Approximately 20 percent of women will develop a pelvic mass at some point in their lives. When a woman is referred to Willamette Valley Cancer Institute, a gynecologic oncologist works to determine whether the mass is benign or malignant.

Understandably, this can be an anxious time for patients and having the right information is important. “When a patient has a consultation, we discuss different scenarios,” say gynecologic oncologist Dr. Kathleen Yang. “What if the mass is benign? And what if the mass is cancerous? We also describe the procedure the patient will undergo and the steps we will take.”

Treating a pelvic mass
Treatment depends on the size of the mass and its appearance on imaging studies, such as an ultrasound or a CT scan. If the mass is small, it may be removed laparoscopically with robotic technology using the da Vinci XI Surgical System.

The da Vinci System features a magnified 3-D high-definition camera and tiny wristed instruments that bend and rotate far greater than the human wrist, enabling surgeons to operate with enhanced vision, precision, dexterity and control, through a few small incisions.

When a mass is too large to remove laparoscopically, it is often removed through a vertical incision in the wall of the abdomen, a procedure called a laparotomy.  While the patient is still under anesthesia, the mass is sent to the lab where a pathologist looks at it under a microscope.

“Twenty minutes after the removal of the mass, we will be able to tell if this is cancer or not,” says Dr. Yang. “If the pathologist determines the growth is benign, we’ll finish the procedure and the patient will go to the recovery room.”

If cancer is present
If the pathologist determines that the mass is ovarian cancer, a complete hysterectomy is generally performed at that time. That includes removal of the uterus, cervix, both ovaries and fallopian tubes. In addition, nearby lymph nodes are removed for biopsy along with sample tissues from the pelvis and abdomen. This will help determine if the cancer is contained to the ovary or if it has spread.
“The goal is to do the entire procedure at one time, under one anesthesia to make it easier for the patient,” Dr. Yang says.

Recovery
Robotic surgery has been proven to reduce recovery time for patients. Often, they are able to go home the same day.

Because a laparotomy procedure requires a large incision, a patient generally remains in the hospital for 3-5 days following surgery. Patients are able to go home once they are able to get up and walk around, tolerate food and urinate. Expect 4-6 weeks for full recovery.

Patient support
Going through cancer can be scary for anyone, which is why we offer support services for patients, including our Ovarian/Gynecologic Cancer Support Group.

Our oncology social worker and oncology care manager provide one-on-one counseling to help patients cope with emotional, psychological and social challenges related to their diagnoses. They also connect patients with support groups, financial aid, and other assistance that may be needed.