Ovarian tumors

Ovarian tumors are challenging to diagnose and often go unnoticed until they grow large enough to cause discomfort, or progress to a more advanced stage. The most common way in which ovarian tumors are found is through routine physical exams. This underscores the importance of having exams regularly so that any changes in the ovaries are detected as early as possible.

If your doctor feels a change in one or both of your ovaries, they may send you for an ultrasound or other imaging to confirm the presence of a tumor. If they suspect malignancy, they will want to perform a biopsy.

Treatment

At Dignity Health, our team delivers personalized care to prevent and treat ovarian tumors. We tailor your care according to your risk factors, reproductive goals, age, and medical condition. In many cases, benign ovarian tumors do not require any treatment or intervention unless they grow large enough to have an impact on your quality of life. In these cases, doctors tend to take a watch-and-wait approach.

Common prevention and treatment strategies for benign tumors include:

• Prescription medication, including birth control pills – Taking birth control pills decreases the risk of ovarian tumors. Injectable hormonal birth control may also reduce risk. For women who have a BRCA1 or BRCA2 gene mutation, doctors can prescribe a medication called tamoxifen to decrease risk of ovarian cancer.
• Laparoscopy – The insertion of a small camera with a light into a tiny incision in the abdomen. Through this incision, your doctor can use specialized surgical instruments to take a biopsy and/or remove the tumor.
• Laparotomy – This is major surgery done to remove a large tumor through a large incision made in the abdominal wall.

If the tumor is malignant, the surgical removal of the ovaries may be recommended, particularly if you are high-risk or you don’t want to have children in the future. Keep in mind that removing the ovaries can decrease, but not wholly eliminate, the risk of ovarian tumors.

If the tumor is malignant, you may also undergo chemotherapy either before or after surgery. This is used to shrink cancerous tumors, to eliminate any remaining cancer, or to prevent a recurrence.

Preparation

There is typically no preparation for a diagnostic appointment since, in most cases, the ovarian tumor is found and diagnosed during a routine examination. If your doctor chooses to perform laparoscopy, there are some things you need to do prior to the procedure, including:

• Not eating, drinking, or smoking after midnight the night before the procedure
• Wearing flat or low-heeled shoes to the procedure
• Wearing loose-fitting clothes
• Removing all nail polish
• Removing all jewelry
• Ensuring you have someone to take you home after the procedure

If you have to prepare for major surgery, such as for the removal of a large tumor or your ovaries, you will meet with your healthcare team before the procedure. They will make sure you know what to expect, answer all your questions, and ensure you are healthy enough for surgery. They will also tell you what to do to prepare, which may include the following:

• When to stop eating and drinking the night before the surgery
• When to stop taking certain medications, such as blood thinners, prior to surgery
• When to be at the hospital
• What to bring with you to the hospital
• How to prepare your home for when you are discharged

You will also need to ensure that you have someone who will drive you home from the hospital and help you in the first days after surgery.

Recovery

If you have been treated for a benign ovarian tumor with laparoscopy, you will most likely be able to get back to your normal activities within a week and have a follow-up appointment at two weeks. If you require a laparotomy, you will likely need four to six weeks to heal, after which you will be able to get back to your normal activities.

If you are being treated for a malignant tumor and have surgery to remove the tumor or ovaries, you will need up to six weeks of healing time. You will also need to recover from your course of chemotherapy, if you are given one. There is a 45.6% five-year survival rate for women treated for ovarian cancer.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.