Tuesday, September 7, 2010

In Honor of Ovarian Cancer Month: Hold On To Your Ovaries!

Shame on The New York Times for printing a one-sided article touting the benefits of female castration as a way of preventing ovarian cancer. The article reported on a study of women who had inherited the BRCA1 or BRCA2 mutations that increase the risk for breast and ovarian cancer. Of the women who kept their ovaries, 6 percent developed ovarian cancer, compared with 1 percent of those who gave permission to remove their ovaries.

Ovarian cancer is deadly serious: 15,000 women a year die from it, and the Ovarian Cancer Alliance has marked September for observance of Ovarian Cancer Awareness Month. Fear of ovarian cancer is the major reason why about 300,000 women a year permit doctors to remove their ovaries, usually at the same time as a hysterectomy. However, only a small percentage of those women have the BRCA mutations; they face a lifetime risk of only 1.39% of developing ovarian cancer (or 1 in 72), while the risk of breast cancer over her lifetime is 12.15% (or 1 in 8), according to the National Cancer Institute. So using fear of ovarian cancer to convince a woman who does not have the mutations to have a hysterectomy, is clearly unwarranted.

Now the question is, how warranted is such a recommendation for women who do have the mutation? Well, if all we were talking about was removing some non-essential or at least less-essential body part--even a breast--then trading a 5% risk for a 1% risk of a deadly cancer, for which there is no good treatment, might indeed be a sensible option.

But no woman should make that choice until she understands all that she will be sacrificing along with her ovaries, and the added health risks that accompany this drastic decision.

As I've blogged about before, losing your ovaries is literally castration and brings on not only a sudden, intense menopause, with severe hot flashes, mood swings, loss of energy, etc., but also drastically raises the odds that a women will suffer other serious problems as a result. A study published in the journal The Lancet in October, 2006, found that women castrated before the age of 45 double their risk of death from heart attack. Some previous studies put the increased risk of heart disease at 5.5 times, regardless of age at time of operation.

And then there are the increased risks for osteoporosis and bone fractures and Parkinson's disease and other forms of dementia.

As for women who have enjoyed sex--well, they can say good-bye to their former selves. Our ovaries continue to function long after menopause, still producing some estrogen and other hormones. Without them, welcome to the world of dry. Libido--gone or dramatically reduced. Ability to feel and enjoy--women can't even remember what it felt like. Impact on your relationships--depends on how understanding and tolerant is your partner.

The Ovarian Cancer National Alliance is pushing for an increase in funding for research for a test that would detect ovarian cancer at an early stage, and for a cure. Amen to that.

But the next time The New York Times or anyone else publishes an article about ovarian cancer prevention through castration, they ought to be sure to tell women about the increased risks and poor quality of life that they will be endure as a result.