Surgery for Ovarian Cancer: Making Treatment Decisions

Dr. Matthew Carlson UT Southwestern Medical Center

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Surgery for Advanced Ovarian Cancer -- Understanding the Options

Many women diagnosed with advanced ovarian cancer will receive surgery to remove the ovaries, uterus, and any other areas to which the cancer has spread
Sometimes, if the cancer has spread too widely to completely remove it through surgery, it may be necessary to receive chemotherapy first
The surgery is a serious procedure that can last up to 6-8 hours, but for many women, the benefits are significant

After a diagnosis of advanced ovarian cancer, many women will be candidates for surgery. Surgery is a common first treatment option in cases where doctors decide it seems possible to remove most or all of the cancer surgically. Other times, though, if the cancer has already spread widely, it may be necessary to receive chemotherapy before surgery. It’s really important that you ask your surgeon questions about your care and feel comfortable with their experience level and understanding of your needs and goals.

“Our goal is to get all of the cancer out at the time of your surgery,” explains Dr. Matthew Carlson, a gynecologic oncologist at UT Southwestern Medical Center in Dallas, Texas. “If it looks like at that time that we cannot get all the cancer out, then we would stop the procedure and give chemotherapy.”

To determine whether to have surgery first or to give chemotherapy before surgery — which is called “neoadjuvant chemotherapy” — doctors can use a procedure called a laparoscopy, during which they use a small surgical camera to identify where the cancer has spread.

If the laparoscopy indicates that it should be possible to remove most or all of the cancer, what comes next is a big surgery.

“That surgery would involve an incision from where the ribs meet the abdomen all the way down to the pubic bone,” says Dr. Carlson. “That would allow us all of the exposure that we needed in order to get all of the cancer out.”

In the case of advanced ovarian cancer, that surgery would usually involve removing both ovaries and the entire uterus in what’s called a “hysterectomy.” Depending on where else the cancer has spread, it can sometimes be necessary to remove the spleen or parts of the colon, too.

“This all sounds like a big surgery,” Dr. Carlson says. “And that’s true. It is… But the benefits of that are that if we get all of the cancer out, that’s giving us the best starting point possible.”

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Dr. Matthew Carlson is a gynecologic oncologist at UT Southwestern Medical Center in Dallas, Texas. Read More

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