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ovary dilemma ovary dilemma

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Unread 01-03-2006, 04:17 PM
ovary dilemma

I'm keeping the left ovary. Wish I could keep them both, but i have a complex cyst on my right and it needs to come out. The hysterectomy is for other issues.
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Unread 01-03-2006, 05:12 PM
ovary dilemma

So here is my question: what is the correlation between keeping the ovaries and the incidence of breast cancer? I was going under the assumption that keeping my ovaries was lowering my risk of breast cancer than being on HRT.
There are many factors that go into figuring our risk for breast cancer; lifetime exposure to estrogens is just one of them. There are also many different types of "HRT", which all behave differently in the body.

A few things to think about when considering your breast cancer risk and the ovaries/HRT decision:
  • There are many substances which are considered carcinogenic. ONE of these is 16 alpha hydroxy estrone, which is a metabolic product of estrogens our ovaries produce as well as of estrogen in the form of HRT.
  • The amount of estrogen (not the harmful 16 alpha hydroxy estrones, but estrogens in total) in HRT dosages commonly prescribed to women in surgical menopause is typically much less than that produced by the ovaries.
  • The amount of estrogens (again, total) our bodies are exposed to in the form of HRT is about 20 times greater if we take oral estrogen than if we use transdermal forms (patches, creams or sublinguals)
  • Diet and exercise influence the metabolism of estrogens. For example, certain substances found in cruciferous vegetables are known to influence the metabolism of estrogens away from the harmful 16 alpha hydroxy estrones and towards harmless ones. One of these substances is diindolylmethane (DIM), which is available in supplement form.
  • Removing one ovary does NOT cut the amount of circulating estrogen in half. In some cases, it may (approximately). However, in others, the remaining ovary increases production to cover the needs of both, and in some, the remaining ovary fails after surgery.
  • All our bodies produce cancer cells randomly throughout our lifetimes, more or less according to which carcinogenic agents we're exposed to.
  • Whether or not we get breast cancer depends on whether or not our bodies are able to kill off the cancer cells before they get a chance to take hold and grow.
  • While most types of estrogens are not carcinogenic, they can accelerate the growth of existing breast cancers.
  • There is also the option to have the ovaries removed and not use HRT. However, many women find that in surgical menopause, their general health and/or quality of life suffer so much that the risks of using HRT far outweigh the risk of breast cancer.
  • The WHI study data indicated an increased rate of diagnosis of breast cancer among women on the combination HRT Prempro. Women on Premarin (a mixture of conjugated equine estrogens) alone did not show the same increase. Prempro is generally not prescribed to women without a uterus (us).
  • The breast cancers diagnosed in women on HRT tend to be diagnosed earlier and tend to have much higher survival rates than women with ovaries who are diagnosed.
  • It takes approximately 7 to 10 years for breast cancer to get started and grow to the point where it's detectable on a mammogram. Most studies to date have not been long enough to draw a conclusion about what has caused the cancers in women who were diagnosed.

In my own case, I had my ovaries removed with my hyst almost four years ago, and went on HRT (bio-identical, transdermal patches and creams) at that time. Two years later, I was diagnosed with breast cancer. (I had no prior family history of the disease.) At that time, after trying unsuccessfully to reduce my dosage of estrogen and take Tamoxifen, I decided to stay on my HRT's and make lifestyle changes to reduce my risk of recurrence.

I've adopted a healthier diet. I started exercising regularly. I've lost over 30 pounds. I take diindolylmethane daily. And, I've had mammograms every six months, all of which have come back clear

There are some excellent links in our Resources directory that further discuss the breast cancer risk/HRT decision; why not check them out? Just click on Resources at the left, and scroll down to the Breast Cancer and Hormone Jungle sections.

Good luck with your decision. I know it's not an easy one. Ultimately, you need to feel comfortable that you've done your homework and made the best decision for YOU based on the information you had at the time. That's all any of us can do. Breast cancer is out there. Like me, you could get it a year or two after your hyst - but, if you do, know that whatever you decided about your ovaries was NOT the cause.

I hope this helps.
Unread 01-03-2006, 05:23 PM
ovary dilemma

Thanks surferbabe! What great information. I read every word very carefully. This is one great website!
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Unread 01-03-2006, 05:25 PM
ovary dilemma

I had LAVH with left ovary removed on November 30th. I too wanted to keep ovaries and cervix, but the left ovary and cervix were too damaged from endo. My experience thus far is hot flashes and night sweats like nobody's business that started the 2nd week after the surgery and have not let up. I went for my 4 week post op apt and the doctor did the blood test to determine hormone levels. I'm still waiting for results. Luckily, I don't go back to work until Jan. 30th because with these flashes and the fatigue, I would'nt last 15 mins!
Unread 01-04-2006, 07:16 AM
ovary dilemma

We are about the same age. I am 48, but the research I have done says that ovaries continue to provide hormonal support well past menopause, however minimal. True, the amount of hormones is low after menopause, but there is still some hormonal secretion going on. So I'm opting to keep the natural stuff rather than the artificial HRT given a choice. I wish I could find the article that I read that explained this, but I can't find it now - sorry!

LSH stands for laprascopic supracervical hysterectomy. The procedure is done through 3 small incisions in the abdomen only, no major incisions and nothing through the vagina. It is considered a "minimally invasive" procedure, although once inside the procedure is still the same to remove the uterus. The cervix is kept intact. Because there is less invasion into the muscle tissue, there is less chance of impairing the blood supply to the ovaries. At least that's what my gyno tells me!
Unread 01-04-2006, 07:40 AM
ovary dilemma

Sorry, I didn't see your post when I answered summerhouse. Thanks for all of the great information. I can see that my assumptions haven't been correct and that I need to do some more research! Maybe that's why my surgery got postponed for two months! Anyway, thanks for the info. And I'm so glad that your mammograms have been coming back clean! That's fabulous!
Unread 01-04-2006, 08:39 AM
ovary dilemma

I too was having the same dilemma. My situation is a little different though because I have endometriosis and there is a 50/50 chance I will get it on that ovary and have to have it removed later.

I have made the decision to remove both ovaries. I had a long talk with my physician assistant and she reminded me the risks of ovarian cancer and said she started taking estrogen the day after her hyst and has never had any problems. I consider her a friend and trust her completely. Plus, my gyn wants to remove both too I just had to hear it from someone else.

Good luck making the best decision for you

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