Ovarian cancer is often advanced at the time of diagnosis. Debulking is a surgical procedure that may prevent or delay disease progression.
Debulking is a type of surgery that removes as many ovarian cancer sites as possible. It’s also known as “cytoreductive surgery.”
The extent of the surgery depends on how far the cancer has spread within the abdomen. Debulking is usually part of a larger treatment plan that may include chemotherapy, radiation, and
This article takes a closer look at treatment goals and what’s involved in debulking surgery for ovarian cancer.
You’ll notice that the language used to share stats and other data points in this article is pretty binary. Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.
Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
The goal of debulking surgery is to remove as much cancer as possible. The surgery has three potential results, including:
- Complete: After surgery, there are no visible signs of cancer.
- Optimal: There are still one or more tumors, but their size is less than 1 centimeter (cm).
- Suboptimal: The tumors left behind are 1 cm in size or larger.
Specific details of the surgery depend on where the cancer has spread. A surgeon will also consider areas where cancer is likely to spread. In ovarian cancer, affected areas may include:
- Ovaries: Removal of one or both ovaries is a procedure called an “oophorectomy.”
- Fallopian tubes: Removal of one or both fallopian tubes is called a “salpingectomy” (ovaries and fallopian tubes removed at the same time is called a “salpingo-oophorectomy”).
- Uterus: Removal of the uterus is called a “hysterectomy.”
- Lymph nodes: Nearby lymph nodes may be removed for biopsy.
- Omentum: Removal of part or all of the omentum (a large layer of tissue covering the abdominal organs) is a procedure called an “omentectomy.”
- Colon: If there’s cancer on the colon, the surgeon may have to remove that piece. They can usually sew the two ends together. If they can’t, you may need a temporary colostomy.
- Small intestine: If there’s cancer on the small intestine, you may need to have that part removed. The ends can usually be reconnected.
Debulking can be the primary treatment before starting chemotherapy and other therapies. In some instances, a doctor may recommend chemotherapy first to shrink the cancer before surgery.
Also, if other health conditions put you at a high likelihood of surgical risks, the doctor may recommend chemotherapy as first-line treatment.
Facts about ovarian cancer
- Ovarian cancer represents about
1%of all new cancer cases.
- A woman’s lifetime risk of developing ovarian cancer is
- The two biggest risk factors are age and having ovaries.
- The annual rate of new ovarian cancers has been declining since 2019.
- You can get ovarian cancer at any age, but it’s rare under age 40. About
one-halfof women are 63 years or older at diagnosis.
- Ovarian cancer is
more commonin white women than in Black women.
- The 5-year relative survival rate ranges from local state to distant stage at
- There are often
no symptomsin early stage disease.
- At the time of diagnosis,
55%of ovarian cancers are already at distant stage.
- Recurrence occurs in almost
25%of early stage cases and more than 80%in more advanced stages.
A doctor may suggest debulking if ovarian cancer has spread beyond your ovaries. If you have advanced ovarian cancer, debulking surgery can help by:
- removing all or most of the abdominal tumors to stop or delay disease progression
- making chemotherapy and radiation therapy more effective
- relieving symptoms of large tumors to preserve quality of life
Debulking is a major surgery that requires general anesthesia, and you’ll likely be in the hospital for 3–7 days. Your stay will be longer if you have serious surgery-related risks.
This surgery usually involves a long incision down the middle of the abdomen. The surgeon will try to remove all visible tumors. They may also remove organs where cancer is likely to spread. In ovarian cancer, these organs usually include the omentum, ovaries, fallopian tubes, and uterus.
In certain cases, the doctor can deliver chemotherapy directly into the abdomen at this time. This procedure is called “intraperitoneal chemotherapy.”
The surgeon will close the wound with stitches, staples, or surgical glue. Following surgery, you may have a catheter and a tube coming from your abdomen to drain fluids. A medical team will remove them within a few days.
The surgery can take anywhere from 3–12 hours, and its length varies according to factors such as:
- how many organs have cancer and how many tumors there are
- whether organs can be safely removed
- whether you’re having intraperitoneal chemotherapy
- surgical risks
In general, recovery takes 4–6 weeks, but everyone is different. Recovery time depends on the specifics of the surgery. Your age and overall health also affect recovery.
Risks of any surgery can include:
- reaction to anesthetic
- tenderness, swelling, and pain at the incision site
- surgical site infection
- accidental injury
- older age
- coexisting medical conditions
- stage 4 disease
- more extensive surgery
Potential risks of debulking surgery can include:
Every case is different, but
The outlook for people with ovarian cancer is better when you have optimal surgery results. A
Debulking is just one part of a total ovarian cancer treatment plan. Most people have a combination of therapies, which may include:
Debulking is the surgical removal of ovarian cancer sites within the abdomen. The goal is to remove as much of the cancer as possible, which usually involves the removal of the ovaries, fallopian tubes, and uterus.
Ovarian cancer can also affect other organs. The extent of the surgery depends on where the cancer has spread.
This surgery can make chemotherapy and radiation more effective. It can also prolong life and ease symptoms of large tumors.
Debulking is a major surgery with potential risks as well as benefits. Each case is different, so you may want to have a conversation with a doctor about whether this is the right treatment choice for you.