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Monday, March 18, 2013

Prevent Ovarian Cancer and Keep Your Ovaries, or Keep Just One?

Women having hysterectomy are often faced with a question: do you keep your ovaries or remove the ovaries, and a further question, do you remove just one? But researchers from the British Columbia Cancer Agency in 2013 have found some research that puts women in a position to keep their ovaries, and still have a surgical solution that will reduce their lifetime chances of ever getting ovarian cancer! Worldwide there are over 200,000 cases of ovarian cancer each year, there are about 14,000 cases in the USA alone. Ovarian cancer is a deadly disease and each year about 140,000 women die of the disease. Of ovarian cancer cases over 10,000 American Women will die of their disease. but getting one's ovaries out is a big decision. Removing both ovaries reduces your chance of ovarian cancer by about 98%. Removing one ovary according to a National Institute of Health study headed by John Chan MD in 2014, did reduce your chances of ovarian cancer by about half. Since we do over 500,000 hysterectomies per year, many women can have potential benefits from such a surgery.

Risk of getting ovaries out are increased overall mortality, coronary heart disease dementia, osteoporosis and other cancer mortality. And women only have abut a 1/10 chance of ever needing their ovaries out in the future if they keep their ovaries at the time of hysterectomy, so there is a lot to consider. Although the average age for hysterectomy is about 42, most women should keep their ovaries if they are under age 60. But if ovarian cancer occurs, it can be very serious. Women with the most advanced forms of ovarian cancer are most likely to die, and with so few symptoms to pay attention to, diagnosis in advanced stages is common. We know that not every case of ovarian cancer is the same, the prognosis and treatment success varies by tissue type. For instance some ovarian cancers are from the tissue of the outer layers of the ovary, some are more related to endometriosis called endometrioid cancer, and some are related to cancers of the germ cells that eggs are made from. The ovary, like other organs, can get invaded by cancers from other places in our body. We began to suspect that the fallopian tubes were more often a source of ovarian cancer than we thought, since reports of tubal cancers found surprisingly at the time of hysterectomy have been emerging. In fact these researchers think that ovarian cancers are more often actually tubal cancers, for a certain group of very advanced cancers. If a cancer is suspected on ultrasound, the use of blood tests like the Ca 125 or the Ova1 test, whether the tube is also involved or not, is a very helpful test. In Canada the group of surgeons that makes recommendations for women, they now say that women should be offered tubal removal at the time of hysterectomy to help prevent ovarian cancer. At Women's Health Practice we offer tubal removal at the time of vaginal hysterectomy, or at the time of the minimally invasive laparoscopic hysterectomies, or as an alternative to traditional tubal ligations in women with high risk.

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