University of Virginia Health System

Preserving Fertility in Women with Ovarian Cancer

For younger women with ovarian cancer, aggressive treatment can end reproductive ability. But a new study from the journal Cancer found that saving the uterus or one ovary of a young woman with early-stage ovarian cancer can preserve her fertility without compromising survival. This is good news for the 17 percent of U.S. women diagnosed as having ovarian cancer at age 40 or younger.

Survival Rates Similar

In the study, researchers looked at data from more than 4,000 ovarian cancer patients age 50 or younger who had surgery during a six-year period. Only about 400 had an ovary conserved and about 650 had uterine preservation. But their survival rates generally matched their counterparts who had the full hysterectomy or ovary removal.

A hysterectomy or removal of both ovaries is often viewed as the best surgical treatment for the cancer. But in addition to ending a woman's reproductive ability, these surgeries can cause estrogen deprivation that leads to many other health issues, such as osteoporosis. However, the findings from this study suggest that conservative surgical management should be considered in young women with ovarian cancer given the potential benefits of ovarian and uterine preservation.

Susan Modesitt, MD, a gynecologic oncologist at the University of Virginia Health System, co-authored a similar study seven years ago that found women with early-stage ovarian cancer can safely consider fertility-sparing treatments.

The main factor in deciding whether to pursue fertility-sparing treatment, she says, is the extent of the cancer. If the cancer has spread or cancerous cells are present in both ovaries, Modesitt says women should consider more aggressive surgical treatment options such as removal of both ovaries with possibly a full hysterectomy.

"From my standpoint, they should choose a less-aggressive treatment option only if it doesn't endanger their chances of survival," she says. "Obviously, though, this is an extremely personal decision and women should discuss it at length with their physicians and families before making these decisions."

Early Detection is Key

Catching ovarian cancer before it has spread gives women a 90 percent chance of living at least five years after treatment. However, there is no specific screening for ovarian cancer; once symptoms appear, diagnostic tests are performed.

Risk factors for ovarian cancer include:

• Older age (ages 50 to 75)
• Obesity
• Having children after age 30 or not at all
• Late onset of menopause (after age 55)
• A family history of other female cancers, as well as colorectal cancer.

Preventing Ovarian Cancer

Ovarian cancer is sometimes called the silent killer. That's because its symptoms aren't that unusual. But it's still important to be aware of possible symptoms, such as persistent abdominal pain and bloating, problems with urination or constipation, or trouble eating. If you experience any of these, mention it to your doctor. Many women fail to do so and by the time ovarian cancer is diagnosed, the disease is usually very advanced.

For information about ovarian cancer or other women's health issues, visit www.uvahealth.com.

Always consult your physician for more information.