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.
In some circumstances surgery first will be the best option, while in other cases 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. 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.
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 can be monitored.
What happens after surgery?
After surgery you should expect to be in hospital between five and eight days. Your recovery will depend 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 the cancer 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.
Last review November 2013
Date of next review November 2015