The ovaries are a pair of organs in the female reproductive system. They are in the pelvis, on each side of the uterus. The ovaries make eggs and female hormones.
The lifetime risk of developing ovarian cancer for a women in the US is approximately 1.3 %. It is the tenth most common cancer among women in the US but the most lethal gynecologic malignancy, with a 5-year survival rate of only 45%.
When ovarian cancer is found in its early stages, treatment works best. The problem is that the majority of ovarian cancer is diagnosed in advanced stages, in part because no screening test exists to detect preinvasive or early stage disease. Effective cancer screening programs typically require identification of either a precursor lesion or an early-stage malignancy. Unfortunately, without a clear precursor lesion or biomarker, ovarian cancer screening has thus far been unsuccessful in identifying pre-invasive or early-stage disease.
As technology has improved and more sophisticated molecular techniques have developed, we now understand that majority of ovarian cancer precursor lesions are not harbored within the ovary but in the fallopian tube. Emerging data suggest that the fallopian tube may play a critical role in the origin of what has traditionally been classified as ovarian cancer. Due to the role of the fallopian tube in ovarian cancer, approaches to gynecologic surgery have already begun to shift and surgical implications may extend beyond prophylactic surgery for high-risk patients.
But going back to the original question, what can we do to reduce the risk of ovarian cancer?
1. Take birth control pills, the use of birth control pills can reduce the risk of ovarian cancer for all women by 50% after 5 years of use.
2. Breastfeeding, some studies suggest that women who breastfeed for a year or more may have a modestly reduced risk of ovarian cancer.
3. Tubal ligation and with the most recent data, if you are schedule to have your tubes tied I will recommend asking your doctor to remove the entire tube rather than just a portion of the tube. There will be no change in your periods or hormones since the fallopian tubes have no function other than getting an egg and sperm together.
4. If you have inherited a particular genetic mutation known by their associated genes as BRCA1 and BRCA2, particularly if ovarian and breast cancer run strong in your family, the procedure of removing ovaries and fallopian tubes as soon as you complete childbearing but no later than age 40 is worth considering.
5. If you are having pelvic surgery for any reason and you are not interested in preserving your fertility consider having your fallopian tubes removed.
6. If you are scheduled to have a hysterectomy (uterus removed) for a benign or non-cancerous condition ask your doctor to remove the fallopian tubes along with the uterus.
There has been considerable debate about the risk and benefits of removing the ovaries at the time of hysterectomy for a benign condition. One one hand, the risk of ovarian cancer is reduced, but this come at the expense of the potential risk of cardiovascular disease, osteoporosis and even cognitive impairment seen with early surgical menopause. The practice of removing the fallopian tube but preserving the ovaries may be a better option for ovarian cancer prevention in women at low risk for ovarian cancer.
For more information about this topic or women health concerns contact Dr. Evelyn Zeda at 939-261-2222.