Debulking Surgery for Ovarian Cancer: What to Expect

September is Gynaecological Cancer Awareness Month, and for women facing advanced ovarian cancer, surgery is often a central part of treatment. If you have been told you need debulking surgery, you probably have many questions. Knowing what the operation involves, from preparation to recovery, can help you feel more prepared and more in control.

What is debulking surgery?

Debulking surgery, also called cytoreductive surgery, aims to remove as much of the cancer as possible. Ovarian cancer often spreads across the surface of organs in the abdomen, so the operation may involve more than removing the ovaries. Women generally do best when the surgeon can remove all visible disease. You can read more on our debulking surgery page.

When is it carried out?

There are two main approaches. In primary debulking surgery, the operation happens first, followed by chemotherapy. In interval debulking surgery, you have around three cycles of chemotherapy first to shrink the cancer, then surgery, then further chemotherapy. Your team will recommend the approach most likely to achieve complete removal, based on your scans, your general health and the extent of the ovarian cancer.

What does debulking surgery involve?

The operation is usually carried out through a cut down the middle of the tummy, under general anaesthetic. Typically, the surgeon removes the womb, both ovaries and fallopian tubes, and the omentum, a fatty apron of tissue that hangs in the abdomen. Depending on where the cancer has spread, parts of the bowel, the lining of the abdomen, the diaphragm or other organs may also need to be removed.

For some women, heated chemotherapy may be given directly into the abdomen at the end of the operation. You can find out more on our ICRS and HIPEC page. Not everyone is suitable, and your team will explain whether it could help you.

Preparing for surgery

Before your operation, you will have tests to check your fitness for surgery, and you will meet members of the team, including a specialist nurse. Staying as active as you can, eating well and stopping smoking all help your body cope with a major operation. Many hospitals follow an enhanced recovery programme, which focuses on getting you eating, drinking and moving as soon as possible afterwards.

It is also worth preparing practically. Arrange help at home for the first few weeks, and think about the questions you want to ask, such as how long you will be in hospital and what support is available. Bring a friend or relative to appointments if you can, as it helps to have a second pair of ears.

Recovering from debulking surgery

Recovery after debulking surgery takes time. Most women stay in hospital for around a week, sometimes longer after more extensive surgery. You will be helped out of bed early, and pain will be managed carefully. Full recovery usually takes six to eight weeks or more, and tiredness is common for a while.

Chemotherapy usually starts or continues a few weeks after debulking surgery, once you have recovered enough. Your team will agree the timing with you. Our patient pathway page explains how your care is organised at every stage.

Support along the way

Facing major surgery for cancer is a lot to take in, and it is normal to feel anxious. Cancer Research UK explains ovarian cancer treatment in more detail, and Target Ovarian Cancer offers information and support for women and their families. Your specialist nurse is also there to answer questions between appointments.

Debulking surgery is complex, and outcomes are best in the hands of an experienced gynaecological oncology team. If you would like to discuss your treatment options with Mr Abu, please contact our team to arrange a consultation.