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If you need an oophorectomy as a part of your ovarian cancer treatment, you probably have some questions.

How much of your internal reproductive system will be removed? Will you still have menstrual periods or be able to conceive a child? How long will it take to recover?

We checked in with a surgeon who specializes in gynecologic cancers, to find out what to expect.

What is an oophorectomy??

It¡¯s the surgical removal of an ovary. If only one ovary is removed, it¡¯s called a unilateral oophorectomy. If both are removed, it¡¯s called a bilateral oophorectomy.

Is an ovary the only part of the female reproductive system that¡¯s removed during an oophorectomy?

Yes, but it¡¯s usually removed with the nearby fallopian tube. That procedure is called a salpingo-oopherectomy.?

What types of cancer are treated with an oophorectomy??

An oophorectomy is most commonly used to treat ovarian cancer, but it can also be used to treat different types of cancer that have spread to the ovary.

Is an oophorectomy ever used for people who don¡¯t have cancer?

Yes. Some hereditary conditions increase a woman¡¯s chances of developing ovarian cancer. So, an oophorectomy is considered a type of risk-reduction surgery.?

In fact, the Ovarian Cancer Research Alliance just issued a new guideline related to risk reduction. It calls for women who have finished childbearing and are undergoing abdominal surgery anyway to have their fallopian tubes removed at the same time. This is because many ovarian cancers are thought to begin in the fallopian tubes.

Menopausal patients undergoing a hysterectomy may also have an oophorectomy, as there¡¯s no real benefit to retaining the ovaries if you¡¯ve already stopped menstruating.?

Is an oophorectomy considered major surgery??

That depends on why and how you¡¯re having it done.

If the ovary is being removed because of a very large tumor, or as part of a debulking procedure to remove as much cancer as possible, then it¡¯s considered major surgery.?

But if the ovary can be removed through small incisions using minimally invasive techniques ¡ª especially as part of a risk-reduction procedure ¡ª then it¡¯s not considered major surgery.

How long does it take to recover from an oophorectomy?

Your recovery depends on the type of surgical incision used and your general health.?

With larger incisions, you can expect to be in the hospital for an average of three to five days. With minimally invasive techniques using small incisions, you can typically go home the same day.?

It varies quite a bit, though. So, the best way to find out what you can expect is to ask your doctor.

Regardless of the type of surgery you have, you should not lift anything heavier than 10 pounds for six weeks, to prevent the development of a hernia.?

What are the possible side effects of an oophorectomy??

Again, that depends on many factors, including:?

• your age
• whether you¡¯re already in menopause, and?
• whether you¡¯re having a unilateral or bilateral procedure.?

If you¡¯re already in menopause, side effects related to hormone levels should be minimal. This is because your ovaries have already shut down, so it won¡¯t matter if one or both are removed.

If you haven¡¯t entered menopause yet, you¡¯ll need to meet with a reproductive endocrinologist before the procedure. They can discuss how it might affect you and your reproductive function.

Could I still conceive a child after an oophorectomy? Will I still have menstrual periods?

Again, that depends. If you only have one ovary removed and you still have one functioning ovary left and a uterus, then the answer to both questions is yes. But if both of your ovaries are removed and you¡¯re still of child-bearing age, the answer is no, unless you¡¯re using assisted reproductive techniques. A bilateral oophorectomy causes instant surgical menopause.

What¡¯s the most important thing to know about oophorectomies??

Talk with your doctors, so you¡¯ll understand exactly what the procedure means for you. If you¡¯re not already in menopause, an oophorectomy could bring about many changes. If you are in menopause, you¡¯ll likely see very little impact on your overall well-being.?

or by calling 1-877-632-6789.

A hysterectomy is a common procedure used to treat gynecologic cancers, like ovarian cancer, cervical cancer and endometrial cancer, and other health conditions impacting the uterus. But there are still many myths surrounding this type of surgery. And, if you need a hysterectomy, you may have anxiety or questions about long-term side effects, including the impact on your fertility.

We spoke with gynecologist oncologist , about what patients planning for a hysterectomy should expect.

What is a hysterectomy?

A hysterectomy is a surgery to remove a patient¡¯s uterus. There are a few types of hysterectomies:

• Total hysterectomy: Removal of the uterus and cervix
  
• Supracervical hysterectomy: Removal of the uterus only
• Simple hysterectomy: Removal of the uterus and cervix, but not the tissue adjacent to the cervix (called parametria) or the upper vagina. This is the most common type of hysterectomy.
• Radical hysterectomy: Removal of the uterus, cervix, upper part of the vagina and supporting tissues adjacent to the cervix called the parametria

Removal of a fallopian tube is known as a salpingectomy. Removal of an ovary is known as an oophorectomy. Removal of both a fallopian tube and an ovary is a salpingo-oophorectomy. Some patients may have both fallopian tubes and/or both ovaries removed.?

It is important to talk to your surgeon about whether your ovaries should be removed at the time of hysterectomy. This decision will be based on your age, the reason you are having the hysterectomy and other medical factors. All women, however, should have their fallopian tubes removed if they are undergoing hysterectomy. This has been shown to decrease the risk of ovarian cancer later, and fallopian tubes have no impact on ovarian or hormonal function.

Hysterectomies may be performed through either:

• open surgery, also called a laparotomy with one larger incision, or
  
• a minimally-invasive, laparoscopic or robotic hysterectomy performed through multiple smaller incisions

Patients should talk to their health care provider to see which type of procedure is right for them. Most cervical cancer patients should avoid a minimally invasive hysterectomy, as studies show this could increase the risk of recurrence.

Who needs a hysterectomy?

A hysterectomy is a part of the standard treatment for patients who have been diagnosed with cervical, endometrial or ovarian cancer. However, some women who wish to try to get pregnant in the future may have the option for conservative therapy that does not involve a hysterectomy. Some women may need a prophylactic hysterectomy to reduce their chances of developing cancer in the future if they have been diagnosed with some hereditary conditions.

Outside of cancer care, hysterectomies are performed to treat uterine fibroids, heavy vaginal bleeding, some uterine prolapse, endometriosis (when the tissue that lines the uterus grows outside of the uterus) or adenomyosis (when the tissue that lines the uterus grows inside the walls of the uterus where it doesn¡¯t belong) that are unable to be controlled through non-surgical means.

Are there any risks?

Often, especially when used for cancer treatment, a hysterectomy is performed along with other procedures, so the risk is specific to each individual patient. It¡¯s important that you talk to your doctor about your risks.

What should patients expect during a hysterectomy?

Patients receive general anesthesia before a hysterectomy. During the procedure, the surgeon will remove the uterus through an incision in the abdomen or the vagina. Surgery can last anywhere from one to three hours. It may take longer if the surgeon is doing additional procedures.

How long does it take to recover from a hysterectomy?

Historically, recovery from a hysterectomy was a difficult process, but thanks to efforts like MD Anderson¡¯s Enhanced Recovery Program, patients who have a minimally invasive or open hysterectomy both recovery relatively rapidly. But the experience does vary depending on which type of procedure you have. Patients who have an open radical or simple hysterectomy can expect to be in the hospital one to four days. Patients who have a minimally invasive hysterectomy will be able to leave the hospital as early as the same day as the procedure.

Regardless of the type of hysterectomy, patients should expect to be up and walking around the same day as the surgery. Patients often experience discomfort at the incision site for about four weeks. Patients should refrain from any heavy lifting for six weeks and from being fully submerged in water, using tampons, having sex or placing anything in the vagina until their doctor says they¡¯ve healed.

What type of long-term side effects should a patient expect?

Patients who have had a hysterectomy will not be able to become pregnant, so it¡¯s best to consider the hysterectomy relative to your goals surrounding fertility. Outside of fertility, patients will not experience any long-term side effects. A common myth is that hysterectomies cause patients to experience early menopause, but this is not true as hormonal function comes from the ovaries.

Will a patient still have a period after a hysterectomy?

This is a really frequently asked question. No, a patient who has a hysterectomy will not menstruate. Despite this, a patient who has a hysterectomy will not go into menopause unless the ovaries are removed.

What advice do you have for a patient interested in preserving her fertility?

Any patient who has been told they need a hysterectomy can weigh need for hysterectomy with their reproductive goals with their care team or seek a second opinion. Cancer patients who need a hysterectomy but are interested in preserving their fertility should seek care at a center with an oncofertility program, like MD Anderson. Our oncofertility specialists don¡¯t just treat people with gynecologic cancers. They treat anyone whose cancer may impact their fertility. They can help patients who are considering a hysterectomy weigh their options so they can make the best decision for themselves.

Does a hysterectomy affect sexual function?

No, a hysterectomy alone does not impact sexual function. Recovery from surgery and undergoing therapy for cancer, including possibly going into menopause, however, may impact sexual function. Some hormone therapies used to treat cancer may cause sexual side effects. Patients should share their side effects and concerns with their care team.

Overall, hysterectomies are a safe and effective option for treating several types of cancer, and many patients who have them continue to live normal lives after.

or by calling 1-877-632-6789.

When I was diagnosed with stage III ovarian cancer in July 2023, it hit me like a thunderbolt. Ovarian cancer doesn¡¯t run in my family. But I¡¯m adopted. So, I didn¡¯t have any way of knowing that I carry the BRCA1 genetic mutation, which makes you more likely to develop both breast and ovarian cancers.

If I had known that before my diagnosis, I might have done things a little differently. That¡¯s why I tell people today not to ignore their symptoms ¡ª no matter how odd or minor they might seem. And don¡¯t try to guess what¡¯s causing them yourself. Ovarian cancer has so many symptoms that can be other things. Go to the doctor, get examined and find out for sure.?

My ovarian cancer symptoms?

My ovarian cancer symptoms started with bloating, though I didn¡¯t realize it at the time. I¡¯m a small person, so it was pretty easy to notice. The bloating started in December 2022. By the time I was diagnosed with cancer the following July, I felt like I was 10 months pregnant. There was also a weird hardening in my abdomen.

The next thing I noticed was weight loss. As a society columnist for a local newspaper, I attend a lot of galas, so I own several ball gowns. I was sitting at my makeup desk one day getting ready for one, when I realized that the top of my dress was too big. It was really weird.?

I have never worried about my weight. I don¡¯t even own a scale. And I wasn¡¯t trying to diet. Yet all of my clothes were suddenly falling off of me. Even my rings wouldn¡¯t fit anymore. I had to have all my ball gowns taken in. By the time a nurse finally weighed me at the doctor¡¯s office, I was stunned. I was down to 111 pounds. I have weighed 120 pounds my entire adult life.?

My ovarian cancer diagnosis

Despite the bloating and weight loss, it wasn¡¯t until I went to a local emergency room that I finally learned I had ovarian cancer. I¡¯d been diagnosed with a mildly prolapsed bladder just a few months earlier and had surgery scheduled to correct it. But a week before the procedure, I noticed something protruding from my vagina while I was in the shower. I was terrified.

The ER physicians performed CT scans of my abdomen and pelvis. It took them a long time to get back to me. Once they finally did, they said, ¡°Well, you have a prolapsed bladder. But we also believe that you have ovarian cancer.¡±

Little did I know that a prolapsed bladder was the least of my worries. It turned out that the reason for the prolapse was two giant masses in my abdomen: one on each ovary. The one on the left side was the size of a football. The one on the right was the size of a small watermelon.?

Why I chose MD Anderson for my ovarian cancer treatment

Once I understood that cancer was the real issue, I knew I was going to MD Anderson. Given its reputation, I didn¡¯t even think about going anywhere else.?

I called and made an appointment at MD Anderson League City, which is the location nearest my home on Galveston Island. There, I met with gynecologic surgeon, .?

She confirmed my diagnosis of stage III high-grade serous ovarian cancer. She recommended a debulking surgery to remove my ovaries, uterus and as much of the cancer as possible. I would also need chemotherapy. But Dr. Richardson warned me that if the cancer had already spread too much, she¡¯d have to stop the procedure and take a different approach. If things went well, though, the surgery would last about seven hours.

I knew it was a good sign when Dr. Richardson gave me a thumbs-up as she walked into the recovery room. But I didn¡¯t breathe easier until I asked her what time it was and she told me late evening. We high-fived, and I just started crying. I knew then that I truly had a chance of surviving this.

Life as an ovarian cancer survivor

My bladder never fully recovered from having so much pressure put on it. Just four months after the hysterectomy, it became dislodged again. So, I have to use a device called a pessary to hold it in place.

I¡¯ll keep taking a PARP inhibitor called olaparib for the next two years to reduce my risk of recurrence. I also get a blood test every three weeks to monitor my CA-125 levels.?

The good news is that it turned out the cancer hadn¡¯t spread at all. It was only in my pelvis. So, Dr. Richardson got it all out. I had six rounds of chemo afterward to kill any microscopic cancer cells that might¡¯ve escaped and rang the bell to celebrate my last infusion on Jan. 18, 2024.

I am still cancer-free today. But I also still can¡¯t quite believe that I went into the hospital thinking I had one thing, only to learn that I had something totally different.

or by call 1-877-632-6789.

Ascites is the accumulation of fluid in the peritoneal space of the abdomen. Though it can be caused by several non-cancerous conditions, when seen alongside a pelvic mass, ascites is often a sign of peritoneal carcinomatosis, a classic symptom of advanced-stage ovarian cancer.

So, what causes ascites? Can it be treated? And, does it ever develop anywhere else?

We went to , a gynecologic oncologist specializing in ovarian and other?gynecologic cancers. Here are eight things he shared about this ovarian cancer symptom.??

How is the word ascites pronounced?

It¡¯s pronounced ¡°as-SYE-teez.¡±

What causes ascites?

Ascites are thought to be caused by a combination of:

• high levels of fluid production in the peritoneal cavity?
• an obstructive process involving the peritoneal lymphatic system and increased vascular permeability ¨C¨C or the exchange of fluids between organs and tissue.?

It is largely caused by increased levels of a protein called vascular endothelial growth factor (VEGF).

Does ascites ever develop anywhere else in the body?

Ascites, by definition, is the pathological accumulation of fluid in the peritoneal cavity. But fluid can also accumulate in other parts of the body. If fluid accumulates around your lungs, for instance, that is called a pleural effusion.

Are any other cancers associated with the development of ascites?

Several, but the ones I am most familiar with are:

• ovarian cancer
• fallopian tube cancer
• primary peritoneal cancer
• endometrial cancer

Can any conditions other than cancer ever cause ascites?

Yes. Chronic hepatitis, liver failure, congestive heart failure, and pancreatitis, to name but a few.

How is ascites typically diagnosed?

In our patients, we often discover ascites during a physical exam.

Ascites can cause the abdomen to become very distended. We can often perceive a ¡°fluid wave,¡± or movement of liquid beneath the surface when assessing patients with it. Patients may also complain of shortness of breath, abdominal tenderness and pain, loss of appetite, indigestion, fatigue, constipation, or back pain.

We can confirm the presence of ascites with imaging, such as an abdominal ultrasound or a CT scan of the abdomen.

Can ascites be treated??

Yes. Patients can undergo a procedure called therapeutic paracentesis, in which a needle is inserted into the abdomen to drain off the fluid. This can relieve their immediate discomfort, but the fluid tends to return without treatment of the underlying cancer.

In patients with advanced or recurrent cancer that is no longer responding to treatment, a catheter can be placed in their abdomen. This allows the patient to drain off fluid whenever they are uncomfortable or having painful symptoms.

What¡¯s the one thing you want people to know about ascites??

Unfortunately, ovarian cancer is a disease that we cannot screen for. That¡¯s why it is important to pay attention to your body. If you have unexplained abdominal distention, pain, or any of the other symptoms mentioned above persistently for a couple of weeks, please talk to your doctor.

or call 1-877-632-6789.