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Endometriosis: Surgery lowers ovarian cancer risk
Swedish study finds surgical treatment for endometriosis lowers the risk of women developing ovarian cancer
10th April 2013 - A new study shows women who undergo surgical treatment for endometriosis have a lower risk of developing ovarian cancer. The Swedish research also found that hormonal treatments for endometriosis did not lower the risk.
The author of the study, Dr Anna-Sofia Melin from the Karolinska Institute in Sweden tells us: "The takeaway message is that you can lower the risk of ovarian cancer substantially by being more aggressive with surgical procedures. You have to take the endometriosis away and then you can lower the risk of ovarian cancer.
"But it's too early to give recommendations for every woman with endometriosis because all women do not get ovarian cancer. We do not know which women with endometriosis are at high risk. You can't say that every woman should take away her ovaries if she has endometriosis on her ovaries."
The study results have been published in a journal of the Nordic Federation of Societies of Obstetrics and Gynaecology.
Endometriosis is a long term, often painful, gynaecological condition which causes heavy periods when small pieces of the womb lining (the endometrium) are found outside the womb, usually in the pelvis and around the womb, ovaries and fallopian tubes.
Endometriosis is not an infection and it is not contagious.
It mainly affects women during their reproductive years. It's estimated two million women in the UK have the condition which, left untreated, can cause infertility.
Using the National Swedish Patient Register, researchers identified women diagnosed with endometriosis between 1969 and 2007. The National Swedish Cancer Register was then used to link women who were diagnosed with ovarian cancer at least one year after a diagnosis of endometriosis.
Information on their treatment, whether hormonal or surgical, was taken from 220 women with endometriosis and ovarian cancer and 416 women with endometriosis only, as a control.
The most significant finding from the research was that the surgical treatment of endometriosis reduced the risk of ovarian cancer. Surgical treatment involved removing one ovary (and leaving the other ovary in place), or surgically removing all the visible endometriotic tissue.
Dr Melin tells us: "The study shows that if you do your surgical procedure properly, if you take away the endometriosis, then you lower the cancer risk by 80%. That is very high.
"I hope this will be something that will wake up the gynaecology community. Endometriosis is a severe disease and it has a lot of implications for women."
She says although the study is about cancer it also has implications on child bearing.
Dr Melin says discussing treatment can be alarming for a woman: "It's very controversial to say that you should take ovaries away from a woman.
"The trend over the last 10 years has been not to take away the ovaries because the woman wants to have children. When she's had children, and that time has passed, I think we should be more aggressive with surgery to take away the ovaries."
There is no known cure for endometriosis but symptoms can be managed. Treatment choices depend on whether a woman wants to control symptoms and whether she also wants to become pregnant in the future.
Endometriosis responds and grows when exposed to oestrogen so hormonal treatments try to end or reduce the production of oestrogen in the body by putting women into a state of artificial pregnancy or artificial menopause.
As a last resort for severe pain, some women have their uterus and ovaries removed ( hysterectomy and oophorectomy) which also causes their oestrogen level to drop.