Surgery is one of the main treatments for ovarian cancer. It can involve the removal of the ovaries, fallopian tubes, and uterus as well as other tissues. The extent of the surgery depends on the stage of ovarian cancer.

Ovarian cancer is when cancer develops in the ovaries. The American Cancer Society estimates that 19,710 people in the United States will be newly diagnosed with ovarian cancer in 2023.

Surgery is one of the main types of treatment that’s used for ovarian cancer. It’s also used during diagnosis and staging. Keep reading to learn more about how surgery is used for ovarian cancer.

Overall, surgery for ovarian cancer has two goals: to accurately stage your cancer and to remove as much of the cancer as possible.

Staging surgery for ovarian cancer typically involves the removal of:

  • both ovaries and fallopian tubes (bilateral salpingo-oophorectomy)
  • the uterus (hysterectomy)
  • the omentum — a layer of fatty tissue that covers your abdominal organs (omentectomy)

Your surgeon may also do the following during this time to help determine the extent of your cancer:

  • remove nearby lymph nodes
  • put a saline solution into your abdominal cavity and collect it to test for cancer cells, a process called peritoneal washing
  • take biopsies from other surrounding tissues

Surgery is also used to remove as much of the cancer as possible. This is often referred to as debulking. In addition to the tissues mentioned above, debulking may also involve the removal of other abdominal tissues, such as:

  • portions of the:
    • large intestine
    • small intestine
    • bladder
    • stomach
    • pancreas
    • liver
  • the spleen
  • the gallbladder

The goal of debulking is to remove all visible cancer or for there to be no remaining tumors that are larger than 1 centimeter (cm). When this is achieved, your cancer is said to be “optimally debulked.”

If possible, try to have a specialist in gynecologic oncology perform the surgery. Research shows that these specialists are more likely to optimally debulk the tumor, which leads to better outcomes.

Some type of surgery is typically necessary at all stages of ovarian cancer. Generally speaking, the extent of surgery that’s needed for ovarian cancer depends on its stage. Approximately 55% of ovarian cancers are diagnosed when the cancer is already advanced.

If you have ovarian cancer that’s early stage and low-grade, it’s possible that only the affected ovary and fallopian tube will be removed. This preserves your fertility if you wish to have children in the future.

However, ovarian cancers at more advanced stages typically involve the removal of at least the ovaries, fallopian tubes, and uterus. Additional tissues may also be removed if the cancer has spread beyond the reproductive tract.

Your recovery time after ovarian cancer surgery will depend on the extent of your surgery. The American Cancer Society notes that most people who have ovarian cancer surgery will need to stay in the hospital for 3–7 days.

You’ll need to wait a few weeks to return to various activities, such as driving, having sex, or doing strenuous physical activity. Overall, it can take 3 months or more to fully recover from your surgery.

Mental and emotional health impact

One of the side effects of removing the ovaries and surrounding tissues is that you’ll experience symptoms associated with menopause such as hot flashes, insomnia, and vaginal dryness.

Physical recovery is just one part of the picture. Receiving an ovarian cancer diagnosis can feel overwhelming in and of itself. Additionally, surgery for ovarian cancer can be a major operation that can affect your fertility.

It’s normal to feel a variety of emotions, such as sadness or anxiety. One small 2020 study found women who had surgery for ovarian cancer reported high distress or uncertainty.

As such, it’s important to take care of your mental health as your recover. This can come in the form of receiving support from family and friends, or engaging with a cancer support group or mental health professional.

It’s possible that some early-stage ovarian cancers can be completely removed with surgery. The outlook for ovarian cancer is better in individuals whose cancer has been optimally debulked.

While some ovarian cancers may be treated with surgery alone, other treatments are typically used either before or after surgery, including:

What if you’re not eligible for surgery?

Some people may not be immediately eligible for surgery due to the extent of their cancer. In these situations, chemo may be given before surgery to help shrink the tumor.

Those who cannot have surgery due to poor overall health or a high risk of surgical complications may receive treatments like chemo or targeted therapy.

What if ovarian cancer comes back?

Ovarian cancer can come back after treatment. This is called recurrence and happens in about 25% of people with early-stage ovarian cancer and over 80% of people with advanced ovarian cancer.

Some research has found that additional surgery followed by chemo doesn’t improve overall survival in recurrent ovarian cancer.

However, another study found that additional surgery followed by chemo can benefit some people with recurrent ovarian cancer who meet a specific set of criteria.

Surgery is an important part of the diagnosis, staging, and treatment of ovarian cancer. Most people who are diagnosed with ovarian cancer will have surgery as a part of their treatment.

The extent of ovarian cancer surgery depends on the stage of your cancer. Typically, the ovaries, fallopian tubes, and uterus are removed. If the cancer has spread further, other tissues may be removed as well.

Surgery is often used along with other ovarian cancer treatments, such as chemotherapy. Some early-stage ovarian cancers can be completely removed with surgery. But, for some people, it’s possible that the cancer may come back.