Women with an increased familial risk of ovarian cancer now have their ovaries and fallopian tubes removed at a young age. This drastic intervention is the only effective way to prevent cancer. Because the ovaries are responsible for the production of sex hormones, the procedure causes women to enter menopause abruptly at a young age.
Previous scientific research shows that women who naturally experience early menopause face a higher risk of cardiovascular disease compared to other women. The same does not apply to women who go through these changes after surgery, as discovered by the researchers from the Netherlands Cancer Institute, Radboud UMC and Erasmus UMC. This study is the result of a collaboration between all university hospitals in the Netherlands, and the Netherlands Cancer Institute. The study participants were recruited from the Hebon study, looking into families with an increased risk of developing breast and ovarian cancer.
“We compared 500 women who had surgery before the age of 46 with 250 women who had surgery after the age of 54”, physician-researcher Maarten Beekman explains. “We used CT scans to measure coronary artery calcium in the vessels providing blood to the heart 20 years after the preventive surgery. We found no evidence that women who underwent surgery at a younger age experienced such calcification, called arteriosclerosis, at a higher rate than women who had surgery later in life. Arteriosclerosis is a well-known precursor of cardiovascular disease.”
These findings are reassuring for women with an increased familial risk who have preventive surgery. “The study results provide patients, their families, and physicians more clarity on the long-term effects of the procedure”, says Maarten, who is part of the research groups led by Floor van Leeuwen (NKI) and Angela Maas (Radboud UMC, cardiology department). “This knowledge is crucial when faced with difficult decisions like these, concerning the unknown long-term effects of treatment.”
Why do women who naturally hit menopause early face an increased risk of developing cardiovascular disease? “It’s possible that menopause isn’t the cause of arteriosclerosis in these women, but a symptom of the same underlying issue: early aging,” Maarten says. “That could explain why the women who undergo surgery don’t face this increased risk of developing arteriosclerosis.” The researchers plan to follow up on monitoring the women in five to ten years to see how this develops at a later age.
This research was financially supported by KWF Dutch Cancer Society, the Maarten van der Weijden Foundation, and Hart voor Vrouwen.