Prophylactic Removal of Ovaries and Quality of Life in High-Risk Patients

Prophylactic Removal of Ovaries and Quality of Life in High-Risk Patients

According to a recent article published in the Journal of Clinical Oncology, the majority of patients at a high risk of developing ovarian cancer who underwent prophylactic surgical removal of the ovaries and fallopian tubes are happy with their decision and would recommend it to other women at high risk of developing the disease.

The ovaries are two small female organs that are located in the pelvis. They are responsible for the development and release of eggs each month. Ovarian cancer is the fourth leading cause of cancer death among women in the US. According to the American Cancer Society, an estimated 22,220 new cases will be diagnosed in 2005.

Since ovarian cancer does not cause symptoms in its early stages and therefore, the majority of cases are not diagnosed until the cancer has spread. Unfortunately, cure rates remain dismal once the cancer has spread from the ovaries.

Patients at a high risk of developing ovarian cancer, either due to a strong family history or specific genetic mutations, may take the chance that if they are diagnosed, it will be at a curable stage or risk side effects from the surgical removal of the ovaries.

A multiple-institution study was recently conducted to evaluate the quality of life in 846 women who were considered to be at a high risk of developing ovarian cancer. Approximately half of the patients underwent a prophylactic salpino-oophorectomy (preventive surgical removal of the ovaries) while the other half underwent regular gynecologic screening for early detection of ovarian cancer.

Overall, patients who underwent preventive surgery reported a good quality of life:

  • No significant difference in quality of life was reported between the two groups of patients.
  • Patients who underwent surgery reported fewer worries about developing ovarian or breast cancer.
  • Patients who underwent surgery reported a more favorable risk of the development of cancer.
  • Patients who underwent screening had fewer endocrine (hormone-associated) problems and worse sexual functioning.
  • 86% of patients who underwent surgery would choose it again.
  • 63% of patients who underwent surgery would recommend it to a friend who is at a high risk of developing ovarian cancer.

The researchers concluded that quality of life does not appear to be significantly reduced in women at high risk of developing ovarian cancer who undergo the preventive surgical removal of her ovaries compared to women who undergo frequent gynecologic screening. However, these decisions are very personal, and women considered at high risk of developing ovarian cancer need to speak with their physician regarding their individual risks and benefits with each preventive or screening option.

Reference: Madalinska J, Hollenstein J, Bleiker E, et al. Quality-of-Life Effects of Prophylactic Salpingo-Oophorectomy Versus Gynecologic Screening Among Women at Increased Risk of Hereditary Ovarian Cancer. Journal of Clinical Oncology. 2005; 23: 6890–6898.

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