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Early Research Shows that Removing Ovaries May Not be Necessary to Reduce Ovarian Cancer Risk

Some women at high risk of ovarian cancer have opted to have their ovaries removed to reduce their cancer risk. Now, a recent study suggests that removing the ovaries may not be necessary to reduce the risk of ovarian cancer in high risk women. In a study with monkeys, researchers found that removing a layer of cells on which ovarian cancer cells tend to form reduced cancer risk while maintaining fertility. While the research is still in early stages, it may provide hope to high-risk women who would like to have children.

Ovarian cancer is the eighth most common cancer among women and the fifth leading cause of cancer deaths in women. Ovarian cancer can be difficult to diagnose early because the majority of women do not appear to have any symptoms of the disease. In fact, ovarian cancer has been called the “silent killer” because the symptoms can be very subtle ("silent") or unnoticeable until the disease has progressed significantly. Symptoms of ovarian cancer include pelvic/abdominal pain, gastrointestinal problems, frequent urination, changes in bowel habits, weight gain or loss, pain during sexual intercourse, fatigue, leg pain, or unusual vaginal bleeding.

There is also no foolproof screening test to detect ovarian cancer. The best method of defense against ovarian cancer is a yearly pelvic exam beginning at age 18. Genetic testing is available to determine whether women carry mutations of the BRCA1 (breast cancer gene 1) or BRCA2 (breast cancer gene 2) genes. Mutations of these genes put women at higher risk of developing both ovarian cancer and breast cancer.Some women at high risk of ovarian cancer, as determined by factors such as a strong family history and genetic testing, consider oophorectomy—a surgical procedure to remove the ovaries. The procedure remains controversial and is not commonly performed. The theory is that removing the body’s main source of estrogen (the ovaries) helps reduce the chances of developing both ovarian and breast cancer since many of these cancers depend on estrogen for growth and survival. A 2010 study published in the Journal of the American Medical Association showed a reduced risk of ovarian cancer among women at genetically high risk of developing the disease who underwent oophorectomies.

 The current study was performed by researchers at Oregon Health and Science University's Oregon National Primate Research Center. Instead of entirely removing the ovaries, researchers removed the ovarian surface epithelium in healthy female monkeys through a minimally invasive surgery.

After the surgery, the researchers observed the monkeys to determine the function of the ovaries changed. They found that the monkeys remained as fertile as before the surgery. Additional research is needed, but the researchers say that they may have found a minimally invasive method to reduce ovarian cancer risk in high-risk women while preserving fertility.