Successful Surgical Outcomes for Ovarian Cancer

Surgical Expectations

When doctors walk into an operating room to perform ovarian cancer surgery, they come in with the expectation that they will remove all evidence of disease. Unfortunately, that doesn’t happen for all patients.

“If we can’t reach that particular target, leaving no more than a centimeter or so of disease [about half an inch] is really our next best expectation,” Dr. McHale explains.

Of course, at the same time as doctors strive to surgically remove any evidence of disease, they also have to ensure that healthy structures in the body remain intact. That can be a tall order for ovarian cancer patients. In fact, up to half of patients with ovarian cancer require additional medical interventions. A few of the more common include:

• Bowel resection: If your disease has spread to the abdomen, and your surgery involves removing portions of the bowel, your doctor may bring up a piece of the bowel to the skin and insert an ostomy bag to relieve the stool. The bag may be temporary.
• Incontinence: If your bladder is affected, your doctor may place a thin tube called a catheter in your bladder to remove urine. Catheters are usually temporary and they remain in place until your bladder resumes normal functioning.
• A blood transfusion: Up to half of ovarian cancer patients need a blood transfusion during surgery, which increases the risk of infection.
• Treatment in the Intensive Care Unit (ICU): Most patients, particularly those who receive a blood transfusion, will require treatment in the ICU to assist with their recovery after surgery.

Improving Surgical Outcomes

The chances of complications following surgery depend on a number of factors, including your age, extent of disease, and whether you have unrelated health conditions. Some patients may not even be eligible for surgery because the burden of disease is so great  and the risk of complications from surgery outweigh any potential treatment benefits.

“Even in the best surgical hands, there are times when the volume of disease is so significant that the effort to remove the disease would result in a significant impact on normal function or quality of life,” Dr. McHale says.

For those patients, a “chemotherapy-first protocol” may reduce the volume of disease–shrink the tumors–so doctors don’t have to remove as much tissue during surgery. In fact, studies suggest that delivering chemotherapy before ovarian cancer surgery can reduce the risk of complications by 25 to 30 percent.

Opting for chemotherapy before surgery may be especially attractive for elderly and frail patients. Not only are these women more likely to develop complications from surgery, but they’re also more likely to suffer from life-threatening complications after an extensive ovarian cancer operation.

No matter what your age or disease stage, your doctor can prepare you by explaining the things you can do before surgery to help improve the outcome, reduce your risk of complications, and streamline your recovery time.

 

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