The length and complexity of ovarian cancer surgery depends on the stage of your diagnosis and how widely your cancer has spread.
If your cancer is diagnosed at an advanced stage, after spreading elsewhere in your abdominal cavity, the surgery may be longer and more invasive.Read More
What Happens During Surgery for Stage III or IV of Ovarian Cancer?
During surgery for stage III or IV ovarian cancer, gynecologic oncologists—sometimes with help from other surgical colleagues—will try to take out as much cancer as they can. With ovarian cancer, this usually means removing the ovaries as well as any cancer found in nearby organs and tissues. This can include the uterus, fallopian tubes, and possibly parts of the bladder or liver. The more cancer your doctors can safely remove during surgery, the better.
How Long Does Ovarian Cancer Surgery Last?
Surgery for ovarian cancer can last anywhere from four to seven hours, and because the procedure is often long and complicated, it’s not uncommon to lose a fair amount of blood along the way. At the Mayo Clinic, where Dr. Kumar works, roughly 20 to 30 percent of patients require a blood transfusion during surgery.
After surgery for advanced-stage ovarian cancer, most women can expect to stay in the hospital anywhere from several days to a week.
How is the Recovery Process for Advanced Ovarian Cancer Surgery?
“A lot depends on how patients are recovering,” Dr. Kumar says. Most teams of doctors will follow a protocol called Enhanced Recovery After Surgery (ERAS), which can help speed along the recovery process. The protocol involves carefully timed transitions back into normal pre-operative functions like eating and walking around, the ultimate goal being to maintain a woman’s normal physiology during and after surgery.
“Most GYN oncologists use some version of an enhanced recovery pathway to help patients recover safely and quickly” Dr. Kumar says. The process ensures safe and effective pain management and can dramatically reduce the risk of complications after surgery. It can dramatically decrease the length of your hospital stay, too.
Other Treatment Options
If your ovarian cancer is diagnosed at an advanced stage, surgery will usually go hand-in-hand with another type of treatment, if not several. Your oncologist might, for example, start you on a chemotherapy regimen before or after your surgery. Chemo before surgery, called neoadjuvant chemotherapy, can help shrink a tumor, making it easier to surgically remove, and chemo after surgery, called adjuvant chemotherapy, can treat residual post-surgery cancer cells.
If ovarian cancer cells are found to have spread to your bowel, intestines, inside your liver, or up inside your lungs, the chances of successfully removing all of your ovarian cancer during surgery can be slim. In these cases, adjuvant chemotherapy is usually given after you’ve recovered from surgery, targeting those difficult-to-reach cells the surgeons couldn’t remove. Some oncologists may prescribe chemo both before and after surgery.
In cases where it is possible to remove most or all of your cancer during surgery, adjuvant chemo may still be used to target cells that are somewhere in hiding, preventing later recurrence.
The question as to whether it’s best to begin ovarian cancer treatment with surgery first or chemotherapy first does not always have a straightforward answer. “Best treatment” means something different for every woman, and it’s important to have these upfront conversations with your oncologist from the onset.