RxPG News Feed for RxPG News

Medical Research Health Special Topics World
  Home
 
   Health
 Aging
 Asian Health
 Events
 Fitness
 Food & Nutrition
 Happiness
 Men's Health
 Mental Health
 Occupational Health
 Parenting
 Public Health
 Sleep Hygiene
 Women's Health
 
   Healthcare
 Africa
 Australia
 Canada Healthcare
 China Healthcare
 India Healthcare
 New Zealand
 South Africa
 UK
 USA
 World Healthcare
 
   Latest Research
 Aging
 Alternative Medicine
 Anaethesia
 Biochemistry
 Biotechnology
 Cancer
  Bladder
  Blood
  Bone Cancer
  Brain
  Breast Cancer
  Carcinogens
  Cervical Cancer
  Colon
  Endometrial
  Esophageal
  Gastric Cancer
  Liver Cancer
  Lung
  Nerve Tissue
  Ovarian Cancer
  Pancreatic Cancer
  Prostate Cancer
  Rectal Cancer
  Renal Cell Carcinoma
  Risk Factors
  Skin
  Testicular Cancer
  Therapy
  Thyroid
 Cardiology
 Clinical Trials
 Cytology
 Dental
 Dermatology
 Embryology
 Endocrinology
 ENT
 Environment
 Epidemiology
 Gastroenterology
 Genetics
 Gynaecology
 Haematology
 Immunology
 Infectious Diseases
 Medicine
 Metabolism
 Microbiology
 Musculoskeletal
 Nephrology
 Neurosciences
 Obstetrics
 Ophthalmology
 Orthopedics
 Paediatrics
 Pathology
 Pharmacology
 Physiology
 Physiotherapy
 Psychiatry
 Radiology
 Rheumatology
 Sports Medicine
 Surgery
 Toxicology
 Urology
 
   Medical News
 Awards & Prizes
 Epidemics
 Launch
 Opinion
 Professionals
 
   Special Topics
 Ethics
 Euthanasia
 Evolution
 Feature
 Odd Medical News
 Climate

Last Updated: Oct 11, 2012 - 10:22:56 PM
Ovarian Cancer Channel

subscribe to Ovarian Cancer newsletter
Latest Research : Cancer : Ovarian Cancer

   EMAIL   |   PRINT
Ovariectomy may put younger women at risk for an earlier death

Sep 14, 2006 - 5:40:00 AM , Reviewed by: Rashmi Yadav
Collectively, this information tells us that a procedure that previously looked advantageous in protecting women's health may actually have disadvantages.

 
[RxPG] Death rates rise when women under 45 years old undergo bilateral ovariectomy -- surgical removal of both ovaries -- and do not receive proper hormone replacement therapy, according to a new Mayo Clinic study to be published in the October 1 issue of The Lancet Oncology. Mortality from all causes increased 1.7 times for women in this age category, and was particularly increased for estrogen-related cancers and diseases of the brain and cardiovascular system. The increased risk was mainly restricted to those women who were not given estrogen after the surgery until at least age 45 (within five years of the approximate age of normal menopause). Also, the increased risk became evident only 10 or more years after the ovariectomy.

Walter Rocca, M.D., Mayo Clinic neurologist, epidemiologist and lead study investigator, made these discoveries serendipitously while investigating links between ovary removal and brain diseases such as Parkinson's disease and dementia.

"These findings reopen the debate about preventive removal of the ovaries for younger women," says Bobbie Gostout, M.D., Mayo Clinic gynecologic surgeon who is not a study author but consulted with Dr. Rocca. "We don't see a dramatic increase in risk for early death from any one condition, but Dr. Rocca's study did show some increase in risk of death from breast and uterine cancers, and neurologic and vascular conditions. Collectively, this information tells us that a procedure that previously looked advantageous in protecting women's health may actually have disadvantages. We need to be very thoughtful about ovariectomy, as it may put younger women at risk for an earlier death."

Dr. Rocca says that if a woman under 45 has ovarian cancer or a benign disease in the ovaries that requires removal, however, compelling reason remains to remove the ovaries. Removal may also be considered in older women and in women with a very high risk of ovarian cancer, he says.

Dr. Gostout indicates that these findings will change her surgical practice for women under age 45.

"For me this changes the nature of the discussion," she says. "Women in whom we've discovered ovarian cancer or benign disease of the ovary will still be counseled to have it treated, including ovariectomy. We will use the findings from the Mayo Clinic study to guide the discussion on estrogen replacement therapy and will encourage most young women to take estrogen until age 50. But, for women with average risk for breast and ovarian cancer where we might have considered preventive ovariectomy, the discussion will have more of an emphasis on conserving the ovaries for protecting the health of the woman."

Continuing preventive ovariectomies in average-risk younger women and emphasizing estrogen replacement therapy thereafter may not be an adequate solution to diminish the risk, however, as compliance is poor for taking estrogen replacement therapy, says Dr. Gostout. Dr. Rocca adds that the protective effect from endogenous estrogen -- estrogen coming naturally from one's own ovaries with daily and monthly cyclic variations -- may not be the same as the effect of estrogen replacement therapy.

The study's investigators propose several theories to explain the finding of increased early deaths for younger women who have preventive ovariectomy without adequate estrogen replacement:

Premature estrogen deficiency following the surgery increased the risk for various diseases that in turn reduced survival

The surgery revealed an underlying pre-existing condition in these women that caused early death following surgery

These women may have a genetic predisposition to uterine diseases or other symptoms that prompted hysterectomy, which then prompted preventive ovariectomy, while the same predisposition also increased the risk of cancer or other causes of death following the surgery

The study findings also have general research implications for the role of estrogen, according to Dr. Rocca. "Our results confirm that estrogen is probably protective of the brain and cardiovascular system," he says. "They also further establish that the effects of estrogen are age-dependent: estrogen may be clearly useful and protective at younger ages, but it may become less important after menopause and then may have no effect or may be disadvantageous if given as treatment in later years."

To conduct this study, Dr. Rocca and colleagues followed women who had undergone unilateral or bilateral ovariectomy between 1950 and 1987 while residing in Olmsted County, Minn., home of Mayo Clinic. All of these women had the surgery prior to menopause and for reasons other than cancer. The study evaluated 1,293 women with unilateral ovariectomy, 1,097 women with bilateral ovariectomy and, for comparison, 2,390 women who had not undergone ovariectomy. All women were followed until their deaths or until the end of the study, which was staggered between 2001 and 2006, via a combination of interviews with the women or a surviving relative, medical records and death certificates. A unique strength of this study, according to the investigators, was a 25- to 30-year median follow-up time. A total of 1,292 women
died during the follow-up; 33 of them died after undergoing bilateral ovariectomy for cancer prevention before age 45. Only a long-term study such as this can reveal these changes in death rates, says Dr. Rocca.

In the United States, 1.2 million ovariectomies are performed annually. Half are unilateral, in which one ovary is removed, and in the other half both ovaries (bilateral) are removed. Half of bilateral ovariectomies are prophylactic -- done to prevent the possibility of future ovarian cancer (approximately 300,000 women per year). The American Cancer Society has estimated approximately 20,000 new cases of ovarian cancer will occur in 2006, and approximately 15,000 women will die from the disease this year.




Publication: The study is to be published in the October 1 issue of The Lancet Oncology
On the web: http://www.mayoclinic.com 

Advertise in this space for $10 per month. Contact us today.


Related Ovarian Cancer News
New technique to visualise tumour cells during surgery
Autophagy helps ovarian cancer cells to survive
Ovarian cancer vaccine trials show promise
VEGF Trap shows activity in patients with advanced ovarian cancer
UBC discovery may lead to focussed therapies for metastatic breast, ovarian cancer
Ovariectomy may put younger women at risk for an earlier death
Chronic stress agitates ovarian cancer
Acetaminophen may lower ovarian cancer risk
Ginger could help fight ovarian cancer
Multimarker assay for ovarian cancer most promising to date

Subscribe to Ovarian Cancer Newsletter

Enter your email address:


 Additional information about the news article
Study authors also include Brandon Grossardt; Mariza de Andrade, Ph.D.; George Malkasian, M.D.; and Joseph Melton III, M.D. Dr. Gostout consulted with Dr. Rocca about how these findings may affect ovariectomy practice at Mayo Clinic.
 Feedback
For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 
Contact us

RxPG Online

Nerve

 

    Full Text RSS

© All rights reserved by RxPG Medical Solutions Private Limited (India)