Cancer of the ovary | ovarian cancer | Glengarry Private, Perth
A cancer is where cells become abnormal & “immortal” and overgrow and spread. Ovarian cancer is not common, but is very hard to diagnose and has often spread before it’s picked up.
Screening for ovarian cancer has been ineffective (see below).
How common is ovarian cancer?
The lifetime risk is about 1 in 60. If you have a close relative who’s had it, your risk goes up to 1 in 20. If you have the BRCA gene the risk can go up to 1 in 2. Overall, cancer of the ovary is the 5th most common cause of death by cancer in women. The average age to get it is 63 years of age.
Prognosis of ovarian cancer
Often spread has already occurred by the time of diagnosis, so the overall survival after diagnosis is about 50%.
Prevention of cancer of the ovaries
If you’ve been on the pill for 10 years or more, your risk is halved.
If you’ve breastfed for a good amount of time, your risk is reduced.
The risk of cancer is reduced if you’ve had a hysterectomy but left your ovaries in place. This is probably because some of the Fallopian tubes have been removed. We think that much “ovarian cancer” starts in the Fallopian tubes.
The risk of cancer is reduced, again probably because part of the Fallopian tube is destroyed when you have a laparoscopic sterilisation.
Screening the ovaries has been attempted using different combinations of ultrasound scans & blood tests. Unfortunately, screening for ovarian cancer is ineffective. No study has shown that deaths from ovarian cancer are reduced by screening. Routine screening of women for ovarian cancer is not recommended by any professional medical society in any country. There are ongoing large research trials in the UK & US but they are now thought to be unlikely to show benefit. There is a solution that works in high risk women and is cost effective – removing the tubes & ovaries.
Keyhole surgery to remove the tubes & ovaries
Ovarian cancer can be prevented by removing the ovaries & tubes. The reason the tubes are removed too is that many ovarian cancers probably start in the tubes and then “seed” the ovary.
Laparoscopy with removal of tubes & ovaries
This is an option for women who have relatives who have had ovarian cancer. Give us a call to make an appointment to discuss laparoscopy to remove the ovaries.
Why doesn’t everyone who has a family history have their ovaries out?
Because it’s surgery, and because there are benefits to keeping the ovaries, even after menopause. For instance, women without a family history of ovarian cancer will live longer if they KEEP their ovaries (according to research). It’s a tricky decision both to remove, and then to time their removal and it depends upon the age your relatives got cancer, your attitude to risk, and other factors.
But I want to keep my ovaries and I have a family history of ovarian cancer, what can I do?
You could have just your Fallopian tubes removed by keyhole surgery. Since the tubes are possibly the source of a third to a half of ovarian cancers, you could halve your lifetime risk and keep your ovaries. This is not proven though, and we would have to discuss this very carefully with you.
The only effective method of reducing your risk of cancer of the ovaries apart from the pill & breast feeding is surgery. This is recommended for those women with a family history of ovarian and breast cancer, and might be performed from 50-55 years. The latest research suggests an even earlier removal for those with BRCA genes. Thorough discussion is needed.
Women having a hysterectomy should have their tubes removed if possible, even if they’re keeping their ovaries.
Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful. A geneticist may also provide very useful information.