The surgeon makes a long cut in the wall of the abdomen. This type of surgery is called a laparotomy. If ovarian cancer is found, the surgeon removes:
- both ovaries and fallopian tubes (salpingo-oophorectomy)
- the uterus (hysterectomy)
- the omentum (the thin, fatty pad of tissue that covers the intestines)
- nearby lymph nodes
- samples of tissue from the pelvis and abdomen
If the cancer has spread, the surgeon removes as much cancer as possible. This is called "debulking" surgery.
If you have early Stage I ovarian cancer, the extent of surgery may depend on whether you want to get pregnant and have children. Some women with very early ovarian cancer may decide with their doctor to have only one ovary, one fallopian tube, and the omentum removed.
You may be uncomfortable for the first few days after surgery. Medication can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan. The time it takes to heal after surgery is different for each woman. It may be several weeks before you return to normal activities.
If you haven't gone through menopause yet, surgery may cause hot flashes, vaginal dryness, and night sweats. These symptoms are caused by the sudden loss of female hormones. Talk with your doctor or nurse about your symptoms so that you can develop a treatment plan together. There are drugs and lifestyle changes that can help, and most symptoms go away or lessen with time.
Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some have chemotherapy before surgery.
Usually, more than one drug is given. Drugs for ovarian cancer can be administered in different ways:
- By vein (IV): The drugs can be given through a thin tube inserted into a vein.
- By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
- By mouth: Some drugs for ovarian cancer can be given by mouth.
Chemotherapy is administered in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the drugs used. You may have your treatment in a clinic, at the doctor's office, or at home. Some women may need to stay in the hospital during treatment.
The side effects of chemotherapy depend mainly on which drugs are given and how much. The drugs can harm normal cells that divide rapidly:
- Blood cells: These cells fight infection, help blood to clot, and carry oxygen to all parts of your body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team checks you for low levels of blood cells. If blood tests show low levels, your team can suggest medicines that can help your body make new blood cells.
- Cells in hair roots: Some drugs can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
- Cells that line the digestive tract: Some drugs can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Ask your health care team about medicines that help relieve these problems.
Some drugs used to treat ovarian cancer can cause hearing loss, kidney damage, joint pain, and tingling or numbness in the hands or feet. Most of these side effects usually go away after treatment ends.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.
Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.
Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, or bloody stools. Also, your skin in the treated area may become red, dry, and tender. Although the side effects can be distressing, your doctor can usually treat or control them, and they gradually go away after treatment ends.