Debulking for advanced ovarian cancer

What options are there?

Surgery is the main treatment for most ovarian cancers.

How much surgery you have depends on how far your cancer has spread and on your general health. For women of childbearing age who have certain kinds of tumors and whose cancer is in the earliest stage, it may be possible to treat the disease without removing both ovaries and the uterus.

Debulking surgery is an operation that decreases the amount of cancer in the body. For many types and stages of cancer, the best surgical method is to remove the entire tumor or all tumors. However, some cancers are too widespread or are too close to essential organs, making it difficult to remove the cancer completely. The idea of debulking surgery is to safely remove as much cancer as possible. The remaining cancer is usually treated with other therapies, such as  chemotherapy or radiation.

What is debulking surgery?

The important goal of ovarian cancer surgery is to remove as much of the tumor as possible − this is called debulking.

Debulking is very important when ovarian cancer has already spread throughout the abdomen at the time of surgery. The aim of debulking surgery is to leave behind no visible cancer or no tumors larger than 1 cm (less than 1/2 an inch). This is called optimally debulked. Patients whose tumors have been optimally debulked, have a better outlook than those left with larger tumors after surgery (called sub-optimally debulked).

In some cases, other organs might be affected by debulking:

• Sometimes your surgeon will need to remove a piece of colon to debulk the cancer properly. In some cases, a piece of colon is removed and then the 2 ends that remain are sewn back together. In other cases, though, the ends can’t be sewn back together right away. Instead, the top end of the colon is attached to an opening (stoma) in the skin of the abdomen to allow body wastes to get out. This is known as a colostomy. Most often, this is only temporary, and the ends of the colon can be reattached later in another operation.
• Sometimes, a part of the small intestine may need to be removed. Just like with the colon, the small intestine can either be reconnected (which is most common) or an ileostomy might be made. This is usually temporary, but will need special care, so talk to your doctor if this is a possibility before having surgery. 
• Debulking surgery might also mean removing a piece of the bladder. If this happens, a catheter will be placed during surgery. This will be left in place until the bladder recovers enough to be able to empty on its own. Then, the catheter can be removed.
• Debulking might also require removing the spleen and/or the gallbladder, as well as part of the stomach, liver, and/or pancreas.

If both ovaries and/or the uterus are removed, you will not be able to become pregnant. It also means that you will go into menopause if you haven’t done so already. Most women will stay in the hospital for 3 to 7 days after the operation and can resume their usual activities within 4 to 6 weeks.

Please see below our patient leaflet.

PATIENT INFORMATION LEAFLET