Surgery
Following diagnosis a surgeon will review your suitability for
surgery. In the majority of cases, treatment for ovarian cancer
includes surgery to remove as much of the cancer as possible and
chemotherapy to get rid of any cancer cells which are left.
Some surgeons believe that surgery first is always the best
option, while others feel that chemotherapy followed by surgery
offers better results. If this is the case, your surgery will
usually be scheduled for about halfway through your course of
chemotherapy.
Because ovarian cancer is a kind of cancer that is very
difficult to diagnose, the cancer may have already spread beyond
the ovary by the time it is discovered. To remove the cancer,
surgery will generally be recommended in most cases. At an
exploratory operation, or laparotomy, the surgeon will see where
the cancer is located, and will usually proceed to remove as much
tumour as possible. In this process, it is often necessary to
perform a hysterectomy (removal of the womb) and an oophorectomy
(removal of the ovaries).
The aim of surgery is to remove as much disease as possible. In
some cases it is possible to remove all the disease, but residual
"seedlings" of cancer cells are unavoidably left behind in the
majority of patients. The amount of cancer left after surgery
varies from person to person. Sometimes only a few cells are left;
in other people larger amounts may remain. Before surgery your
doctors may have performed a scan to assess the situation. A
further scan may be performed after surgery so that your progress
on treatment can be monitored.
In most cases the surgeon will perform a hysterectomy (removal
of the womb) and a salpingo-oophorectomy (removal of the ovaries
and fallopian tubes). The surgeon will also take samples of tissue
from around your abdomen, to find out whether the disease has
spread and see what stage your cancer is at.
What happens after surgery?
After surgery you should expect to be in hospital betwee 5 and 8
days. Your recovery will vary depending on the extent of the
operation and how quickly your bodily functions return to normal.
The hospital staff will be able to provide you with more specific
advice about your stay.
Once doctors have assessed what stage your cancer is at they
will advise you on further treatment. The treatment of choice is
usually chemotherapy, unless you have a stage 1a tumour. In this
case, surgery alone is usually sufficient. Radiotherapy is
occasionally used for ovarian cancer where the tumour is bulky. It
can help reduce the size of the tumour as well as treating any
symptoms
After surgery the majority of patients are given chemotherapy
drugs, to kill as many of the remaining cancer cells as possible.
This kind of treatment should be given under the supervision of an
oncology clinic where you can receive specialist care and detailed
information about all aspects of the treatment.
What will chemotherapy do for me?
In most patients, chemotherapy is able to kill off the majority
of cancer cells. This results in the shrinkage of the cancerous
lumps, improvement in your symptoms, and a positive effect on the
progression of your illness. When all of this happens - and the
cancer has shrunk up like this - it is said to be in
"remission".
Sometimes, all the detectable cancer disappears. This is called
complete remission. In other cases - and for no known reason - most
of the cancer disappears, but a small amount remains and can still
be seen on scans or through blood tests. This is known as partial
remission.
In a minority of cases, the cancer cells resist the effects of
chemotherapy drugs, and the disease does not improve. If this
happens, other drugs which work in different ways may be used to
try to control the cancer.
