I am 43. My mother, grandmother, and aunt have all had ovarian cancer, and my mother died from it three years ago. My OB-GYN says I should stay on the birth control pill, which I have been on for many years. He said the pill may help prevent ovarian cancer. I am concerned with breast cancer, though. He said there is very little risk for that. He has also suggested that I get a hysterectomy. I do not want to get a hysterectomy unless it is really necessary. Would just getting my ovaries out be an option?

Doris

You do have a strong family history for ovarian cancer. Prophylactic removal of the ovaries is still very controversial, and is usually reserved for women with either two first-degree relatives (mother, sister, daughter) with ovarian cancer or women with the BRCA-1 or BRCA-2 cancer mutation. This mutation increases the odds of developing both breast and ovarian cancer, but testing for it requires blood samples from multiple affected relatives, as well as yourself.
The birth control pill does decrease the risk of developing ovarian cancer, and the amount of reduced risk is significant; use of the pill for more than seven years has been associated with a 50 percent reduction in ovarian cancer! As for breast cancer, there are as many studies showing a decreased risk of breast cancer in pill users as there are studies showing an increase in risk. The consensus today is that use of the pill does not significantly increase the risk of developing breast cancer.

As for your question about just removing the ovaries: Yes, that could be done without also removing the uterus, but you would need to take both estrogen and progesterone to prevent the development of endometrial cancer (cancer of the uterine lining) from estrogen alone. You also may continue to have periods, but you would be sterile. Unless a woman is very young and would consider egg donation in order to carry a pregnancy, the uterus is usually removed when both ovaries are going to be removed. Certainly, this is up for discussion between you and your gynecologist, and you would need to be informed of all potential risks and benefits of any surgery.

Recent findings in large-scale research studies suggest that HRT may increase a woman's risk of breast cancer, heart disease and stroke. In addition, when estrogen is prescribed alone, it may increase the risk of ovarian cancer. Consult a physician before starting any medication regimen.