Surgery is an important tool used to diagnose various stages of cancer and treat it, and to manage certain cancer-related symptoms. The surgical procedure followed depends on various factors, such as type, size, location, grade and stage of the tumor, as well as general health factors like age, physical fitness.
In most cases, surgery is combined with other cancer treatments, such as chemotherapy, radiation therapy or hormone therapy. These nonsurgical treatments may be administered prior to or after surgery to prevent cancer growth, spread or recurrence.
The two main goals for Epithelial ovarian cancer being Staging and Debulking are important in the surgery.
Staging epithelial ovarian cancer
One of the two goals in the surgery is to stage the cancer, which means to diagnose how far the cancer has spread from the ovary. Generally, this means removing the uterus (hysterectomy), along with both ovaries and fallopian tubes (a bilateral salpingo-oophorectomy or BSO). Ovarian cancer sometimes spreads to the layer of fatty tissue called omentum and hence, additionally, the omentum is also removed (an omentectomy). Some lymph nodes in the pelvis and abdomen are biopsied. The fluid in the pelvis or abdominal cavity is also removed for analysis, if symptoms are found. The surgeon may “wash” the abdominal cavity with saline and analyzed in this case.
Debulking epithelial ovarian cancer
Another important goal of surgery is to remove major part of the tumor, which is called debulking. Optimally debulking is the main aim of debulking surgery which leaves behind no tumors larger than 1 cm. At times, a part of colon is removed to debulk the cancer properly and the two ends that remain are sewn back together. By this, the top end of the colon is attached to an opening (stoma) in the skin of the abdomen allowing body wastes to move out which is either called as a colostomy, and it is a temporary process.
Debulking surgery might also mean removing a part of a bladder. If this occurs, a catheter will be placed during surgery. The catheter is removed, when bladder empties on its own.