Summarizing the Risks of Hysterectomy

When a women has surgery to remove her uterus, and way too often her healthy ovaries at the same time, she increases her risk of dying prematurely, diminishing her sex life, and suffering from a host of other health problems.

Here's a quick summary of the Risk Increase shown by some of the research, with sources:

Hysterectomy Alone

• Incontinence: 60% greater risk by age 60 than an intact woman ("Vital Signs: Consequences; Hysterectomy and Risk of Incontinence." The New York Times, Aug. 22, 2000. By Eric Nagourney
• Coronary Heart Disease: 3 times grater risk if hysterectomy done before menopause (American Journal of Obstetrics & Gynecology, Jan. 1981; 139 (1):58-61)

Oophorectomy (removal of ovaries)

• Early Death: twice the risk if ovaries removed before age 45 and no estrogen replacement given ("Survival patterns after oophorectomy in premenopausal women: a population-based cohort study." Lancet Oncology Volume 7, Issue 10, 2006, pp.821-828; by W.A. Rocca, MD, and others.)
• Dementia: 33% higher over all than women who keep their ovaries through menopause; 74% higher if her ovaries are removed on or before age 43 ("Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause." Neurology 2007; 69:1074-1083; by W.A. Rocca, MD, and others)
• Heart Attack: double the risk if a woman loses her ovaries between the ages of 40 and 44; 40% higher if ovaries removed after age 50 ("Ovarian Conservation at the Time of Hysterectomy for Benign Disease." Obstetrics & Gynecology, Vol. 106, No.2, Aug. 2005
• Bone fractures from osteoporosis: 54% more fractures when ovaries removed after menopause (same study, Ovarian Conservation, etc., cited above)

This is not a list you will find in any of the literature given out by gynecologists. Nor, when they try to talk women into letting them take out their ovaries while doing the hysterectomy, will they reveal that the average woman's risk of ovarian cancer is 1 in 72 (or 1.39% over her lifetime). By comparison, the lifetime risk of breast cancer is 1 in 8 (or 12.15% over her lifetime).

Of course, some women have genetic and family risk factors for ovarian cancer that make their decision much more difficult. I feel for them. But for other women, a gynecologist who uses the fear of ovarian cancer to convince her to consent to ovary removal is nothing less than unethical. Such a doctor should do women the favor of finding some other line of work.

Enough Walking for the Cure

Enough walking for the cure. It's time to get serious about stopping the cancer epidemic, and that means shifting activist efforts to prevention. As Devra Davis makes eloquently clear in her book, The Secret History of the War on Cancer, published last fall, cancer wasn't always common. It became common in the 20th century as chemicals of all kinds entered the food supply and the environment, and as workers were forced into contact with cancer-causing substancees. Davis offers proof drawn from unpublished research that there was clear evidence in the 1930s that cigarettes, for example, cause lung cancer. But the information was suppressed. She writes: “For nearly a hundred years, we have known that smoking, sunlight, industrial chemicals, hormones, bad nutrition, alcohol and bum luck, all affect the chance we will get cancer.”

If you want to know who the villains were, this book names them, and they include well-known leaders of cancer organizations and eminent physicians who engaged in both deliberate deceit and wishful thinking, that, for example, a safe cigarette was possible.

But don't read this book just for the history. Read it for the warnings about what we're doing to ourselves and our children. On the list of suspected and known cancer-causing agents are Ritalin, diagnostic X-rays--in particular, CAT scans being used more and more on children--cell phone use by children, and aspartame, the artificial sweetener better known as Nutra Sweet.

What we need is screening of the thousands of chemicals to which we are exposed every day.We should demand a ban on use of the chemical Bisphenol A in the linings of all canned food and beverages (Japan did so years ago) and in those clear, hard plastic baby bottles. I first wrote about this chemical in 2003, after a lab accident caused chromosomal abnormalities in lab animals. This chemical is an artificial estrogen, similar to the DES given to pregnant women in the 1970's that resulted in their girl children growing up with abnormal genitals. It causes changes in tissue that resemble early-stage breast cancer. A leading researcher, Frederic Vom Saal predicts it is only a matter of time before the FDA bans it.

Let's walk for this kind of prevention, and use the money we raise to fund real prevention efforts such as those by Davis at the University of Pittsburgh's Environmental Oncology Center.