You Have an Ovarian Mass. What Should You Do Next?
Finding an ovarian mass does not automatically mean that you have ovarian cancer.
Ovarian cysts and masses can have different causes. Their significance depends on factors such as your age, symptoms, ultrasound or CT findings, blood tests and other clinical information.
You may be advised to seek specialist evaluation if your report mentions:
- Complex ovarian cyst: A cyst with internal structures or other features that require closer assessment.
- Ovarian or adnexal mass: A growth involving the ovary or the area around the ovary that may require further evaluation.
- Elevated CA 125: A blood test result that may be raised in ovarian cancer as well as several non-cancerous conditions.
- Ascites: Fluid within the abdomen that may require further investigation when seen with an ovarian mass.
- Peritoneal deposits: Abnormal areas involving the lining of the abdominal cavity that may indicate spread of cancer.
- Omental thickening or caking: Changes involving the omentum that can occur when cancer spreads within the abdomen.
The next step is not to assume a diagnosis based on one finding. It is to understand the complete clinical picture and determine whether surgical evaluation is needed.
What Does Your Ovarian Cancer Report Mean?
If you recently received an ultrasound, CT scan, MRI, or blood test report, some of the terminology may be difficult to understand.
Complex Ovarian Cyst
A complex cyst contains features that distinguish it from a simple fluid-filled cyst. Depending on the imaging appearance, age and clinical situation, further assessment may be recommended.
Ovarian Mass With Ascites
Ascites means fluid in the abdominal cavity. When it occurs alongside an ovarian mass, the underlying cause needs careful evaluation.
Peritoneal Deposits
The peritoneum is the lining of the abdominal cavity. Ovarian cancer can spread along peritoneal surfaces. If imaging suggests peritoneal involvement, the location and extent of disease become important when considering surgery.
Omental Caking
The omentum is a layer of tissue within the abdomen. Abnormal thickening or involvement of the omentum can be seen when certain cancers spread within the abdominal cavity.
Bilateral Ovarian Masses
Masses affecting both ovaries may require further evaluation. Their significance depends on their appearance, associated findings and the overall clinical picture.
Elevated CA 125
A raised CA 125 level does not by itself confirm ovarian cancer. It needs to be interpreted alongside imaging, symptoms, and other clinical findings.
If your report contains any of these terms, bring the complete report and imaging for specialist assessment rather than trying to interpret one finding in isolation.
What Happens After Ovarian Cancer Is Diagnosed?
Once ovarian cancer is suspected or confirmed, the next question is usually:
“What happens now?”
Treatment planning depends on the extent and location of disease, the patient's overall health, pathology and other clinical factors.
A surgical oncologist may assess:
- Where is the cancer located? The ovaries, pelvis, peritoneal surfaces and other abdominal structures may need to be evaluated.
- How extensive is the disease? Imaging and other investigations help establish the distribution of disease and guide treatment planning.
- Is surgery appropriate at this stage? Some patients may undergo surgery as the initial major treatment. In others, treatment may begin with chemotherapy before surgery.
- What type of surgery may be required? The surgical approach depends on the disease location and how extensively it has spread.
- Could CRS and HIPEC be considered? For selected patients with peritoneal surface involvement, cytoreductive surgery followed by HIPEC may be considered.
The treatment sequence is individualised rather than determined by a single test result.
Ovarian Cancer Surgery in Pune
Surgery can be an important part of ovarian cancer treatment. The type and timing of surgery depend on the extent of disease and the patient's individual circumstances.
Primary Cytoreductive Surgery
For selected patients, surgery may be performed as the initial major treatment. The aim is to remove visible tumour as extensively as possible when this can be achieved safely and appropriately.
Interval Cytoreductive Surgery
In some patients, chemotherapy may be given before surgery. Surgery may then be considered based on the response to treatment and the patient's suitability for an operation.
Complex Ovarian Cancer Surgery
Advanced ovarian cancer can involve multiple areas within the abdomen. Surgery in these situations may require a detailed assessment of disease distribution and careful planning.
CRS and HIPEC
For selected patients with peritoneal surface involvement, treatment may involve Cytoreductive Surgery followed by Hyperthermic Intraperitoneal Chemotherapy, commonly referred to as CRS and HIPEC.
The suitability of this approach depends on factors including the extent and distribution of disease, the possibility of achieving adequate tumour clearance and the patient's overall condition.
Could HIPEC Be an Option for Ovarian Cancer?
HIPEC is not required for every patient with ovarian cancer.
In selected cases involving peritoneal surface disease, HIPEC may be considered alongside cytoreductive surgery.
The decision requires assessment of factors such as:
- Extent and distribution of disease
- Involvement of the peritoneal surfaces
- Whether adequate cytoreduction can be achieved
- Previous treatment and response
- Overall health and suitability for major surgery
- Findings from imaging and other clinical investigations
Dr Snita has specialised fellowship training in Peritoneal Surface Malignancy and HIPEC from the National Cancer Institute in Milan, Italy.
Whether HIPEC is appropriate can only be determined after a detailed assessment of the individual case.
Explore CRS and HIPEC
Why Consult Dr Snita Sinukumar for Ovarian Cancer Surgery?
Focused Surgical Oncology Expertise
Dr Snita Sinukumar is a Surgical Oncologist with a focused practice in advanced cancer surgery, including ovarian cancer, peritoneal surface malignancy and complex cytoreductive procedures.
Training at Tata Memorial Hospital
Dr Snita completed her MCh in Surgical Oncology at Tata Memorial Hospital, Mumbai, after completing her MS in General Surgery at B.J. Medical College and Sassoon Hospital, Pune.
Her training at Tata Memorial Hospital provided specialised exposure to complex cancer surgery.
Specialised HIPEC Training
Dr Snita completed specialised fellowship training in Peritoneal Surface Malignancy and HIPEC at the National Cancer Institute in Milan, Italy.
Her clinical interests include peritoneal surface malignancy, ovarian cancer surgery, gastrointestinal oncology and robotic cancer surgery.
Research in Ovarian Cancer and HIPEC
Her academic work includes research involving advanced epithelial ovarian cancer and recurrence following cytoreductive surgery and HIPEC.
She received the Best Abstract Award at the 12th International PSOGI Conference in 2021 for research involving recurrence after CRS and HIPEC in advanced epithelial ovarian cancer.
Experience in Complex Cancer Surgery
Her professional experience includes surgical oncology roles at Tata Memorial Hospital and consultant experience in surgical oncology and HIPEC in Pune.
Her practice is centred on surgical cancer care rather than offering every form of cancer treatment under one roof.
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Embed Dr Snita's ovarian cancer video
Is Your Ovarian Cancer Operable?
This is one of the most important questions patients and families ask after diagnosis.
Whether ovarian cancer can be operated on depends on factors such as:
- Where the disease is located
- How extensively it has spread
- Which abdominal structures are involved
- Whether adequate tumour removal is technically possible
- The patient's overall health
- Response to any treatment already given
A scan alone does not always provide the complete answer.
A surgical oncologist can review the available imaging, pathology, and treatment history to assess surgical options and discuss the potential approach.
Should You Get a Second Opinion?
A second opinion can help you understand your diagnosis and proposed treatment before making decisions about major cancer surgery.
It may be particularly useful if:
- You have been advised to undergo extensive surgery
- Your scans show disease in multiple areas of the abdomen
- You have been advised to receive chemotherapy before surgery
- You have been told that surgery may not be possible
- CRS and HIPEC have been suggested
- You are uncertain about the proposed surgical approach
For a useful second opinion, bring the complete medical record, not just a summary of your diagnosis.
What Should You Bring to Your Ovarian Cancer Consultation?
Bring as many of your relevant medical records as possible, including:
- Ultrasound reports and images
- CT or MRI reports and images
- Biopsy or pathology reports
- CA 125 and other blood test reports
- Previous surgery records
- Previous chemotherapy records, if applicable
- Discharge summaries
- Previous treatment plans
If your scans are available digitally, bring the actual images along with the written reports.
Questions to Ask Your Ovarian Cancer Surgeon
A cancer diagnosis can make it difficult to know what to ask during a consultation.
You may want to ask:
- What does my scan show?
- Has the cancer spread outside the ovary?
- Is surgery appropriate in my case?
- Do I need chemotherapy before surgery?
- What type of surgery might I need?
- Can the visible disease be removed surgically?
- Could CRS and HIPEC be considered in my case?
- What would the surgery involve?
- What should I expect during recovery?
- What happens after surgery?
Frequently Asked Questions About Ovarian Cancer Surgery
Take the Next Step With a Surgical Oncology Consultation
If you have been diagnosed with ovarian cancer, have an ovarian mass that requires specialist evaluation or want a second opinion about ovarian cancer surgery, bring your reports and imaging for a detailed consultation.
Consult Dr Snita Sinukumar
Ovarian Cancer Surgeon | Surgical Oncologist | CRS and HIPEC Specialist in Pune
Consultations: Kharadi, Pune
Surgical Care: Apollo Hospitals, Pune