Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Nell Suby

Nell Suby, MD

Gyn Oncology

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Sacramento Medical Center
Appt/Advice: 916-614-4055

See all office information »

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Overview

Most tumors in the ovaries are noncancerous (benign) and don’t spread outside of the ovary. A cancerous (malignant) tumor in your ovary can damage it and nearby tissues. If the cancer spreads (metastasizes), it can damage other parts of your body.

Women have 2 ovaries, 1 on each side of the womb (uterus). These small, almond-shaped glands:

  • Make and release eggs (ova) during women’s childbearing years.
  • Are the main source of the hormones estrogen and progesterone.
  • Stop releasing eggs and decrease hormone production during menopause.

After we have confirmed the type and stage of ovarian cancer you have, we’ll talk with you about treatment options. Surgery and chemotherapy are the most common treatments. 

Together we’ll make a plan that is best for you.

Additional References:

Surgery

When ovarian cancer is found during exploratory surgery, we will:

  • Remove the cancerous tissues.
  • Usually remove both ovaries and both fallopian tubes (bilateral salpingo-oophorectomy), and the uterus (hysterectomy). 

In women who have early-stage cancer, we can sometimes leave 1 ovary, 1 fallopian tube, and the uterus in place. Younger women may prefer this option if they plan to become pregnant.

Surgery for ovarian cancer usually also includes removal of nearby lymph glands and the omentum (a fatty organ in the upper abdomen), even if they look normal. We check these tissues for cancer.

During your surgery, we may find that cancer has spread beyond the nearby lymph glands. If so:

  • The surgeon will perform a procedure called an optimal tumor cytoreduction.
  • Our aim is to leave no visible cancer behind. 

Recovery usually takes 4 to 6 weeks, depending on the type of surgery you have.

Surgery Methods and Side Effects

Your Ob/Gyn or a gynecologic oncology (women’s cancer) specialist may perform your surgery. 

Surgical options include:

  • Laparotomy. Surgery is performed through an incision in your abdomen.
  • Laparoscopy. A thin tube called a laparoscope is inserted through a small incision in your abdomen. A camera and surgical instruments are inserted through the tube.

Side effects. If both ovaries are removed, you will:

  • Not be able to become pregnant.
  • Stop producing the female hormones estrogen and progesterone.
  • Enter menopause, if you haven’t already.  

The sudden loss of female hormones can cause you to have hot flashes, night sweats, and vaginal dryness (menopausal symptoms). 

Other side effects of surgery include:

  • Short-term pain and tenderness
  • Difficulty urinating
  • Constipation

We will help you manage any side effects.

Chemotherapy

Depending on the stage of your cancer, we may recommend chemotherapy after surgery to kill any remaining cancer cells in your body. Usually 2 drugs are given in combination. 

Based on how serious and aggressive your cancer is, chemotherapy is given in one or both of these ways:

  • Intravenous (IV) chemotherapy. Anticancer drugs are delivered into one of your veins.
  • Intraperitoneal chemotherapy is injected directly into your abdominal (peritoneal) cavity.

Neoadjuvant treatment. In this treatment, you receive chemotherapy before we perform a procedure called de-bulking. In de-bulking surgery, we remove part of a large tumor. 

Your cancer specialist and you will decide on the best chemotherapy method for you.

Chemotherapy Side Effects

Chemotherapy drugs kill cancer cells but can also damage normal cells. Side effects can range from mild to serious. They can include:

  • Tiredness and/ or anemia (low level of red blood cells).
  • Increased risk of infection (low level of white blood cells).
  • Easy bruising and bleeding (low level of blood platelets).
  • Nausea, vomiting, loss of appetite.
  • Hair loss.
  • Numbness, tingling, or pain in hands and feet.
  • Decreased kidney function.
  • Hearing loss.
  • Hot flashes, night sweats, and vaginal dryness.

We have effective treatments to help you manage side effects.

Additional References:

Clinical Trials

We may suggest that you join a clinical trial. Clinical trials are designed to study how to improve cancer treatment for patients.

Some clinical trials research new treatments. Others compare new treatments to those already in use.

Additional References:

Follow-up Care

After treatment we’ll make a follow-up care plan. We want to keep a careful eye on you, to quickly catch any sign of cancer returning and help you with any ongoing treatment side effects.

For the next few years, your follow-up visits will:

  • Occur every 6 months.
  • Be with your regular gynecologist, a doctor who specializes in women’s cancers, or another cancer specialist.
  • Include a physical exam and possibly blood tests and X-rays.
  • Give you time to talk with us about any side effects of treatment that bother you. We can help you manage this important part of your recovery.

Contact us immediately if you develop:

  • Vaginal bleeding.
  • A cough that doesn’t go away.
  • Pain in your belly or pelvis.
  • Unexplained weight loss.

What You Can Do

Taking care of yourself throughout and after your treatment is very important. Be sure to:

  • Choose healthy foods.
  • Stop smoking.
  • Be active every day, when you feel well enough.
  • Keep your follow-up appointments.
  • Join a support group to talk to people with similar experiences.
  • Talk with your partner or a therapist about any intimacy issues.
Additional References:

Getting Your Care at Kaiser Permanente

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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