Surgery
Surgery is commonly the first step in treating primary peritoneal cancer. It should be done by a gynecologic oncologist. The goal is to take out all visible disease. Doing so can improve survival. The process is called tumor debulking.
When all visible disease is removed, the patient is said to be optimally debulked. Sometimes, where the tumor is does not allow for optimal debulking. And sometimes the patient’s condition doesn’t allow it. In either case, chemotherapy is given first. Then the patient might have surgery later. Most surgery is done with a laparotomy. With this procedure the surgeon makes a long cut in the wall of the abdomen. If PPC is found, the surgeon does the following procedures:
- Salpingo-ooophorectomy: both ovaries and fallopian tubes are removed.
- Hysterectomy: the uterus is removed usually with the attached cervix.
- Omentectomy: the omentum, a fatty pad of tissue that covers the intestines, is removed.
Sometimes, some nearby lymph nodes will be removed. Based on the surgical findings, more extensive surgery may be done. This could include removing parts of the small or large intestine. It could also include taking tumor from the liver, diaphragm, and pelvis. Taking out as much tumor as possible is one of the most important factors for cure rates.
Side Effects of Surgery
Some discomfort is common after surgery. It often can be controlled with medicine. Tell your treatment team if you are having pain. Other possible side effects are:
- nausea and vomiting
- infection
- fever
- wound problem
- fullness due to fluid in the abdomen
- shortness of breath due to fluid around the lungs
- anemia
- swelling caused by lymphedema, usually in the legs or arms
- blood clots
- difficulty urinating
- constipation
Talk with your doctor if you are concerned about any of the problems listed.