes. If the cancer has spread, surgeons may also need to remove tissue in the abdomen.

One to two weeks before surgery, your doctor will run tests — X-rays, blood and urine tests, and an electrocardiogram (EKG or ECG) to ensure that you’re healthy enough to undergo the procedure. It’s important to be eating well and exercising regularly during this time period to build your strength and keep your energy level high prior to surgery.

“Many patients with ovarian cancer suffer from fluid in their abdomen and experience bloating, cramping and abdominal discomfort,” Dr. Levinson says. “Obviously, those symptoms can make eating well and exercise more difficult. But the more we can build up stamina before surgery, the better off you’ll be after surgery.”

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