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