Cancer is a word that strikes fear into the hearts of many, and when it’s ovarian cancer, the storm clouds seem darker still. For women grappling with the reality of this diagnosis, the complexities of treatment can be confusing and overwhelming. Among these choices, an oophorectomy—a surgical procedure to remove one or both ovaries—often emerges as a viable option. But is it right for you, your body, and your life?
Only you and your healthcare team can decide that. That’s why it’s essential to gather as much information about this procedure as possible. By the end of this article, you will have a better idea if an oophorectomy for ovarian cancer is right for you, so you can confidently discuss the option with your doctors.
What Is an Oophorectomy, and Are There Risks?
Oophorectomy, commonly known as ovarian removal surgery, involves the surgical removal of one or both ovaries. It is a fairly safe procedure and in the US alone, over 300,000 women undergo oophorectomy every year.
The decision to undergo this operation is never light, mainly since the ovaries play a vital role in your reproductive and hormonal health. According to the Mayo Clinic, an oophorectomy carries risks but is a relatively safe procedure.
Possible risks include:
- Bleeding
- Infection
- Damage to nearby organs
- Rupture of a tumor, spreading potentially cancerous cells
- Retention of ovary cells that continue to cause signs and symptoms, such as pelvic pain, in premenopausal women (ovarian remnant syndrome)
- Inability to get pregnant on your own if both ovaries are removed
Will an Oophorectomy Cause Menopause?
If you haven’t yet experienced menopause, yes. Having an oophorectomy that removes both of your ovaries will cause menopause. This is because your body won’t get as much estrogen and progesterone produced by the ovaries. You may experience:
- Signs and symptoms of menopause, like hot flashes and vaginal dryness
- Heart disease
- Memory problems
- Depression
- Anxiety
- Osteoporosis
- Decreased sex drive
If you’re under 45, the risk of experiencing these symptoms increases. According to the Mayo Clinic, you can reduce your risk by taking low doses of hormone replacement drugs after your surgery until you turn 50. That carries its own risk, so be sure to discuss any decision with your doctor before starting a hormone replacement regime.
When Is an Oophorectomy Needed?
An oophorectomy may be done at the start of ovarian cancer treatment or later if the cancer comes back. Factors like your health, cancer stage, and individual circumstances help decide this. A conversation with your oncologist, gynecologist, and even a fertility expert can help you determine whether the procedure is right for you and when it’s needed on your treatment journey.
Your doctor may recommend an oophorectomy as part of your primary treatment for ovarian cancer if the tumor is confined to one or both ovaries and has not spread extensively beyond the pelvis. Surgical removal of the affected ovaries, along with any adjacent tissues or structures that may be involved, can help reduce the tumor burden and improve the chances of successful treatment.
Oophorectomies are often performed as part of the surgical staging process for ovarian cancer, which involves removing tissue samples and examining them under a microscope to determine the extent of the disease. It may be performed even if there are no visible tumors on the ovaries, as microscopic cancer cells may still be present.
In cases where ovarian cancer has spread beyond the ovaries and into the surrounding pelvic or abdominal tissues, an oophorectomy may be part of a debulking surgery aimed at removing as much of the tumor as possible. Debulking surgery can help improve the effectiveness of subsequent treatments, such as chemotherapy, by reducing the tumor burden and enhancing treatment response.
In some cases, particularly for women with a high risk of ovarian cancer due to genetic mutations such as BRCA1 or BRCA2, preventive (prophylactic) oophorectomy may be recommended to reduce the risk of developing ovarian cancer in the future. A preventive oophorectomy is typically performed in women who have already had children or who have completed menopause. It’s often accompanied by the removal of the fallopian tubes (salpingectomy) to reduce cancer risk further.
Suppose your ovarian cancer has recurred after initial treatment or has spread to other parts of the body. In that case, an oophorectomy may be considered as part of palliative care to relieve symptoms, such as pain or ascites (fluid buildup in the abdomen), and improve the quality of life. While oophorectomy may not cure the cancer at this stage, it can help alleviate symptoms and prolong survival.
Ultimately, the decision to perform an oophorectomy for ovarian cancer is based on a careful evaluation of your cancer stage, tumor characteristics, overall health, and treatment goals.
Types of Oophorectomy Procedures
There are different types of oophorectomy procedures, including unilateral (removal of one ovary) and bilateral (removal of both ovaries). Of course, which procedure you undergo depends on several factors, including the type and stage of your ovarian cancer.
A unilateral oophorectomy is typically performed when there is a benign (non-cancerous) condition affecting one ovary, such as an ovarian cyst or a tumor, that requires removal while preserving the function of the other ovary. It may also be performed as part of the treatment for ovarian cancer if the disease is confined to one ovary and sparing the other ovary is feasible.
A bilateral oophorectomy may be performed for various reasons, including the treatment of ovarian cancer, particularly in cases where the disease has spread to both ovaries or when there is a high risk of cancer recurrence. Bilateral oophorectomy may also be performed as a preventive (prophylactic) measure in women at high risk of developing ovarian cancer due to genetic mutations such as BRCA1 or BRCA2.
Additionally, a bilateral oophorectomy may be part of a hysterectomy (removal of the uterus) procedure, particularly in cases of gynecologic conditions such as uterine fibroids or endometriosis or as a means of permanent contraception.
What to Expect Before an Oophorectomy
Understanding the trajectory of an oophorectomy—from preparation to recovery—is crucial. This section demystifies each process step so you can feel informed and equipped to make the best decisions for your health.
Talk With Your Doctor
Of course, it all starts with your doctor. Open communication with healthcare providers is paramount, as it clarifies the procedure, addresses concerns, and outlines expectations. Your healthcare provider should meticulously guide you through the procedure’s ins and outs, explaining the operation’s specifics and answering any questions that arise.
This is your opportunity to familiarize yourself with the unknown, so come ready with your questions.
You should feel empowered to voice your preferences and concerns, ensuring a collaborative and patient-centered approach. This is your body, health, and future, so don’t hold back.
Preoperative Tests and Evaluations
Before surgery, you will undergo a series of tests and evaluations to assess your overall health and readiness for the procedure. These may include blood tests, imaging studies, and cardiac assessment, among others, to optimize safety and efficacy. Your healthcare team will want to ensure you’re in a condition to undergo the procedure, so this is an important step.
Mental and Emotional Preparation
Preparing for oophorectomy extends beyond the physical realm. Mental and emotional readiness are just as important. Coping strategies, support networks, and open dialogue with loved ones can help alleviate anxiety and boost your courage ahead of the procedure.
Lifestyle and Dietary Considerations
Adopting a healthy lifestyle and nutritious diet before surgery can ease recovery and improve overall well-being. Lean into healthy habits such as regular exercise, drinking lots of fluids, and balanced nutrition. These will lay a solid groundwork for a smoother surgical experience and postoperative recovery.
The Oophorectomy Procedure
The day of surgery arrives, with it, a mix of emotions. What will the experience entail? How will you feel afterward? Let’s explore.
An Overview of the Procedure
The oophorectomy procedure typically involves several key steps, including anesthesia induction, incision, ovarian removal, and wound closure. Your surgeon should explain all of this upfront and provide an estimate of the surgery’s duration.
Anesthesia Options and Considerations
Anesthesia is necessary for an oophorectomy, ensuring your comfort and safety throughout the procedure. Depending on your individual circumstances and preferences, you may receive general anesthesia or regional anesthesia, which is carefully monitored by skilled anesthesia providers.
Duration and Recovery Time
The duration of an oophorectomy varies depending on factors such as surgical approach, complexity, and patient-specific considerations. Once you’re out of surgery, you’ll be moved into a post-operation room to begin your recovery and to be monitored for any complications.
Potential Complications and How They Are Managed
While complications are rare, they can occur following oophorectomy, ranging from minor discomfort to more severe issues such as bleeding or infection. Vigilant monitoring, prompt intervention, and collaborative care among healthcare providers help mitigate these risks and ensure optimal recovery outcomes.
Oophorectomy Recovery and Rehabilitation
Your healing journey can begin once you’re out of surgery and clear post-op. Your healthcare team will work to ensure it’s as easy as possible.
Hospital Stay and Immediate Postoperative Care
After surgery, expect a hospital stay so you can receive diligent postoperative care and monitoring. These are essential to promote healing and prevent complications. During this time, your healthcare providers manage pain, monitor vital signs, and guide postoperative care instructions and follow-up appointments.
Pain Management Strategies
An oophorectomy is an extensive surgery, so, yes, unfortunately, there will be pain. Effective pain management is vital to the postoperative recovery process, improving your comfort and making it easier for you to move around. Your doctor may combine medication and nonpharmacological interventions like physical therapy to help you alleviate pain while minimizing side effects and promoting early mobilization.
Getting Back to Normal Life
As your recovery progresses, you can gradually resume daily activities at your own pace. There’s no one-size-fits-all path to feeling fully “healed,” so listen to your body and doctors. Let your instincts and your healthcare team’s recommendations guide you. While balancing rest and activity is essential, you should prioritize self-care and be mindful of your body’s cues throughout the recovery journey.
Long-Term Recovery and Follow-Up Care
Long-term recovery from oophorectomy encompasses ongoing monitoring, follow-up appointments, and supportive care to optimize your overall health and well-being. Keep a journal of your recovery, noting any symptoms or side effects you experience, and report those and any complications to your doctor regularly.
Coping Strategies and Support
Recovery from an oophorectomy doesn’t stop when your wounds are healed. This is a major surgery that can bring significant changes to your life. For some, that can be not easy to navigate. Maintaining your emotional health
Dealing with Emotional and Psychological Effects
The journey through ovarian cancer treatment, including oophorectomy, can spark a range of emotions, from fear and uncertainty to hope and resilience. Seeking support from loved ones, mental health professionals, and support groups can provide validation, guidance, and a sense of community during challenging times.
Resources for Support Groups and Counseling Services
Many resources are available to women navigating ovarian cancer and post-oophorectomy life, offering tailored support, education, and empowerment. Support groups, online forums, and counseling services provide invaluable opportunities for connection, shared experiences, and emotional healing. Taking advantage of any support resources available to you is highly encouraged at any stage of your ovarian cancer journey.
Building a Support Network
Building a robust support network is essential for women facing ovarian cancer and its aftermath. Whether comprised of family, friends, healthcare providers, or fellow survivors, a strong support system offers comfort, encouragement, and practical assistance throughout the treatment.
Lifestyle Changes and Adaptations
Life may look a bit different once you’ve found your way to recovery. Some adjustments may make transitioning into this new every day easier on your mental and physical health.
Hormone Replacement Therapy (HRT)
For women undergoing bilateral oophorectomy, hormone replacement therapy (HRT) may be recommended to mitigate menopausal symptoms and reduce long-term health risks associated with estrogen deficiency. Discuss this option with your doctor, and together, you can devise an individualized treatment regime and a plan for monitoring your health.
Nutrition and Exercise Recommendations
Nutrition and exercise are pivotal in promoting overall health and well-being on any given day, especially following an oophorectomy. Embracing a balanced diet rich in nutrients and regular physical activity supports recovery, enhances quality of life, and reduces your risk of chronic health conditions.
Integrative Therapies and Complementary Medicine
Complementary therapies, such as acupuncture, massage, and mindfulness-based practices, offer holistic support as you’re navigating the aftereffects of an oophorectomy and ovarian cancer treatment. Integrating these modalities into comprehensive care plans can bring relaxation, symptom management, and overall wellness.
Oophorectomy Fertility Preservation Options
Fertility concerns are top of mind for many women deciding if an oophorectomy is the right decision for them. Choosing between your health and your family’s future is difficult, but you should know there are options available to help you preserve that possibility.
Fertility Preservation Techniques Before an Oophorectomy
For women of reproductive age, fertility preservation options may be available, enabling them to preserve the possibility of future pregnancy. Depending on individual circumstances and preferences, these may include embryo or egg freezing, ovarian tissue cryopreservation, or other assisted reproductive technologies.
Alternative Family Planning Methods After Surgery
If preserved fertility isn’t a possibility, you can explore alternative family planning options, such as adoption, surrogacy, or donor conception. Your dreams of parenthood and growing your family don’t have to end with an oophorectomy. While the path may differ from conventional expectations, these alternatives offer viable pathways to building a family and embracing motherhood.
Are There Alternatives?
Typically, most women with ovarian cancer will require a combination of therapies involving oophorectomy and chemotherapy or radiation.. Depending on your case specific factors such as age, fertility preservation goals, type and stage of ovarian cancer, alternative treatments like chemotherapy or radiation therapy can offer beneficial results while also maintaining ovarian function. Additionally, hormone therapies may prove effective in specific scenarios, varying based on the type of ovarian cancer and individual factors.
Chemotherapy for Ovarian Cancer
Chemotherapy for ovarian cancer typically involves the administration of powerful medications, either intravenously (IV) or orally, that target and destroy cancer cells throughout the body.
It may also be administered before surgery (neoadjuvant chemotherapy) to shrink the tumor, making it easier to remove. Alternatively, it may be given after surgery (adjuvant chemotherapy) to eliminate any remaining cancer cells and reduce the risk of recurrence. Treatment schedules can vary but often consist of multiple cycles spaced over several weeks or months. It is typically performed as an outpatient procedure, meaning you do not have to be admitted to a hospital overnight, and generally takes up to 3-6 months.
Chemotherapy affects rapidly dividing cells, including cancer and healthy cells. The drugs are powerful, so side effects can be challenging. Common side effects may include fatigue, nausea, vomiting, hair loss, decreased appetite, and increased infection susceptibility. Your doctors will monitor your condition closely and may offer medications or supportive therapies to manage these side effects.
Regular monitoring is essential throughout chemotherapy treatment to assess treatment response, monitor for potential side effects, and adjust the treatment plan as needed. Your healthcare team will provide ongoing support, guidance, and symptom management to help you cope with treatment’s physical and emotional challenges.
Chemotherapy has been shown to be highly effective in treating ovarian cancer. However,it also carries certain risks of complications, such as bone marrow suppression (leading to low blood cell counts), neuropathy (nerve damage), and increased risk of certain infections. Your healthcare team will take measures to minimize these risks and ensure your safety throughout treatment.
Despite its challenges, chemotherapy offers significant benefits in disease control and improved quality of life. Most women with ovarian cancer find that the benefits of treatment outweigh the temporary side effects, allowing them to resume normal activities and maintain a fulfilling lifestyle.
Radiation Therapy for Ovarian Cancer
Radiation therapy is not typically used as a primary treatment for ovarian cancer, as ovarian tumors are often located deep within the pelvis and may not respond well to external beam radiation. However, in some instances, radiation therapy may be recommended as part of a comprehensive treatment plan, either before or after surgery or in combination with other treatments, such as chemotherapy.
There are two main types of radiation therapy used in the treatment of ovarian cancer: external beam radiation, which directs high-energy radiation beams from a machine outside the body to target and destroy cancer cells, and internal radiation, where radioactive materials are placed directly into or near the tumor site. This allows for precise delivery of radiation to the cancer cells while minimizing exposure to surrounding healthy tissues.
Like other cancer treatments, radiation therapy can cause side effects, which may vary depending on the dose, duration, and area of treatment. Common side effects may include fatigue, skin irritation or redness at the treatment site, gastrointestinal symptoms (such as nausea or diarrhea), and temporary changes in bowel or bladder function.
Radiation therapy is often used in combination with other treatments, such as surgery and chemotherapy, to achieve the best possible patient outcomes. Your healthcare team will develop a personalized treatment plan tailored to your needs and circumstances, considering factors such as cancer stage, tumor characteristics, and overall health.
Overall, while radiation therapy is not typically the primary treatment for ovarian cancer, it can play a valuable role in some instances, either as part of curative treatment or for palliative purposes. By working closely with your healthcare team and understanding radiation therapy’s goals and potential benefits, you can make informed decisions about your treatment plan and optimize your cancer care journey.
Hormone Therapy for Ovarian Cancer
Like radiation therapy, hormone therapy is not typically used as a primary treatment for ovarian cancer because ovarian tumors are usually not hormone-sensitive. Unlike certain other types of cancer, such as breast or prostate cancer, ovarian cancer cells typically do not have hormone receptors that respond to hormonal manipulation.
However, hormone therapy may have a limited role in the treatment of a specific subtype of ovarian cancer known as hormone receptor-positive ovarian cancer, which is relatively rare. In these cases, the cancer cells may have receptors for estrogen or progesterone, making them potentially responsive to hormonal treatments.
Hormone therapy for ovarian cancer may involve the use of medications that interfere with hormone signaling pathways or block hormone receptors on cancer cells. For example, selective estrogen receptor modulators (SERMs) or aromatase inhibitors may be used to reduce estrogen levels or block estrogen receptors in hormone receptor-positive ovarian cancer.
It is generally considered a treatment option for hormone receptor-positive ovarian cancer that has recurred or progressed despite other treatments, such as surgery and chemotherapy. It may also be considered for patients who cannot tolerate standard treatments or as part of a combination therapy approach.
Hormone therapy for ovarian cancer is not as well-established or widely used as it is for certain other hormone-sensitive cancers, such as breast cancer. Its effectiveness in ovarian cancer is still being studied, and it may not be suitable for all patients or tumor types. Response rates to hormone therapy can vary, and some tumors may develop resistance over time.
Like other cancer treatments, hormone therapy can cause side effects, which may include menopausal symptoms (such as hot flashes, vaginal dryness, and mood changes), bone loss (osteoporosis), and an increased risk of blood clots. Your healthcare team will monitor your condition closely and may offer supportive care or adjustments to your treatment regimen to manage these side effects.
Overall, while hormone therapy is not a standard treatment for most ovarian cancers, it may be considered in select cases of hormone receptor-positive disease. As ongoing research advances our understanding of ovarian cancer biology and treatment options, hormone therapy may continue to evolve as a potential treatment strategy for certain patients. Suppose you have questions about hormone therapy or other treatment options for ovarian cancer. In that case, discussing them with your healthcare team to determine the best course of action for your situation is essential.
Make an Informed Decision
The decision to undergo oophorectomy is a big one, and that’s why informed decision-making is so important. Every patient, including you, should have all the information about a procedure available so you are well equipped to make the best decisions for you and your family.
Let’s discuss how to empower ourselves to actively participate in treatment plans and advocate for our health and well-being in and out of the doctor’s office.
Advocating for Yourself in the Healthcare System
Navigating the healthcare system can be daunting, but every woman has the right to advocate for their needs, preferences, and concerns, especially when we’re talking about a severe procedure like an oophorectomy for ovarian cancer. Communicate openly and assertively, if in doubt seek second opinion, and partner with knowledgeable advocates to empower yourself to be heard and access the highest quality of care.
Most importantly, know that you are not alone in this difficult choice. Hundreds of thousands of women in the United States undergo this procedure yearly. You are surrounded by a community of support, compassion, and resilience, ready to uplift and empower you through every step of your journey. As research advances and treatment options evolve, there is reason for optimism in the fight against ovarian cancer. With continued dedication, innovation, and advocacy, we can strive for improved outcomes, enhanced quality of life, and a brighter future for all affected by this disease.
