WOMEN'S HEALTH
August 26, 2009

Fertility and Ovarian Cancer

Women with Stage 1 ovarian cancer may be able to remain fertile and avoid the early menopause brought on by removal of their ovaries...

Women who are diagnosed early with ovarian cancer may be able to preserve their fertility if a healthy ovary or the uterus is kept intact. The new study, published in the American Cancer Society’s journal Cancer, finds that survival rates are similar in women who have both ovaries or the uterus removed and women in whom the organs are preserved. Over 21,000 women were diagnosed with ovarian cancer in 2008.

Estimates suggest that about 17% of women who are diagnosed with ovarian cancer are of child−bearing age – under 40 years old.

Estimates suggest that about 17% of women who are diagnosed with ovarian cancer are of child−bearing age – under 40 years old. Typically, treatment for this type of cancer involves removing both ovaries, even if only one is cancerous, and the uterus. Not only does this method end a woman’s ability to conceive a child, but it also leaves her in estrogen deprivation from what may be an early age.

A team of researchers, led by Jason Wright at Columbia University’s College of Physicians and Surgeons, wanted to see how a woman’s survival rate was affected, if at all, when one ovary or the uterus was left intact in women who were diagnosed early (i.e., stage I). They followed women who were part of the National Cancer Institute's Surveillance, Epidemiology and End Results database, a huge registry that has data on over a quarter of the United States population.

They first followed 1,186 women (all younger than 50) with stage I ovarian cancer – a little over a third of the women had one ovary left intact, and the other two thirds had both ovaries removed. The team found that the survival rates between the two groups of women were similar over the five years they were studied.

The researchers next looked at survival rates for 2,911 women who had their uteruses preserved, which was about one quarter of the participants, versus those who had the organs removed. Again there was no difference in survival rate between the two groups.

The authors say that in the Eastern and Western United States it has become more and more common for doctors to try to preserve a healthy ovary or the uterus, particularly in younger women.

Wright underlines the other benefits associated with this practice, namely the protective effects of the hormones produced by the organs: “If the other ovary is preserved, that essentially means women don't go through the menopause. They don't experience hot flashes, vaginal dryness, osteoporosis. There is additional data that women who undergo the removal of their ovaries before age 55 are also at increased risk for cardiovascular disease, earlier death and dementia."

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