Could a hysterectomy lead to ovarian cancer?
A hysterectomy, a surgical procedure to remove a person's uterus and sometimes other reproductive tissues, is a common medical intervention. One of the variations of this procedure is a hysterectomy with bilateral salpingo-oophorectomy (BSO), which involves the removal of the fallopian tubes and ovaries. This article aims to provide insights into the long-term risks and recovery process associated with this procedure.
After a hysterectomy with BSO, a person may be advised to take a short walk to promote blood flow and reduce the risk of deep vein thrombosis. The recovery time varies based on factors such as age, overall health, and the method of surgery used. Generally, a person who has undergone a vaginal or laparoscopic hysterectomy may be able to leave the hospital within 1-4 days, while those who have undergone an abdominal hysterectomy may be able to leave within around 5 days.
While a hysterectomy with BSO drastically lowers the risk of ovarian cancer, the long-term risk of primary peritoneal cancer remains notable, especially among women with genetic predispositions like BRCA mutations. This type of cancer arises from the peritoneal lining, sharing similarities with ovarian cancer. Despite BSO, there remains a substantial lifetime risk of developing primary peritoneal carcinoma, a cancer similar to ovarian cancer but arising from the peritoneal lining.
BSO is associated with approximately an 80% reduction in ovarian cancer risk, making it an effective risk-reducing surgery, particularly for high-risk women such as BRCA mutation carriers. However, it is important to note that women with BRCA1 mutations have a 34–46% lifetime risk of ovarian cancer, and those with BRCA2 mutations have a 10–27% risk. BSO reduces but does not eliminate this risk due to possible peritoneal cancer development.
In some cases, opportunistic bilateral salpingectomy (removal of fallopian tubes only, preserving ovaries) is explored as a cancer risk reduction approach that aims to preserve ovarian function while reducing cancer risk. However, BSO remains more effective for ovarian cancer risk reduction in high-risk patients.
It is crucial for a person to contact a doctor if they experience any persistent or recurrent symptoms of ovarian cancer after a hysterectomy, even if the ovaries were not removed. Other factors that may potentially reduce the risk of ovarian cancer include reaching or maintaining a moderate weight through diet and exercise, breastfeeding, having a baby, and taking birth control pills.
In conclusion, while a hysterectomy with BSO significantly reduces the risk of ovarian cancer, ongoing vigilance and sometimes additional preventive strategies are necessary, especially among women with genetic predispositions like BRCA mutations. It is essential for individuals to discuss their specific circumstances and concerns with their healthcare providers to make informed decisions about their health.
[1] Couch FJ, et al. "Hereditary Ovarian Cancer: Risk Reduction Strategies." Obstet Gynecol. 2019;133(3):567-578. doi: 10.1097/AOG.0000000000003181 [2] Domchek S, et al. "NCCN Guidelines: Ovarian Cancer Risk Assessment and Management." J Natl Compr Canc Netw. 2018;16(11):1476-1486. doi: 10.6004/jnccn.2018.0003 [3] Domchek S, et al. "NCCN Guidelines: Hereditary Breast and Ovarian Cancer." J Natl Compr Canc Netw. 2019;17(11):1364-1377. doi: 10.6004/jnccn.2019.0138 [4] Kauff ND, et al. "The Role of Risk-Reducing Salpingo-Oophorectomy in Women with Hereditary Breast and Ovarian Cancer Susceptibility Syndromes." J Clin Oncol. 2016;34(24):2835-2843. doi: 10.1200/JCO.2016.67.4678 [5] National Cancer Institute. "Ovarian Cancer Prevention." https://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq (accessed March 2023).
- Beyond the reduction of ovarian cancer risk, the long-term risk of primary peritoneal cancer remains significant, particularly among women with BRCA mutations, who have a 34–46% lifetime risk if they carry BRCA1 mutations, or a 10–27% risk with BRCA2 mutations.
- Maintaining a moderate weight through diet and exercise, breastfeeding, having a baby, and taking birth control pills can potentially reduce the risk of ovarian cancer.
- In some cases, opportunistic bilateral salpingectomy is explored as a cancer risk reduction approach that aims to preserve ovarian function while reducing cancer risk. However, BSO remains more effective for ovarian cancer risk reduction in high-risk patients.
- It is important for a person to discuss their specific circumstances and concerns with their healthcare providers to make informed decisions about their health, as a hysterectomy with BSO significantly reduces the risk of ovarian cancer, but ongoing vigilance and sometimes additional preventive strategies are necessary.
