Out with the Ovaries

 Updated 7/21/15
The other day there was a discussion in a Facebook group I belong to about what happens when a women has her ovaries removed ( oopherectomy) prophylactically.  I thought to myself - prophylactically or due to surgery / chemotherapy -  the effects are the same.

I know which side effects I experienced when I  had my ovaries (along with other organs) removed due to ovarian cancer. Even if your ovaries are not surgically removed, they may be damaged due to chemotherapy which can cause menopause and infertility. 

What can happen? Symptoms you may experience when your ovaries are removed include:

• hot flashes / night sweats
• vaginal dryness
• decreased sex drive
• skin changes
• sleep disruptions
• urinary symptoms
• bone loss (osteopenia/ ) osteoporosis
• fatigue
• weight gain 
• trouble focusing
• increased risk for heart disease

So how do we deal with these side effects?

There are various ways to help with the symptoms of menopause including hormonal therapies, non-hormonal therapies, complimentary therapies and bioidentical hormones (FDA statement on bio-identicals) .  Be sure to ask your doctor which therapy is acceptable for you to use if you are in treatment or at risk for breast cancer / ovarian cancer.

Some helpful resources include:

This American Cancer Society article on menopause and cancer risk is a good place to turn for information on options you can talk to your doctor about. (http://www.cancer.org/cancer/cancercauses/othercarcinogens/medicaltreatments/menopausal-hormone-replacement-therapy-and-cancer-risk. )

The NCI has a brochure Health Care Maintenance for Women Undergoing Risk-Reducing Ovarian Surgery ( GOG 0199) as well as  a number of online resources on dealing with the side effects of premature menopause. The resources may be found at
http://ovariancancer.gog199.cancer.gov/premature.html

You may also find the Menopause Guidebook from the the North American Menopause Society) helpful. Download it at http://www.menopause.org/publications/consumer-publications/-em-menopause-guidebook-em-7th-edition

Another good source of information is the US National Library of Medicine's Medline Plus site on Menopause . http://www.nlm.nih.gov/medlineplus/menopause.html#cat77

Many of the pre-menopausal women diagnosed with ovarian cancer I have spoken to have gotten limited information on dealing with the side effects of menopause.  It is important that valuable resources like those listed above are part of the conversation that women have with their health care provider when their ovaries are removed prohylactically or due to a cancer diagnosis.

Dee
Every Day is a Blessing!

Research News : Aspirin and Oophorectomies

ASPIRIN

Feb 6,2014 Journal of the National Cancer Institute

Chronic inflammation has been shown to increase the risk for cancer.Aspirin is known to possess  anti-inflammatory properties. Using data from 12 large epidemiological studies (8000 women with ovarian cancer and 12,000 without the disease) researchers at the NIH studied whether aspirin, non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs) or acetaminophen had a lower risk of ovarian cancer.

Conclusion:  Daily use of low-dose aspirin was found to reduce the risk of ovarian cancer by 20-34% depending on the dose and frequency. The same low dose aspirin regime has show Cardiovascular  benefits.

My Take: Further prospective randomized studies are needed to verify this research.
There are risks to taking aspirin such as gastrointestinal bleeding but this may be a readily available low cost was to reduce a women's risk for ovarian cancer. .


OOPHORECTOMY 
Feb 24 Journal of Clinical Oncology

This study included over 5000 women with BRCA1 & 2  mutations who had their ovaries removed. The goal of the research was to estimate the reduction in the risk of developing ovarian, fallopian and peritoneal cancers by the age the women had their ovaries removed.The study also looked at the impact the surgery had on the women's mortality. 

Conclusion: Preventative oophorectomy in women with BRCA1 mutations reduces the risk of ovarian cancer by 80%. The study also found a 77% reduction in deaths by any cause by the age of 70 when women had the surgery. 

Recommendation: Women with BRCA1 mutation should  have their ovaries removed by age 35.  Waiting to a later age for the surgery increases the risk of being diagnosed with ovarian cancer. 

My Take: This study verified the importance of ovary removal at age 35 for women who carry the  BRCA1. Having to deal with menopause at an early age is not easy but women who are BRCA1 should discuss this surgery with their doctors . 


Notes:  Risk is the chance a person has of developing cancer over their lifetime. The risk of a woman developing ovarian cancer is 1.37 or 1 in 73 women. Data from ACS.


Dee
Every Day is a Blessing!