A person set to undergo a hysterectomy — removal of the uterus and sometimes other parts of the female reproductive system — may be curious whether the surgery may reduce their risk of ovarian cancer. This gynecologic cancer usually presents in a late and less-treatable stage.
Undergoing a hysterectomy could reduce a person’s ovarian cancer risks, though there are various factors at play. Here, we will break down the link between hysterectomies and the risk of ovarian cancer.
Ovarian cancer is caused by genetic mutations that cause cells to become abnormal and disorganized. Despite its name, however, ovarian cancer can actually affect cells in some organs besides the ovaries. Specifically, fallopian tube cancer and peritoneal cancer (cancer of the tissue lining the abdominal cavity) are often grouped as ovarian cancer. That’s because all of these conditions arise from the same cell type (epithelial cells) and tend to act in a similar fashion. Cancer in the ovaries may also be caused by cancerous germ cells or stromal cells.
Hysterectomies are surgical procedures primarily intended to remove a person’s uterus — although other tissues may also be removed. There are different kinds of hysterectomies:
Generally, none of these types of hysterectomies removes the ovaries, so any risk of developing ovarian cancer would not change from these procedures. In other words, it is possible to get ovarian cancer after a partial, total, or radical hysterectomy because the ovaries remain intact.
Hysterectomies with bilateral salpingo-oophorectomy do remove both ovaries, as well as both fallopian tubes. “Bilateral” means “both sides,” meaning both ovaries are removed. “Salpingo” refers to the fallopian tubes (which connect the ovaries to the uterus), and “oophorectomy” means any procedure that removes the ovaries.
Once a person’s ovaries are removed via a salpingo-oophorectomy — combined with any type of hysterectomy — their risk of developing ovarian cancer decreases significantly. Some ovarian cancers come from the fallopian tubes, so the removal of these tubes decreases the risk of ovarian cancer even further.
Although some hysterectomies can decrease a person’s risk of ovarian cancer, no hysterectomy is likely to bring that risk down to zero. Even after a bilateral salpingo-oophorectomy with the hysterectomy, a person still faces a small risk of developing a rare type of cancer called primary peritoneal cancer. The cells involved in the most common type of ovarian cancer, epithelial ovarian cancer, are the same type of cells that line the inside of your abdominal cavity. This inner lining is called the peritoneum. Hysterectomies do not get rid of this tissue, and there’s a small chance its cells could become cancerous.
With or without surgery, many other risk factors may increase (or decrease) a person’s lifetime risk of ovarian cancer.
Certain gene mutations, such as the BRCA mutations (BRCA1 and BRCA2) can run in families, resulting in a family history of ovarian cancer or breast cancer. People with mutated versions of BRCA1 and BRCA2 can have a much higher risk of eventually developing ovarian cancer.
People who have multiple family members with these cancers may be recommended for genetic testing. Those found to carry the BRCA mutations or other high-risk mutations may be advised to follow up with specialists in gynecology or oncology. They also may require more frequent cancer screening. Those at very high risk might also need to have a preventative (prophylactic) hysterectomy with oophorectomy to help prevent ovarian cancer from developing.
Two main hormones are primarily responsible for female reproductive health: estrogen and progesterone. These two hormones operate in harmony to balance one another out. However, certain people may be exposed to much more estrogen, tilting the balance in one direction. Increased estrogen exposure throughout a person’s lifetime — such as through hormone therapy after menopause — is thought to put a person at higher-than-average risk of ovarian cancer.
Birth control pills may potentially increase a person’s risk of breast cancer, but they have been found to significantly decrease one’s risk of ovarian cancer.
Other risk factors for ovarian cancer include smoking and being overweight or obese. Having one or more full-term pregnancies is a protective factor against ovarian cancer, as is having breastfed a baby.
Statistics and numbers represent a summary of a wide range of people. Every person is unique, and you should talk to your primary care provider, gynecologist, and other members of your health care team if you have questions about your individual ovarian cancer risk. Gynecological oncologists in particular specialize in treating cancer that affects the female reproductive system. They are well-versed in the newest research, developments, and recommendations in ovarian cancer.
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