It depends on the type and the extent of cancer that you have. For instance, most patients with endometrial (uterine) cancer have a cancer that presents at an early stage, before it has spread to other parts of the body. Thus, many can have their cancers removed and staged with a minimally invasive approach. This usually includes removal of the uterus, the ovaries and the lymph nodes that drain the pelvis with a laparoscopic procedure. However, patients with advanced or recurrent ovarian cancers are not likely to benefit from a laparoscopic approach. These bulky tumors are not easily removed from the small incisions that we make for a minimally invasive procedure.
This is a common situation for many patients and one that can cause a great deal of anxiety. Most masses near or on the ovary can be evaluated and removed with a minimally invasive approach. Once removed, our pathology team evaluates the mass under the microscope and determines if it is a cancer of the ovary. If so, in some cases it is possible to perform a procedure laparoscopically. This includes removing the uterus, the lymph nodes that drain the pelvis, and the other ovary.
Yes. One exciting application of minimally invasive techniques is to use it in conjunction with vaginal surgery for treating women with early stage cervical cancer. In these cases, the lymph nodes are removed via a minimally invasive approach, while the cancerous portion of the cervix is removed vaginally. This leaves a small portion of cervix and the uterus in place for a future pregnancy. Early stage ovarian cancers can also be treated with a minimally invasive approach that maintains fertility. In these cases, the other ovary and the uterus are left in place, after being biopsied, and the rest of the staging procedure is performed with the laparoscope.
Unfortunately, there is no screening test currently available that can identify early ovarian cancers when they would be most easily treated. Patients with a strong family history of ovarian or breast cancer may benefit from a preventive (prophylactic) surgery to remove the ovaries. Minimally invasive surgery to remove the ovaries in such high-risk individuals has been shown to be safe and can significantly reduce the risk of developing ovarian and fallopian tube cancer. Pre-menopausal women must balance the risks of going into early menopause, due to the loss of the ovaries and their hormones, with the protective effects of the surgical procedure.