Ovaries produce eggs and female hormones during a woman’s reproductive life. Women have two ovaries, one on either side of the uterus (womb) in the lower abdomen.
The organs and tissues of the body are made up of tiny building blocks called cells. When your body’s cells are healthy, they grow and divide to make new cells. When old cells die, new ones take their place. Cancer is a disease of these cells. A cancerous tumour starts from one abnormal cell. However, the exact reason why a cell becomes cancerous is unclear. Cancerous tumours have the ability to spread beyond the original site, and if left untreated, it may invade and destroy surrounding tissues. Sometimes, cells break away from the original (primary) cancer and spread to other organs in the body via the bloodstream or lymphatic system. When these cells reach a new site they may continue to divide and form a new tumour, often referred to as “metastasis”.
There are various types of ovarian cancer. They are classified by the type of cell from which the cancer originates.
In many cases, women with cancer of the ovary in the early stage do not display any symptoms. Symptoms may only be noticed when the cancerous tumour has become quite large.
In most cases, the reason why an ovarian cancer develops is not known. However, there are some factors which increase your risk.
Further TestsYou may be advised to go for further tests depending on the symptoms that you have and the results of the initial tests.
Surgery is required for diagnosis and to determine the extent of the disease (staging). Ovarian cancer surgery is preferably done by a gynaecological oncologist to achieve a desirable outcome. Gynaecological oncologists are specialist cancer surgeons who are specially trained in the management of women’s cancers.
This is the removal of the uterus with cervix (total hysterectomy), both ovaries and the tubes (bilateral salpingo-oopherectomy), the fat ‘apron’ in the abdomen (omentectomy) and lymph nodes (lymphadenectomy). In some cases, the cancer may have spread into other nearby structures. Therefore, a more extensive operation is needed to remove as much of the cancer as possible. This is called debulking surgery which may involve removal of the bowel. This will usually be done through a midline or vertical incision in the abdomen.
Younger women who desire fertility may want to speak to your doctor for advice.
There are risks and complications associated with any major surgery. Due to some blood loss during your operation, blood transfusion is sometimes required. In rare cases, there may be internal bleeding after the operation, making a second operation necessary.
Occasionally, it is possible to develop blood clots in the veins of the leg, pelvis or in rare cases, in the lungs. Moving around after your operation can help prevent blood clots. Our physiotherapist will visit you after your operation to advise and assist with your mobility. To reduce the risk of blood clots, you will also be given injections to thin your blood during your stay in the hospital.
During any major operation involving the pelvic organs, there is a small risk of injury to the bladder and bowel. If this occurs, the injury will be repaired. There may be a small risk of developing an infection in the chest, wound, pelvis or urine. To reduce this risk, you will be given an antibiotic just before the operation.
In rare cases, wound breakdown (dehiscence) may occur and re-suturing of the wound maybe required.
Ovarian cancer is “staged” based on the findings at the time of surgery and the extent of the disease.
There are four stages of ovarian cancer. Knowing the stage of cancer helps your doctor to decide on the most appropriate treatment.
The final pathology report is usually received about one or two weeks after surgery. The pathology slides will be reviewed by a panel of gynaecologic cancer experts, including the medical oncologist at the Gynaecological Cancer Centre (GCC)’s weekly Tumour Board Meeting. Recommendations for any further treatment will be made by your doctor and will be discussed with you and your family.
The majority of women with ovarian cancer will require chemotherapy after surgery. However, chemotherapy can also be given before surgery. Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. You will be referred to a medical oncologist for advice on chemotherapy treatment (Please refer to the Chemotherapy brochure).
Even after the completion of chemotherapy treatment, follow-up examinations are recommended every three months for the first two years and subsequently four to six-month intervals in the following years. Despite treatment, there is a risk that cancer may recur and further treatment may be required.
For enquiries or more information, please contact our
KK Gynaecological Cancer Centre at
+65 6394-8803/2160 during office hours.