Surgery for ovarian cancer

• A quick guide to what's on this page
• Types of surgery
• Interval debulking surgery
• Before your surgery
• After your operation
• Recovering from a hysterectomy

Surgery for ovarian cancer is usually quite a big operation. This is to make sure that as much cancer as possible has been removed. You will be in hospital for 5 to 10 days. And recovering at home afterwards for at least another month or so.

There is more detail about the operation for each stage of ovarian cancer in the CancerHelp UK section about which treatment for ovarian cancer? If you are young and have a borderline or low grade, early stage cancer you may have just the affected ovary and fallopian tube removed. But otherwise if you have stages 1 to 3 ovarian cancer you are most likely to have ovaries, fallopian tubes, womb including the cervix and the omentum (a layer of fatty tissue close to the ovaries) removed. This is called a 'total abdominal hysterectomy' and 'bilateral salpingo-oophorectomy'.  It is often referred to as TAH and BSO for short. Removing the omentum is called 'omentectomy'.

You may also have lymph nodes removed from the pelvis and abdomen. These will be sent to the laboratory to see if they contain cancer cells.

If your surgeon finds any cancer elsewhere in your pelvis or abdomen during your operation, they will remove as much as possible. This is sometimes called 'debulking'. The less cancer there is, the easier it is for chemotherapy or radiotherapy to kill off any cells left behind.

This is sometimes done after 3 or 4 courses of chemotherapy. The aim is to remove any cancer that could not be removed during your first operation. The chemotherapy may have shrunk the tumour so that it is now possible to remove it. Further chemotherapy is given after the operation. This is a new approach to treating ovarian cancer that has been tested in trials. But so far it isn't clear whether this works better than just having chemotherapy after your first operation. It may be more helpful for particular groups of women. We need more research to find out how best to use surgery and chemotherapy together like this.

Your surgeon will need to be sure you are fit for your operation. You may have had some of these general tests when your cancer was being diagnosed. If so, you won't need to have them again. You will probably have

• A chest X-ray
• Blood tests
• Urine test
• ECG (heart monitor)

You will have an appointment before your operation where you meet the surgical team members and have any tests that you need. Sometimes the tests are done when you get to the hospital the night before your operation. You will be given information about your operation and will be asked to sign a consent form to say that you agree to have the surgery. The doctor should explain the form fully to you before you sign it.

When you go into hospital for your surgery, you will be seen by the anaesthetist and one of the surgical doctors. Your nurse or a physiotherapist will talk to you about the breathing and leg exercises that you will need to do after surgery to prevent blood clots in your legs and chest infections. You may be given heparin injections which will also help prevent blood clots as well as antibiotics to help prevent infections.

If you have not emptied your bowels that day, you may be asked to have suppositories or an enema to clear out your bowel. This helps to avoid constipation after your operation.

Your doctor or nurse will tell you when you need to stop eating or drinking before your operation. This is called being 'nil by mouth'.

When you wake up after your operation you will have a few tubes in place. You may have

• A drip (intravenous infusion) into a vein in your arm to give you fluids until you are eating and drinking again
• A tube (catheter) into your bladder to drain your urine
• One or more fine tubes (wound drains) into your abdomen to drain away fluid and help the wound to heal.

You will not be able to eat or drink at first. But as soon as you are fully awake you will be able to wet your mouth with sips of water. Your nurses will advise you about gradually increasing the amount you drink. When you can drink normally you will be able to start eating light foods. You should be able to eat and drink normally again within a couple of days.

Feeling sick

Some people feel sick after a general anaesthetic. Pain killers can also make you feel sick. Do tell your nurse or doctor straight away. They can give you anti-sickness medicines. If the medicines aren't working it can help to change to another drug. Let the staff on the ward know if you feel sick as you won't be able to start eating and drinking. Then you may have a drip up for longer. 

Painkillers

You will almost certainly have some pain for the first few days after your operation. But there are many pain killing drugs you can have. Painkillers are often given by epidural after surgery for ovarian cancer. An epidural is a small tube into your back, which anaesthetic is pumped into. If you are in pain it is important you tell the nurse or doctor as soon as possible. With your help, they will be able to find the right type and dose of painkiller for you. There is more information about different types of painkillers in our pain control section.

Getting up

The nurses and physiotherapist will get you up as soon as possible, maybe even the morning after your operation. You should have had your painkillers before you have to get out of bed. While you are still in bed, do the breathing and leg exercises you have been taught. This helps to stop chest infections and blood clots.

Going home

You usually go home about 4 to 10 days after your operation. Your stitches are taken out 7 to 10 days after surgery, often by the nurse at your GP surgery. You'll have an outpatient appointment arranged before you leave the ward. This will be at least a couple of weeks after you go home. At that appointment you will be given the results of the surgery and your doctor will discuss your future treatment with you. Sometimes you can choose to be given some of this information by phone.

If you live alone, or might have difficulty managing when you return home, let the nurses know when you first go into hospital so plans can be made to help you.

It takes time to get over a hysterectomy. It is a big operation. And it can affect you emotionally as well as physically. There is more about recovering from hysterectomy in the CancerHelp UK section about living with ovarian cancer.