Endo cancer, keep ovaries?

Hello Sisters,

I have endometrial cancer, stage 1. My onc recommends taking everything, including tubes, ovaries, cervix. I have read where it might not be necessary to take ovaries. Does anyone here have knowledge/experience about that? I want to keep them. Even after menopause, they serve a purpose including protection against osteoporosis.

Thanks for your input.

I went through this decision and still don't know if I made the right decision. Checking the ovaries is part of the staging. You could look at just the uterus and think it's stage 1, then find it spread to an ovary unexpectedly and staging changes-----and that has happened to women here. So usually unless you are very young they take the ovaries. I was told about 10% chance cancer had spread there----so leave them or take them? 10% seemed high to me, but someone else might think otherwise. Yes ovaries have a purpose but if cancer has spread there, they should go. The question for me was, how much of a chance am I willing to take? If only we could know in advance----but we can't. Since I've seen women who were told they "probably" had a stage 1 actually end up a stage 3, I can see predictions aren't always accurate. So I can't tell you what to do, except to ask your GYN onc for more info on your risks. It is a really hard decision for some of us. I'm glad they didn't find cancer in my ovaries but wish there had been a way to know that in advance.

{{{Hunnah}}}

I was told that ovaries should be taken out as they secrete the estrogen that an drive endometrial cancer. It may also depend on your age. I had my taken along with lymph samples during my hysterectomy, and I was post-menopausal. I just take more calcium and try to more weight bearing exercise, as I was trending to osteopenia.

Best wishes
Wendy

I had endo cancer and it turned out it had spread to one ovary. It wouldn't have been found if I kept them.

The other thing is as Wendy said, estrogen promotes the growth of endo cancer so they need to come out IMO.

Good luck with whatever you decide.

I would have to reiterate what the others have said.
It is routine to take out the ovaries with endometrial cancer, .... for good reason. The other reason (for me anyways) to avoid future ovarian cancer. It is a cancer with very few symptoms and so most are diagnosed late.
I have recently read where they are starting to remove the fallopian tubes with routine (non cancer) hysterectomies, as well as when women have a tubal ligation, to also prevent ovarian cancer. They have recently found that one type of ovarian cancer originates in the fallopian tubes.
Anyways, the ovaries are on place endometrial cancer often spreads to, and so, removing them would be the only way to find that out.
(mets often cannot be seen and are found by the pathologist later on), which is why all of the organs need to be removed for full staging of endo cancer.
This certainly is a hard thing for some women to decide, and I wish you the best with that decision.
Janet

You are all so kind to offer your thoughts and insights to my question. Thank you..!

I have another question for endo cancer patients who turned out to have cancer in one or both ovaries: Did you ever feel pinches in your left or right lower abdomen? I feel that sometimes, more on the left.

I opted to keep my ovaries for two reasons - for fertility (we did IVF with a gestational surrogate to have our baby) and also because in my family there is terrible cardiovascular risk but no history of ovarian cancer.

I'm also pre-menopausal, and while the gyn-oncs are concerned about gyn cancer recurrence there are no studies about overall mortality with pre-menopausal women with and without ovaries.

At my surgery the gyn onc did a pelvic wash looking for stray cancer cells and did careful visual examination of the ovaries. If pathology had shown an aggressive cancer or something more invasive, I'd have had the ovaries taken out immediately. I'm still not sure I'll keep the ovaries in forever, I was told that having the ovaries removed at a future time is a relatively simple surgery.

The "usual" path to remove the ovaries is largely done because the majority of women with endometrial cancer are post-menopausal and the doctors think they don't "need" the ovaries anymore. Treatments in medicine evolve very slowly, and doctors - especially those dealing with cancer - are very cautious to try new approaches unless there is a compelling reason.

	Quote:
Originally Posted by Hunnah You are all so kind to offer your thoughts and insights to my question. Thank you..! I have another question for endo cancer patients who turned out to have cancer in one or both ovaries: Did you ever feel pinches in your left or right lower abdomen? I feel that sometimes, more on the left.

I did have pinches sometimes but I don't really think the spot on my ovary was big enough to cause that. One of my ovaries had adhesions that had it attached to my intestines and I think that's what caused my pinches. That was scar tissue from a previous surgery.

Make sure you mention the pinches to your gyn-onc. It might be nothing but it's something s/he should be aware of.

I understand your concerns re removing ovaries even if one is menopausal. IMHO for most menopausal women removal very likely is the better choice especially IF one learns that one's endometrial cancer was estrogen drive as is much endometrial cancer. Removal in these cases should help avoid a recurrence. Also, as another member mentioned,removal also will eliminate the possible development of ovarian cancer which is a silent killer as symptoms very often do not appear until the disease has moved to more advanced stages.

In the end, however, the decision to remove or not is an individual one and this must be respected. I know you will chose the decision right for you.

This was a question I asked my GP too Hunnah, do I have to lose my ovaries because of cardiovascular and osteoporosis issues. She basically said the same thing as the ladies here, that ovarian cancer is a quite silent type of cancer that often doesn't produce many symptoms, which is why it is to be avoided if possible.

Also, its the estrogen that the ovaries produce that contributes to the problem.

She also advised me not to worry about the cardiovascular and osteoporosis concerns, because there are ways to keep those problems at bay without ovaries. I'm due for my hyster on the 19th and am quite happy now to lose 'the lot" in order to keep cancer at bay! For a woman who, before her diagnosis, was determined not to have a hysterectomy, I can't get rid of it fast enough now!!

Anyhow, all the best to you.

X.