Actress Angelina Jolie did it. Should you?
Preventive surgery to remove the ovaries — the reproductive glands responsible for producing and releasing eggs (oocytes) — is an option that women with a high risk of developing ovarian cancer and breast cancer may consider in order to reduce their risk. Doctors refer to this surgery as “preventive (prophylactic) bilateral oophorectomy.” The procedure has advantages and risks that women and their doctors must balance before scheduling surgery.
Who is a candidate for ovary removal surgery?
In most cases, doctors reserve prophylactic oophorectomy for women with:
- Inherited gene mutations. Women with an increased risk of malignancies, especially cancer of the ovary and breast, may have the option to surgically remove their ovaries if they have an inherited mutation in the BRCA1 or BRCA2 gene, both of which are associated with a myriad of cancers affecting females. Read Genetic Disorders That Increase Cancer Risks and Breast Cancer Genes 101 to learn more about these important cancer risk factors.
- Strong family history of certain cancers. A doctor may recommend prophylactic ovary removal if the patient has a strong family history of ovarian cancer and/or breast cancer, even with no known genetic alteration. In addition, a physician may also recommend the procedure if the patient has a strong likelihood of carrying the gene mutation based on her family history.
Can oophorectomy eliminate the risk of cancer?
For women with a BRCA mutation, a prophylactic oophorectomy can help:
Despite the favorable figures, it is crucial to understand that although the procedure may reduce the risk of breast and ovarian cancer in others, for a great deal of women, the potential side effects and risks of oophorectomy may not be worth the reduced likelihood of cancer.
What are the risks?
Prophylactic oophorectomy is a generally safe procedure with a small risk of complications, all of which depend on how a surgeon performs it.
Though rare, a patient may experience these complications:
- Infection
- Injury to an internal organ
- Intestinal blockage
However, total loss of the hormones supplied by the ovaries is a more prevalent concern. When a patient who undergoes oophorectomy still has her monthly period prior to the procedure, then she will enter early menopause as a result of removing the ovaries.
Early menopause has many risks, including:
- Bone thinning (osteoporosis). Removing the ovaries lowers the amount of bone-building estrogen the body produces. As a result, the patient becomes more prone to breaking a bone in her body.
- A wave of uncomfortable sensations. Hot flashes, sleep disturbances, vaginal dryness, sexual problems, and changes in cognitive functions are common during menopause.
- Increased risk of heart disease. A woman’s susceptibility to heart disease may increase after oophorectomy.
- Lingering risk of cancer. It is important to understand that removing the ovaries only reduces — not eliminates — the risk of ovarian and breast cancers. According to Mayo Clinic, even if a woman has a total hysterectomy with salpingo-oophorectomy — which is a procedure that removes the cervix, uterus, ovaries, and fallopian tubes — it does not remove all risk.
- Infertility. Many patients mourn the loss of their ability to become pregnant, even if they had no plans of having children.
The bottom line: is oophorectomy right for you?
Although many women, usually mothers, might sleep better at night knowing they have a lower chance of developing cancer, oophorectomy is not always right for everyone. The decision to remove the ovaries and other reproductive organs is a difficult one, particularly due to the consequences that can take a toll on a woman’s physical and mental health.
If you have an increased risk of ovarian or breast cancer, discuss prophylactic oophorectomy and the possible alternatives with your doctor to better understand how they may impact your health and quality of life. Your decision should depend on your individual cancer risks, as well as how aggressive you want your cancer prevention efforts to be.