Health Watch (Ovarian Cancer)

Ovarian Cancer — Beware of This Silent Killer!

Ovarian cancer begins in the ovaries — the female reproductive glands that churn out eggs and hormones — and is a potential threat to the fallopian tubes and peritoneum of a female human body. Reputed oncologists Dr. Sai Lakshmi Daayana and Dr. Ajay Chanakya Vallabhaneni lend an insight into this critical disease and instruct postmenopausal women to be on the ball.

Photo Credit: Pexels.com

BY PRAMITA BOSE

Scarce in Prepubescent Girls

It is important to note that though rare but even girls before attaining their puberty or adolescence could be affected by ovarian cancer. “In prepubertal girls, this is extremely unusual but possible,” echoes Dr. Ajay Chanakya Vallabhaneni, ace Hyderabad-based surgical oncologist and robotic surgeon. “Even though the frequency is very less yet ovarian cancer can occur to young girls, particularly in the form of germ cell tumors,” avers Dr. Sai Lakshmi Daayana, gynaecological oncologist of Apollo Hospitals at Jubilee Hills in Hyderabad.

However, women only after experiencing menstrual cycles become more prone to ovarian cancer. “The risk of ovarian cancer is significantly higher in women who have already gone through puberty and menstruation since hormonal and reproductive factors play a vital role in its development,” inputs Dr. Daayana. “The risk definitely increases post puberty due to hormonal changes, regular ovulation and exposure to estrogen over time,” agrees Dr. Vallabhaneni.

Causes

The exact source of this malignant malady is unknown but multiple risk factors, such as genetic mutations (a permanent change in the DNA sequence of an organism, inherited or acquired, and inducing harmless or adverse effects (BRCA1, BRCA2, genes that help prevent cancer by repairing damaged DNA. Mutations in these genes can increase the risk of developing breast, ovarian, and other cancers), family history, advancing age, hormone replacement therapy, obesity, endometriosis (a tissue similar to the lining of the uterus grow outside the uterus causing severe pelvic pain and making it difficult to get pregnant) and certain reproductive issues like never having children may increase the prospects of an ovarian cancer development.

Ovary Transplant and Its Surgical Procedure

Dr. Vallabhaneni confirms that ovary transplant is possible. “It involves transplanting the ovarian tissue or the entire ovary from a donor or preserved tissues,” he adds.

Dr. Daayana dispenses that “while whole ovary transplants are rare, ovarian tissue transplantation has been successfully performed so far. This involves freezing and re-implanting the ovarian tissue, usually for women who wish to restore fertility after cancer treatment.”

Perils

There are some risks involved in ovary transplant, which is a major operation. Probable dangers include infections, bleeding, surgical complications, organ rejection of the transplant, hormonal imbalance and failure of the transplanted ovary or tissue to function properly.

Recovery Period Post Oophorectomy

This is regarding the surgical removal of one or both ovaries or ovariectomy. It takes typically four to six weeks to recuperate. Physical recovery takes about two to six weeks, while hormonal and emotional adjustments can take several months. Hormone replacement therapy may be required to manage symptoms of a sudden menopause.

Reproduction With Single Ovary

Doctors validate the fact that if one ovary is removed, the other can produce enough eggs to continue the reproductive activity in a female body. “Well, if the remaining ovary is healthy, it can compensate and continue producing eggs and hormones, allowing normal reproductive function. Many women with a single ovary can conceive naturally,” says Dr. Daayana.

Untimely Menopause

A young cancer patient with both ovaries being removed can experience an immediate and untimely menopause. “Removing both ovaries (bilateral oophorectomy) causes sudden menopause, also known as surgical menopause. This results in an abrupt drop in estrogen and progesterone (a type of body-made hormone that plays a substantial role in the menstrual cycle and pregnancy) levels, triggering symptoms like hot flashes, mood swings, risk of osteoporosis, cardiovascular issues and even bone loss,” reports Dr. Vallabhaneni.

Fertility Resumption

Good news is that fertility can be resumed to normalcy like before post a successful ovary transplant. “However, such chances depend on factors like the patient’s age, ovarian tissue quality and her underlying health conditions. Moreover, the success ratio is not 100% guaranteed,” warns Dr. Vallabhaneni.

Dr. Daayana too insists with a word of caution that “in some cases, ovarian function can certainly return to regularity after a successful transplant and women may be able to conceive naturally. However, success rates vary from case to case and there is no assurance of full fertility restoration.

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