Introduction:
Hysterectomy is a procedure in which the surgeon removes the uterus. In some cases, the other parts of the female reproductive system, including the fallopian tubes, cervix, and part of the vagina, are removed. The surgical procedure may reduce the risk of ovarian cancer, but it does not eliminate it. Ovarian cancer is cancer that develops from the cells in the ovaries. The female reproductive system comprises two ovaries, where the eggs are produced, and estrogen and progesterone hormones are released. Ovarian cancer is caused due to a genetic mutation in the ovary. It can occur in the epithelial cells present on the outer surface of the ovary, inside the germ cells of ovaries, or in hormone-producing stromal cells. The risk of ovarian cancer is reduced if either one or both ovaries are removed.
What Are the Types of Hysterectomies?
Based upon how much the surgeon removes the uterus and the surrounding tissue, there are several different types of hysterectomy.
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Partial or Supracervical Hysterectomy - The surgical removal of the upper part of the uterus and leaving behind the cervix. The cervix is present in the lower part of the uterus.
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Total or Pan Hysterectomy - The surgical removal of the entire uterus and cervix.
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Total Hysterectomy With Bilateral Salpingo-oophorectomy - The surgical removal of the uterus, fallopian tube, cervix, and ovaries.
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Radical Hysterectomy - The surgeon removes the cervix, uterus, and top part of the vagina and tissues on both sides of the cervix.
What Are the Risk Factors of Ovarian Cancer?
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Various factors can increase the risk of developing ovarian cancer. Females above 40 years, pregnant, having their first child after thirty-five years of age, having a family history of ovarian and breast cancer, undergoing fertility treatment (IVF), and undergoing hormone therapy due to menopause are at high risk.
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Lifestyle changes like smoking, alcohol, obesity, and being overweight increase the risk.
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Other risk factors include exposure to too much estrogen. Conversely, excess estrogen may put a female at high risk of ovarian cancer.
What Are the Symptoms of Ovarian Cancer?
In the early stage of the disease, not all females experience symptoms. In the late stage, the symptoms include fatigue, abdominal bloating, pelvic pain, back pain, constipation, loss of appetite, heartburn, difficulty eating, irregular periods, painful intercourse, and upset stomach.
Is It Possible to Develop Ovarian Cancer After a Hysterectomy?
A female can develop ovarian cancer after a hysterectomy if the surgeon does not remove ovaries. If a surgeon removes one or both ovaries, the risk of developing ovarian cancer is lower. Still, there is some risk because the ovarian cells may migrate to the perineum area (area between the vagina and anus). If the migration happens before the surgeon removes the ovaries, the ovarian cells may become cancerous. After the surgery, the ovarian cells can affect the peritoneum and put people at risk of developing ovarian cancer.
Peritoneal (abdominal wall lining) cancer is also linked with ovarian cancer because both cancers form in the same type (epithelial cells) of tissue. In addition, the symptoms, diagnosis, and treatment of ovarian and peritoneal cancers are the same. Peritoneal cancer has a link with gene mutations that may increase the risk of ovarian and breast cancers. In addition, a female who undergoes a hysterectomy may have a chance of developing peritoneal cancer.
What Is the Risk of Developing Ovarian Cancer After a Hysterectomy?
Breast cancer gene mutations (BRCA gene) can increase the risk of developing ovarian cancer. But, 75 to 80 % of people with BRCA gene mutation undergo a bilateral scalping-oophorectomy hysterectomy may reduce the risk of ovarian cancer. If the surgeon removes one or both ovaries, it can decrease the risk of ovarian cancer.
How Can Ovarian Cancer After a Hysterectomy Be Diagnosed?
After a hysterectomy, most females experience the symptoms of ovarian cancer. However, if a female has ovarian cancer before a hysterectomy, the doctor may prescribe the following test to diagnose ovarian and peritoneum cancer.
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Physical Examination - A doctor may do a physical examination to check for pelvic pain and abdominal bloating and may ask the patient about the symptoms.
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Blood Test - The doctor may recommend a blood test to check the associated antigen or tumor markers such as CA-125.
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Imaging Tests - The doctor may prescribe Computed tomography (CT) or Magnetic resonance imaging (MRI) scan to detect the tumors.
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Biopsy - The doctor may take a biopsy of the ovary and send it to a laboratory to check the cancerous cells of the ovaries.
How Can Ovarian Cancer Be Managed?
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A hysterectomy procedure can help in the management of ovarian cancer. During a hysterectomy, a surgeon can inject intravenous medications into the arm of the patient. Then, a urinary catheter is inserted to drain the urine, a drainage tube to drain the blood, and a gauge pack in the vagina to minimize the bleeding.
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The doctor may prescribe antiemetic drugs like Promethazine and Dimenhydrinate to relieve pain and discomfort. The stitches can be removed after five to seven days.
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The recovery time will depend on the patient's age, health status, and type of hysterectomy used by the surgeon. The recovery time is around six to eight weeks.
What Are the Risks of a Hysterectomy?
Hysterectomy may be associated with complications and risks. These include.
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Complications from general anesthesia are rare and include nerve damage and allergic reactions.
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Most infections can be due to antibiotic treatment after a hysterectomy.
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During a hysterectomy, damage to the bladder, ureter, or bladder can lead to infection and frequent urination.
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There may be heavy bleeding.
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After surgery, there may be blood clots, slow wound healing in the vagina, and one or both ovaries may experience ovary failure.
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Due to a hysterectomy, a female can experience early menopause.
How Can Ovarian Cancer Be Prevented?
Genetically some females develop ovarian cancer. Some preventive measures can reduce the risk of disease. The surgeon may remove the ovaries by bilateral oophorectomy hysterectomy if the female carries breast cancer gene mutations to reduce the risk for fallopian tubes, peritoneum, and ovarian cancer. In addition, removing the ovaries before menopause may reduce the risk.
Conclusion:
Ovarian cancer is a common type of cancer. Around 20 % of ovarian cancer are diagnosed at an early age. Depending upon the part of the uterus and surrounding tissues removed, several types of hysterectomy are used to treat ovarian cancer. After a hysterectomy, there are chances of developing ovarian cancer. However, cancer cases can be reduced if the surgeon removes ovaries. In addition, extended follow-up in the patients who underwent hysterectomy may lower the chances of developing ovarian cancer.
