Ovarian cancer risk after a hysterectomy

By
Jenna Fletcher   
Reviewed
by Valinda Riggins Nwadike
Hysterectomy
types | Hysterectomy and ovarian cancer | Risk factors Reducing the risk
Symptoms | Seeing a doctor | Summary
A hysterectomy is a surgical procedure
in which a surgeon removes a person’s uterus. However, the surgeon often leaves
part or all of the ovaries intact, which means it might still be possible for
an individual to get ovarian cancer.


Ovarian cancer starts when
tumor cells develop in the ovaries or the surrounding tissues.
The ovaries are part of the
female reproductive system and are responsible for producing eggs and releasing
the female hormones estrogen and progesterone.
A person has two ovaries, one
on each side of the uterus (womb). Eggs travel from the ovaries to the uterus
via the fallopian tubes.
Depending on the type of
hysterectomy, the surgeon removes all or part of the uterus, as well as some
other parts of the female reproductive system. This may or may not include the
ovaries.
In this article, we discuss
the different types of hysterectomy and how these affect a person’s risk for
ovarian cancer. We also cover risk factors, symptoms, and when to see a doctor.
Types
of hysterectomy
A hysterectomy is a major
operation in which a surgeon removes a person’s uterus.
There are several types of
hysterectomy, which differ according to how much of the uterus and surrounding
tissues the surgeon removes. These include:

  • Supracervical or partial
    hysterectomy. The surgeon removes the upper uterus but leaves the cervix (the
    lower part of the uterus) in place.
  • Total hysterectomy. The
    surgeon removes both the uterus and cervix.
  • Radical hysterectomy. The
    surgeon removes the uterus and cervix along with tissue on either side of the
    cervix and the top part of the vagina.
  • Total hysterectomy with
    bilateral salpingo-oophorectomy (BSO). In addition to the uterus and cervix,
    the surgeon also removes the fallopian tubes and ovaries.
Hysterectomy
and ovarian cancer risk
Individuals who have had a
hysterectomy may think that they cannot get ovarian cancer. However, while
having a hysterectomy can reduce the risk of developing the disease, it is
still possible to get it.
According to the American
Cancer Society (ACS), there is evidence that having a hysterectomy that leaves
the ovaries in place can still reduce the risk of ovarian cancer in some
people.
The ACS also state that having
a hysterectomy with BSO can reduce the risk of ovarian cancer by 85–95 percent
and the risk of breast cancer by 50 percent or more in some people carrying a
BRCA gene mutation. Mutations in the BRCA1 and BRCA2 genes increase a person’s
risk of certain types of cancer.
A large study from 2015 also
indicates that removing both ovaries during a BSO decreases the incidence of
ovarian and peritoneal cancer. The researchers also concluded that having only
one ovary removed may also reduce the risk of ovarian cancer, but further
research is needed to confirm this.
However, the ACS warn that a
person should only have a hysterectomy for a valid medical reason and not just
for reducing the risk of ovarian cancer.
A doctor may recommend a
hysterectomy to treat people who have:

  • recurring pelvic pain
  • heavy periods
  • cancer of the ovaries, cervix,
    or uterus
  • a prolapse of the uterus
  • uterine fibroids
Risk factors for ovarian
cancer


Factors that can increase a
person’s risk of getting ovarian cancer include:

  • being older than 40 years
  • having a first baby after the
    age of 35 years
  • never carrying a pregnancy to
    term
  • being overweight
  • having fertility treatments,
    such as in vitro fertilization (IVF)
  • using hormone therapy
    following menopause
  • having a family history of
    ovarian, breast, or colorectal cancer
  • having BRCA1 or BRCA2 gene
    mutations
  • having breast cancer
Reducing
ovarian cancer risk
For people at high risk of
developing ovarian cancer, such as those carrying a BRCA gene mutation, a
doctor may recommend a prophylactic bilateral oophorectomy.
During this procedure, a
surgeon removes the person’s ovaries. However, although a prophylactic
bilateral oophorectomy significantly reduces the risk, there is still a chance
of developing ovarian cancer.
Other steps a person can take
to reduce the risk of ovarian cancer include:

  • maintaining a healthful weight
    through diet and exercise
  • having a baby
  • breastfeeding
  • using birth control pills
Symptoms of ovarian cancer

Not everyone with ovarian
cancer experiences symptoms in the early stages. Early symptoms can be similar
to other, less serious conditions, which can make them difficult to recognize.
These symptoms can include:

  • pelvic or abdominal pain
  • bloating
  • loss of appetite or feeling
    very full quickly
  • needing to urinate frequently
As ovarian cancer progresses
or spreads, other symptoms can also appear. These can include:

  • constipation
  • fatigue
  • back pain
  • an upset stomach
  • irregular periods
  • abdominal swelling
When
to see a doctor
A person should see a doctor
if they experience any of the symptoms listed above for extended periods. This
is especially important for people over 40 years old or those with a family
history of ovarian or breast cancer.
After having a hysterectomy, a
person should see a doctor if they experience:

  • bleeding at the site of the
    incision
  • redness or swelling at the
    site of the incision
  • fever
Summary

There are several different
types of hysterectomy, which differ according to how much of the uterus and the
surrounding tissues the surgeon removes. Some hysterectomies leave part or all
of the ovaries intact.
Even when a surgeon removes
both ovaries, small traces of them can remain. Because of this, it is still
possible for a person to develop ovarian cancer following a hysterectomy.
However, having any type of
hysterectomy does reduce the risk of getting ovarian cancer.
SOURCE:
MEDICAL NEWS TODAY
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.