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Ovarian Cancer Surgery

Ovarian cancer is a cancer of the ovaries. It occurs as a result of a growth of abnormal cells that multiply to form a tumor. Treatment is therefore necessary to stop the cancer from spreading further by surgical removal of the ovaries and the uterus. Epithelial ovarian cancer, primary peritoneal cancer, cancer of the fallopian tube, stromal tumors and germ cell tumors are a few types of ovarian cancers.
 

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Symptoms

Ovarian cancer may or may not present with symptoms.

  • Abdominal pain
  • Nausea and difficulty eating
  • Bloating and pain
  • Irregular menstrual cycles
  • Vaginal bleeding
  • Indigestion and constipation
  • Fatigue and heartburn
  • Pain and bleeding during or after sexual intercourse
  • Back pain
  • Frequent urination and increased urge to urinate

Diagnosis

Ovarian cancer can be diagnosed with the help of the following tests:
  • Transvaginal ultrasound (TVUS) - it is an imaging technique which uses sound waves to detect abnormalities like tumors in the reproductive organs. 
  • Blood tests- blood tests for the cancer antigen 125 (CA-125), a biomarker.
  • Biopsy- tissue samples from the ovary are taken for diagnostic purposes. Cancer is detected by placing these samples under a microscope and examining them. Biopsies help in determining whether a tumor is benign or cancerous. It is also the only way to confirm cancer with utmost surety.
  • Other imaging tests such as abdominal CT scan and MRI

Treatment

The treatment for ovarian cancer is to surgically remove the ovary, fallopian tubes or uterus based on the type of cancer present and the extent to which the cancer has spread. The first step before a surgery can take place is known as staging. This process helps determine the extent to which the cancer has spread and to determine how much of the uterus needs to be removed. Usually in epithelial ovarian cancers, the entire uterus is removed. This is known as a hysterectomy. A bilateral salpingo-oophorectomy (BSO) may also be performed, which involves removing both the ovaries and fallopian tubes. An omentectomy (removal of the omentum) along with nearby tissue and lymph nodes may also be required. In certain cases, where complete removal is not possible, a procedure called debulking may be performed. The goal of debulking is to remove as much of the tumor as possible, while leaving behind tumors not more than one cm large. In cancers such as an ovarian stromal tumor, only one ovary is usually affected, and therefore only the affected ovary may be removed if the cancer has not metastasized.

 

Risks

The risks and complications associated with ovarian cancer are similar to those of any other major surgery. Infection at the site of the incision, scarring, excessive pain or excessive bleeding, difficulties with bladder and bowel function are some of the problems the patient may face. 

After Procedure

Follow-up appointments with the doctor along with a few tests such as blood tests and X-rays maybe required to look for signs of cancer or to identify any other problems post treatment and surgery. 

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