Is Ovarian Removal Necessary After Cervical Carcinoma In Situ?

In cases of cervical carcinoma in situ, if the ovaries are unaffected, is there a need for removal?

Hello Doctor: My mother (65 years old) underwent a vertebral resection surgery four years ago.
E-Da Hospital originally arranged for a biopsy, but my mother chose to have surgery at another hospital directly.
After the surgery, she attended one follow-up appointment but refused to return for the report and has not undergone any Pap smears since then.
Due to privacy laws, we are unable to intervene.
This year, for unknown reasons, she went to a health center for a Pap smear, which again showed abnormalities.
The health center staff kept calling her, and due to peer pressure, she went to Kaohsiung Veterans General Hospital for further examination, where a biopsy was performed (the doctor said fortunately it had not turned into cancer cells).
Surgery has been scheduled to remove her uterus, and the doctor inquired whether she would like to have her ovaries removed as well (the ovaries are currently fine).
I would like to ask if it is necessary to remove the ovaries? Is it possible to keep them and monitor her condition later? Since the ovaries have a function, I would prefer to keep them if possible, but I am concerned about potential issues in the future.
Will my mother be unable to have Pap smears after this? Wishing you all the best, Xiao Wu.

Xiao Wu, 40~49 year old female. Ask Date: 2021/04/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if it is cervical carcinoma in situ, health insurance only covers the cost of a hysterectomy.
At 65 years old, if the ovaries are no longer functioning, the decision to proceed with the surgery is up to you.
Whether to pay out of pocket for additional procedures varies by hospital.
It is still recommended to continue regular Pap smear follow-ups.
Wishing you good health.

Reply Date: 2021/04/15

More Info

When considering whether ovarian removal is necessary after a diagnosis of cervical carcinoma in situ (CIS), it is essential to weigh the risks and benefits of such a procedure. Cervical carcinoma in situ is classified as a pre-cancerous condition, meaning that while abnormal cells are present, they have not invaded deeper tissues or spread to other parts of the body. The primary treatment for CIS typically involves surgical procedures such as conization or hysterectomy, depending on the extent of the disease and the patient's reproductive plans.

In your mother's case, since she is 65 years old and has already undergone a conization procedure, the decision to remove the ovaries should be based on several factors. First, it is important to consider the current health of the ovaries. If they are functioning normally and there are no signs of disease, many healthcare providers may recommend keeping them. The ovaries produce hormones such as estrogen and progesterone, which play significant roles in various bodily functions, including bone health and cardiovascular health. Removing the ovaries can lead to surgical menopause, which may have implications for her overall health and quality of life.

However, if there is a family history of ovarian cancer or if the ovaries show any abnormalities during imaging or examination, the physician may recommend their removal as a precautionary measure. The risk of ovarian cancer increases with age, and some women may opt for oophorectomy (ovarian removal) as a preventive strategy, especially if they have a strong family history of gynecological cancers.

Regarding follow-up care, if the ovaries are removed, your mother will no longer need Pap smears, as these are specifically designed to screen for cervical cancer. However, she should continue to have regular check-ups and discussions with her healthcare provider about her overall health and any symptoms she may experience.

In conclusion, the decision to remove the ovaries should be made collaboratively between your mother and her healthcare provider, taking into account her medical history, the current health of her ovaries, and her personal preferences regarding hormone replacement therapy and future health monitoring. If she chooses to keep her ovaries, regular monitoring and communication with her healthcare team will be essential to ensure her ongoing health and well-being.

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