Ovarian Cancer

Surgery for ovarian cancer

Surgery may be the first treatment for ovarian cancer, and is sometimes needed to make the diagnosis, or may follow a course of chemotherapy (aimed at shrinking the cancer). Surgery is done through a cut in the abdomen (tummy) - what is removed and how this is done depends upon the size and spread of the tumour (cancer). Sometimes this is not known before the operation, and sometimes the surgeon does not know whether the tumour is malignant (cancerous) or benign until it has been removed and examined in detail. Laparoscopic surgery can be used for staging of early ovarian cancer. This ensures a quicker recovery and avoids a large scar.

If the cancer is in the early stages, removal of one or both ovaries may be enough treatment. Younger women who have only one ovary removed may still be able to have children. More commonly the the womb (uterus) and cervix are removed as well as both ovaries and fallopian tubes (total abdominal hysterectomy TAH and bilateral salpingo-oophorectomy BSO). The surgeon may also remove the fatty tissue lining the abdomen (the omentum) and may take other samples to check if the cancer has spread.

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Women said that before surgery they had been worried about pain, the side effects of anaesthetic and what the scar would be like, but most had been impressed with the pain control and the speed of healing.

If the cancer has spread to the bowel, a piece of bowel may be removed and the two ends rejoined. More rarely, the bowel may be rerouted through an opening (stoma) onto the front of the abdomen and the stools collected in a bag worn over the stoma. This is called a colostomy, and is often only temporary. Several women had a piece of bowel removed and some were asked to consent to a colostomy in case this was found necessary during the operation. Many women worried about the possibility of a 'stoma', which was sometimes the first thing they felt for when they came round after surgery. (For more on living with colostomies see our bowel cancer site).

Sometimes the cancer had spread too much to enable all the affected tissues to be removed. If chemotherapy failed to destroy all the remaining cancer a second operation was sometimes done. One woman had a second operation to remove the omentum where her oncologist feared the cancer might spread. Another had a second operation cancelled because her cancer turned out to be of 'borderline' malignancy and only needed to be watched. 

Some women had their first operation done as an emergency to treat a blocked bowel. If the surgeon did not know that ovarian cancer was the cause, a second operation was needed to remove other affected tissues. When surgeons knew the cancer would be difficult to remove, chemotherapy was given before surgery to shrink it and make it easier to remove. 

As with any surgery women were not allowed to eat or drink for several hours before the anaesthetic and had to use a strong laxative to purge the bowel the night before the operation.

Many women praised the care they received in hospital but some who were in surgical rather than oncology wards voiced criticisms. Some found it difficult being the only cancer patient on the ward. One who experienced difficulties getting pain relief was moved to an oncology ward. 

For a few days after surgery most women are connected to a drip to maintain their body fluids until they can eat and drink again. They may also have a tube put in their bladder to drain their urine, and a drain from their wound to stop excess fluid collecting. It is normal to have some pain for a few days after surgery and some women described feeling ill. One woman felt the nurses made her sit up too soon after her operation, but others were pleased to achieve milestones such as sitting, getting out of bed and taking a shower.

Women can usually go home 3 - 4 days after their surgery depending on the type of operation and the woman's speed of recovery. Women often wanted to go home to see their families, or because they found it hard to eat or sleep in hospital. One woman pointed out that, even though she had lost weight, her abdomen was swollen and tender after the surgery and she needed to borrow a pair of loose jogging trousers to wear at first. Some women feel very protective about the scar - one described feeling as though her 'insides were going to fall out' the first time she stood up, and later discovered that this was a common sensation.

Most women recovered well. They were warned to avoid strenuous physical activity, heavy lifting and told not to drive for 6 weeks. A few found their recovery boring or frustrating because they were limited in what they could do. Women who were lucky enough to be able to go away said it helped them recover - one said she was playing table tennis on a cruise three weeks after leaving hospital.

Follow-up care sometimes had gaps: two women found that the hospital had not contacted their GPs and another did not receive an expected visit from a nurse. People were not always told what to expect after surgery - one woman had a bleed which she did not know could happen.

Last reviewed June 2016.

Last updated June 2016.

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