Ovarian Cancer
Surgery is the main treatment for most ovarian cancers . The extent of surgery that you have depends on how far your cancer has spread ,the type of ovarian cancer you have, your general health, stage of the cancer & whether you have completed your family or not
Surgery Has Two Main Goals
Staging & debulking. If your cancer is not staged properly & debulked ,you may need to have further surgery.
Surgery For Epithelial Ovarian Cancer
The first goal of ovarian cancer surgery is to stage the cancer – to see that how far the cancer has spread from the ovary.
It involves removal of uterus (hysterectomy)along with both ovaries & fallopian tubes ( bilateral salpingoophorectomy) ,removal of fatty layer of tissue covering the abdominal contents ( omentectomy ) ,biopsies from different areas inside the abdomen & pelvis ( peritoneal wall biopsies) , putting some sterile fluid inside abdomen & pelvis & then taking it out ( peritoneal washing) , removal of appendix ( appendectomy ) in some cases (mucinous tumours ) & removal of some lymph nodes in the pelvis & abdomen ( in certain cases).
The important goal of ovarian cancer surgery is to remove as much tumour as possible – this is called Debulking.
Debulking is very important , the aim is to leave no visible cancer behind or no tumour larger than 1 cm.
The patients who are optimally debulked have a better long term outcome as compared to those who are suboptimally debulked.
Sometimes the cancer has spread to other organs, in that case surgeon has to remove that part to optimally debulk.
In some cases a piece of colon needs to be removed & then the two ends that remain are sewn back together. In other cases, the ends cannot be sewn back right away, instead, the top end of colon is attached to an opening (stoma in the skin of the abdomen to allow stool to get out).
This is known as a colostomy. Most often, it is only temporary, and the ends of the colon can be reattached later in another operation.
Sometimes, a part of the small intestine needs to be removed. Just like with the colon, the small intestine can either be reconnected or an ileostomy might be made. This is usually temporary, but will need special care.
Debulking surgery might also mean removing a piece of the bladder, spleen & or gallbladder /pancreas or liver.
More About Ovarian Cancer
Surgery For Ovarian Germ Cell Tumors & Ovarian Sex Cord Stromal Tumors
In Germ cell & Stromal tumours, the main goal is to surgically remove the cancer.
If the cancer is still in one ovary & you wish to have children then ,only the ovary containing the cancer & the fallopian tube on the same side are removed ,staging is done , leaving behind the other ovary & fallopian tube & the uterus.This is called FERTILITY PRESERVING COMPLETION SURGERY ON OVARIAN PROTOCOL.
Ovarian stromal tumours are often confined to just one ovary ,so surgery may just be removal of that ovary & fallopian tube however if the cancer has spread, more tissues may need to be removed. This could mean hysterectomy, bilateral salpingoophorectomy & even debulking.
At times, after child bearing is complete, surgery to remove the other ovary, the other fallopian tube & the uterus may be recommended for both Germ cell & Stromal ovarian tumours.
Surgery For Boderline Ovarian Tumors
Borderline epithelial tumours look same as invasive epithelial ovarian cancers on ultrasound or CT /MRI scan. One cannot be sure whether a tumor is invasive or borderline until a biopsy sample has been taken and histopathology done.
Surgery for borderline tumour is similar to invasive ovarian cancer with the aim being removal of whole cancer along will full staging & debulking.
For women who have completed child bearing, the uterus, both fallopian tubes and both ovaries are removed. Surgical staging is done to see if the tumor has spread outside the ovary or pelvis.
For women who want to be able to be pregnant in future, only the ovary along with the fallopian tube on that side is removed. Surgical staging is done to see if the tumor has spread.
If the tumor has spread outside the ovary when it’s first diagnosed, we might have to remove as much as possible( debulking ).
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Questions To Ask Your Doctor
In our attempt to empower every patient, we have prepared a list of questions that may help you in decision making.
If you have suspected or possible ovarian cancer & have been recommended to undergo surgery, ask following questions:-
- What are the options besides surgery?
- Is there a way to diagnose ovarian cancer without surgery? Can a biopsy be performed?
- Is it necessary to have the surgery performed by a gynaecological oncologist?
- What type of incision will be made?
- Is laparoscopy appropriate?
- What is fertility preserving surgery? What are its pros & cons?
- What is the likelihood of needing a bowel resection?
- What are the risks & possible complications?
- Can surgery cause the ovarian cancer to spread?
- How important is it to schedule surgery for ovarian cancer right after diagnosis?
- Is there a safe window of time?
If You Have Already Undergone Surgery & Been Diagnosed With Ovarian Cancer, Ask These From Your Doctor
- What is the stage of the cancer?
- Was all the cancer removed?
- Is additional treatment necessary, if so why?
- What are the chances of recurrence?
- What are the warning signs of recurrence?
Ovarian Cancer: Understanding Symptoms and Seeking Expert Care
Ovarian cancer is a serious condition that often starts with an ovarian cyst and can progress if not diagnosed early. Ovarian cancer symptoms include abdominal pain, bloating, and changes in bowel habits. It’s crucial to seek advice from a specialized ovarian cancer doctor, who provides expert care and advanced treatments. With her extensive experience in diagnosing and treating ovarian cancer, Dr. Nazish Khalid offers compassionate and effective care to help patients navigate their journey. Early detection and expert management are vital for the best outcomes in ovarian cancer treatment.
Ovarian Cancer Treatment: Comprehensive and Advanced Care
Ovarian cancer treatment involves a combination of surgery, chemotherapy, and targeted therapies. Dr. Nazish Khalid, a specialist in ovarian cancer diagnosis, offers cutting-edge treatments tailored to each patient’s needs. Early detection and ovarian cyst treatment can significantly improve outcomes. For those facing treatment for recurrent ovarian cancer, Dr. Nazish Khalid provides innovative options that focus on extending survival and enhancing quality of life. Trust Dr. Nazish Khalid for expert and compassionate ovarian cancer treatment that addresses both initial and recurrent cases, ensuring the best possible care for her patients.
Chemotherapy for Ovarian Cancer: Tailored Treatments for Every Stage
Chemotherapy for ovarian cancer is a critical component in treating all stages of this disease. For chemotherapy for ovarian cancer stage 1, targeted drugs may prevent recurrence. Chemotherapy for ovarian cancer stage 2 aims to eliminate remaining cancer cells post-surgery. Chemotherapy for ovarian cancer stage 3 involves more aggressive treatments to manage advanced disease. In cases of chemotherapy for ovarian cancer stage 4, it focuses on controlling symptoms and improving quality of life. Innovative approaches like intraperitoneal chemotherapy for ovarian cancer deliver drugs directly to the abdomen, enhancing effectiveness. Dr. Nazish Khalid offers comprehensive, stage-specific chemotherapy to ensure the best possible outcomes for her patients.
Ovarian Cancer Symptoms and Signs: Early Detection is Key
Understanding ovarian cancer symptoms and signs is crucial for early detection. Common indicators, such as persistent bloating and pelvic pain, may overlap with ovarian cyst symptoms but require prompt medical evaluation. Germ cell ovarian cancer symptoms often include abdominal swelling and early satiety. Unlike cervical cancer, cervical ovarian cancer symptoms can manifest as abnormal bleeding and back pain. In more advanced stages, advanced ovarian cancer symptoms may involve weight loss and difficulty breathing. Dr. Nazish Khalid emphasizes the importance of recognizing these signs early for effective treatment and better outcomes.
