NCCN Guidelines for Patients® | Ovarian Cancer - page 33

Part 4: Treatment with surgery
NCCN Guidelines for Patients
: Ovarian cancer
Version 1.2013
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Removal of small
amounts of tissue or fluid to
be tested for disease
Surgery with
a long, up-and-down cut in
the abdomen (belly area)
Lymph node:
groups of special disease-
fighting cells located
throughout the body
A tool that
uses lenses to see things
the eyes can’t
Surgical staging:
Procedures during surgery
that are used to find out
how far cancer has spread
See pages 22–24 for
staging procedures
and biopsy details.
If you have clinical stage III or IV ovarian cancer that has grown into a lot of
tissue, it may not be possible to safely remove it all with surgery. In this case,
you will first have a biopsy—FNA or paracentesis—to confirm it is ovarian
cancer. If the biopsy confirms ovarian cancer, you will have chemotherapy
(treatment with cancer drugs) to shrink the tumors before surgery.
Chemotherapy drugs kill fast-growing cells, including cancer cells and normal
cells. Chemotherapy given before surgery is called neoadjuvant treatment.
After chemotherapy, you will have surgery if your doctor thinks all or most of the
cancer can be removed. It is important that a gynecologic oncologist makes this
assessment and treatment decision. A gynecologic oncologist is a doctor who’s
an expert in treating cancer that starts in the female organs that help make
Next steps:
After surgery and staging, see Part 5 on page 41 for
information about chemotherapy and page 46 for chemotherapy treatment
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