This is the last day of Heart Month in Canada (where I live) so I want to take this opportunity to give a very important shout out to one of my medical advisors, Dr. William Parker, who has done some ground-breaking research in the area of heart disease and ovary removal.
More on that in a second. First some basic background.
Of all gynecological cancers, ovarian cancer is the deadliest. The American Cancer Society predicted there would be approximately 22,280 new cases of ovarian cancer in 2012 in the US and about 15,500 deaths from the disease.
Ovarian cancer can be hard to detect, because the symptoms are not that obvious and are often missed. There is no screening test to detect it, but if found early, ovarian cancer has a survival rate of 90 percent.
So what does this have to do with hysterectomy?
According to Dr. Parker, almost half of all hysterectomies in the US involve the elective removal of women’s ovaries. That means half of the 650,000 women undergoing hysterectomy actively choose to remove their ovaries, or are encouraged to do so by their gynecologists, despite the absence of disease. The fancy term is a prophylactic oophorectomy.
While that may not sound like a big deal for those who ascribe to the “since you’re in there anyway you may as well remove them to prevent ovarian cancer” school of thought, it is a big deal.
While ovary removal is certainly understandable for women who have ovarian cancer or who are at high risk because they have a family history of the disease or they carry the breast cancer gene (BRCA), most women who undergo oophorectomies are not at increased risk. Their ovaries are removed “just in case.”
So what’s the big deal?
The big deal is, Dr. Parker and other scientists, including Dr. Jonathan Berek (Professor and Chair of the Department of Obstetrics and Gynecology at Stanford University School of Medicine and another one of my medical advisors), have discovered a link between ovary removal and an increased risk of other, more deadly diseases.
“What we found is the women who had hysterectomies and took their ovaries out had a higher risk of stroke, heart disease, lung cancer for reasons we don’t biologically understand,” Dr. Parker told me during one of our interviews for my book, The UnHysterectomy.
“Heart disease kills 30 times more women in the United States every year than does ovarian cancer,” Dr. Parker went on to say. “Don’t get me wrong … ovarian cancer is a terrible disease. I don’t mean to discount it in any way. It’s scary, hard to detect early on. Once you get it it’s hard to take care of you. It’s horrible. I don’t mean to make light of that but you’re 30 times more likely to die of a heart attack than ovarian cancer.”
In 2009, Dr. Berek, Dr. Parker and several colleagues published a landmark study that found that removing a woman’s ovaries might increase her risk of developing heart disease, lung cancer and other serious conditions.
The study examined 29,380 women, 16,345 of whom had both ovaries removed during hysterectomy and 13,035 who retained their ovaries during hysterectomy. Researchers evaluated the disease and death rates among those women from heart disease, stroke, breast cancer, ovarian cancer, lung cancer, colorectal cancer, all cancers, hip fracture, pulmonary embolus (obstruction of the arteries in the lungs, often caused by blood clots) and death from all causes.
What they found is that removing ovaries in women at average risk of ovarian cancer did not reduce death rates overall, but rather led to a higher risk of death from cardiovascular disease and coronary artery disease, particularly in premenopausal women. Researchers also discovered that among women who had their ovaries removed, there was a 30 percent increase in deaths from lung cancer.
As well, in 2009, Dr. Anita Koushik, a researcher at the Université de Montréal’s Department of Social and Preventive Medicine, found that women who experienced non-natural menopause through ovary removal are at almost twice the risk of developing lung cancer as women who experienced natural menopause.
Ultimately, what researchers have discovered is that our ovaries continue to emit small amounts of hormones that protect our vital organs long after menopause.
So on this last day of Heart Month, gals, I want you to consider this:
If we know that:
- hysterectomy is the most common major surgery performed on Canadian and American women, second to C-sections
- half of all hysterectomies involve the elective removal of our ovaries
- our ovaries continue to emit hormones that protect our hearts and lungs even after menopause
- that surgically removing our ovaries increases our risk of heart disease and lung cancer
- that heart disease and stroke are the leading cause of death in Canadian women and
- that lung cancer is the leading cancer killer among women…
Is it possible we could lower deaths from heart disease and lung cancer by reducing unnecessary ovary removal?
I am no scientist, but I can’t help but wonder if there is.
All the more reason, gals, to do your homework and discuss your risk factors for developing ovarian cancer. If the risks of retaining your ovaries outweigh the benefits, then of course, it’s a no-brainer, but not every woman carries the ovarian cancer gene.
A last important fact to consider
While ovary removal is certainly understandable for women who have ovarian cancer or who are at high risk because they have a family history of the disease or they carry the breast cancer gene (BRCA), most women who undergo oophorectomies are not at increased risk. It ends up being a personal choice, and one which women should base on sound research and consultation with their health care provider. But it should be an informed choice.
Got a comment? Please share your thoughts below.
Dr. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists, has a private practice in Santa Monica, California and is a Clinical Professor at the UCLA School of Medicine.