“One of the reasons I love my job is that every single surgery is different,” says Dr. Elizabeth Jewel, Gynecologic Surgeon at Memorial Sloan-Kettering Cancer Center. Each case of ovarian cancer is different, so therefore each surgery will be different, but there are some things women should expect when going into the operation.
“When I meet patients I start by explaining that you will have a big up and down incision. My goals in the operating room are to remove all of the cancer, the parts that I know are going to be removed are the uterus, the cervix, both fallopian tubes, both ovaries, and the omentum–that fat pad that hangs over top of the intestines,” says Dr. Jewell. These are the steps that everyone undergoing the operations will experience. Using CT scans, the doctor will determine how far the cancer has spread– through a process referred to as “staging” — and then perform a hysterectomy (removal of the uterus), a bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries), and an omentectomy (removal of the omentum). Since both the ovaries and the uterus are being removed, this means that the patient will no longer be able to bear children, and if the patient has yet to experience menopause, she will enter it. The woman will no longer have periods,” Dr. Jewell says.
Some younger women of childbearing age undergoing surgery for ovarian cancer choose first to have their eggs retrieved and frozen so they can have the chance of having biological children down the road using a surrogate mother.
Other than removing a woman’s reproductive capabilities, losing these organs does not interfere with the body’s essential functions.
After these surgical removals are complete, there is a possibility that there will be fluid on the pelvis. This pelvic fluid will be taken back to lab and analyzed to see if the cancer has spread from the ovaries to elsewhere in the body.
The next step is what is called “debulking,” the portion of the surgery where the majority of the cancerous cells are removed. Debulking is especially important if the cancer has started to spread throughout the body and needs widespread attention. The CT scans done prior to surgery will allow the doctors to have an idea of just how far the cancer has spread. “Based upon the CT scan then I will have a pretty good idea as to whether or not we are going to have to preform a removal of cancer along the diaphragm,” says Dr. Jewell. “If that is the case, then sometimes you would require a chest tube, which will be removed prior to your discharge from the hospital,” she added.
There is a possibility during the debulking process that the patient may need to have bowel surgery, where a piece of the intestines will be taken out. This can sometimes lead to the patient receiving an ostomy bag, a prosthetic device that diverts waste from the colon into a bag on the side of the abdomen. “Most of us try to avoid giving an ostomy bag unless it is absolutely necessary to protect where we put together the intestines,” says Dr. Jewell. All of this is dependent on how far the cancer has spread and is not needed for all surgeries. And these precautions are taken so the doctors can remove as much of the cancer as possible, either to set up chemotherapy implementation or to completely remove the cells and have no gross residual disease.
Surgery for ovarian cancer is major surgery and women should expect the usual side effects of exhaustion and post-surgical pain following the procedure. The hospital stay will last normally five to seven days, and most women can resume their regular routines within four to six weeks– sometimes while undergoing post-surgery chemotherapy.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Elizabeth Jewell is a gynecologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center. She is also the Director of Surgery at MSK Monmouth and MSK Basking Ridge in New Jersey. Read More
“One of the reasons I love my job is that every single surgery is different,” says Dr. Elizabeth Jewel, Gynecologic Surgeon at Memorial Sloan-Kettering Cancer Center. Each case of ovarian cancer is different, so therefore each surgery will be different, but there are some things women should expect when going into the operation.
“When I meet patients I start by explaining that you will have a big up and down incision. My goals in the operating room are to remove all of the cancer, the parts that I know are going to be removed are the uterus, the cervix, both fallopian tubes, both ovaries, and the omentum–that fat pad that hangs over top of the intestines,” says Dr. Jewell. These are the steps that everyone undergoing the operations will experience. Using CT scans, the doctor will determine how far the cancer has spread– through a process referred to as “staging” — and then perform a hysterectomy (removal of the uterus), a bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries), and an omentectomy (removal of the omentum). Since both the ovaries and the uterus are being removed, this means that the patient will no longer be able to bear children, and if the patient has yet to experience menopause, she will enter it. The woman will no longer have periods,” Dr. Jewell says.
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Some younger women of childbearing age undergoing surgery for ovarian cancer choose first to have their eggs retrieved and frozen so they can have the chance of having biological children down the road using a surrogate mother.
Other than removing a woman’s reproductive capabilities, losing these organs does not interfere with the body’s essential functions.
After these surgical removals are complete, there is a possibility that there will be fluid on the pelvis. This pelvic fluid will be taken back to lab and analyzed to see if the cancer has spread from the ovaries to elsewhere in the body.
The next step is what is called “debulking,” the portion of the surgery where the majority of the cancerous cells are removed. Debulking is especially important if the cancer has started to spread throughout the body and needs widespread attention. The CT scans done prior to surgery will allow the doctors to have an idea of just how far the cancer has spread. “Based upon the CT scan then I will have a pretty good idea as to whether or not we are going to have to preform a removal of cancer along the diaphragm,” says Dr. Jewell. “If that is the case, then sometimes you would require a chest tube, which will be removed prior to your discharge from the hospital,” she added.
There is a possibility during the debulking process that the patient may need to have bowel surgery, where a piece of the intestines will be taken out. This can sometimes lead to the patient receiving an ostomy bag, a prosthetic device that diverts waste from the colon into a bag on the side of the abdomen. “Most of us try to avoid giving an ostomy bag unless it is absolutely necessary to protect where we put together the intestines,” says Dr. Jewell. All of this is dependent on how far the cancer has spread and is not needed for all surgeries. And these precautions are taken so the doctors can remove as much of the cancer as possible, either to set up chemotherapy implementation or to completely remove the cells and have no gross residual disease.
Surgery for ovarian cancer is major surgery and women should expect the usual side effects of exhaustion and post-surgical pain following the procedure. The hospital stay will last normally five to seven days, and most women can resume their regular routines within four to six weeks– sometimes while undergoing post-surgery chemotherapy.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Elizabeth Jewell is a gynecologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center. She is also the Director of Surgery at MSK Monmouth and MSK Basking Ridge in New Jersey. Read More
