What Kind of Surgeon for Ovarian Cancer

Hello Doctor
I will be having surgery for a solid mass that was found on my ovary that looked like a papillary escresenna (spell?) to the reviewer of the ultrasound. I am having a CAT scan MOnday the 8th, and a colonoscopy also before my surgery on the 24th, a laproscopy. I am 60, no cancer identified in family, mostly heart disease,) I have high cholesterol, blood pressure okay with meds, and hiatal hernia). You had rec those tests, and my internist prescribed them as part of my pre surgery information. What I am wondering about is that I have read information about staging and how important that is in surgery. I have a gyno who has done laproscopies in her practice. In what I am reading, they suggest that getting all the cells is important if cancer is found, and debulking if needed. Is this something I can go ahead and do with my gyno the laproscopy and if cancer is found, get a second surgery. Or will my surgeon be able to get pathology results done while I am in surgery, or does it take a few days to find out. Do you wait until you find out if something is cancerous before you usually get with a gynocologist/oncologist surgeon? I'm trying to compact all this info in as my surgery is already scheduled..I have trust in my gyno, but don't know what type of surgeon is needed from the biopsy on..thanks. Jossy

[Annekathryn Goodman, M.D.]

Dear Jossy,
It sounds like you have had a great evaluation. That CT scan will be very helpful. It it shows anything more than the mass on your ovary, your doctor will probably refer you to a gynecologic oncologist. A gynecologic oncologist is a cancer specialist who has special training (another three years of training) over a generalist in cancer surgery, chemotherapy, and other management of women with gyn cancers.

Findings that could be considered suspicious on a CT scan include:
free fluid in the abdomen - that is called ascites
masses or growths in other areas especially the area called the omentum
enlarged lymph nodes.

If all that looks fine, your regular gynecologist is the perfect person to do your surgery. She knows you and has been right on top of your work up. At the time of surgery, biopsies can be taken for a first pathological analysis of the mass. This is called a frozen section. If the biopsy comes back with a malignant diagnosis your doctor has two options:
She can call in a gyn oncologist to complete the appropriate surgery or she can stop ( with laparoscopy, one can just look, do a biopsy and nothing more and that is just fine) and then refer you to a gyn oncologist for a second surgery. It does not compromise your care to undergo two surgeries.
best wishes to you