Ovarian Cancer Debulking

Ovarian cancer debulking at a glance

• Debulking of ovarian cancer is a surgical treatment to locate, remove and reduce the size of cancerous tumors.
• Ovarian cancer debulking increases survival rates and improves the effectiveness of subsequent chemotherapy and radiation.
• Debulking is very important for women whose ovarian cancer has spread significantly throughout the abdomen at the time of surgery.
• The goal of debulking is to leave no tumor larger than 1cm, which is called optimally debulked.
• Depending upon the extent of cancer, the debulking often coincides with removal of part or all of affected reproductive organs: ovaries, uterus, cervix and fallopian tubes.

What is ovarian cancer debulking?

In terms of ovarian cancer treatment, debulking or “cytoreduction” is a type of surgery with the goal to remove as much cancerous tissue in a patient’s abdomen as possible. Some tumors may be completely removed while others are just reduced in size.

In these cases, “optimal debulking” reduces tumor size to <1cm in order to make subsequent treatment strategies (chemotherapy or radiation) more effective.

Depending upon the extent of the cancer, debulking surgery typically coincides with removal of affected reproductive organs. These surgeries may remove part or all of a woman’s ovaries, uterus, cervix, fallopian tubes or lymph nodes.

Removing or reducing the size of cancerous tissue can significantly improve patient survival rates, in part due to improved efficacy of chemotherapy and radiation. This is particularly important for women whose ovarian cancer has spread throughout the abdomen at the time of surgery.

The success of treatment depends on numerous factors, including patient health, the location of the tumors, and the surgeon’s expertise. Ovarian cancer debulking surgery is best performed by a gynecologic oncologist, a doctor specifically trained to provide both surgical and medical care for women with gynecologic cancers. Studies show that gynecologic oncologists are more likely to optimally debulk ovarian cancer than general surgeons.

Ovarian cancer debulking treatment

Ovarian cancer debulking is usually an “open” surgical procedure, which includes a traditional vertical incision in the abdomen. This type of surgery allows a surgeon to explore the pelvic area for cancer and remove any tumor masses. Most women will remain in the hospital for 3-7 days after the operation and can resume their usual activities within 4 to 6 weeks. For several days after surgery, a woman may also have difficulty emptying her bladder and having bowel movements.

Surgeons may also opt to perform the surgery using minimally invasive techniques such as a laparoscopy. This procedure involves only a few very small incisions to allow a small camera and special surgical instruments to be inserted to perform the debulking surgery. Pain and recovery time are greatly reduced with minimally invasive procedures, and most surgeries are done on an outpatient basis. Most women will resume their normal activities within a week.

However, some women cannot be optimally debunked with laparoscopy and a large incision is necessary to complete the procedure.

As with any surgery, debulking ovarian cancer carries inherent risks. In general, most cancer operations carry a risk of:

• Pain
• Infection
• Bleeding
• Blood clots
• Reactions to anesthesia

Concurrent surgical procedures

During the debulking surgery, a gynecologic oncologist may also perform various related procedures, depending on the type, stage and size of the ovarian cancer.

A surgeon will discuss the best surgical approach for each patient including:

• Salpingo-oophorectomy: surgery to remove either one ovary and fallopian tube (unilateral) or both (bilateral).
• Hysterectomy: surgery to remove part or all of the uterus and cervix.
• Omentectomy: surgery to remove part or all of the omentum, a fold of fatty tissue inside the abdomen.
• Lymph node biopsy: surgical removal of lymph nodes in the abdomen.
• Abdominal fluid biopsy: procedure to take fluid samples from the abdomen (if fluid is present) for testing.

Women who have had both ovaries and/or the uterus removed will not be able to get pregnant. Women who have had the ovaries and fallopian tubes removed, but not the uterus, may be able to get pregnant with donor eggs, or may wish to freeze their own ovarian tissue to use later for in vitro fertilization (see CU Fertility Preservation and Reproductive Late Effects Program for more information).

Removing the ovaries means removing a woman’s source of estrogen and progesterone, the female hormones produced in the ovaries until menopause. The lack of estrogen may cause osteoporosis and menopausal symptoms such as hot flashes and insomnia.

University care is driven by its patients, not profits.

The Division of Gynecologic Oncology at CU Anschutz provides comprehensive treatments and services for all patients.

Because the University of Colorado Anschutz is a research-backed institution, our doctors can take on even the most complex cases, and patients receive the best and most modern care available.

Patients may also participate in the many available cancer research and clinical trials.