Oophorectomy and Bone Health
by Drea Thew
For women at high genetic risk of ovarian cancer, oophorectomy— surgical removal of the ovaries and fallopian tubes—before ovarian cancer is diagnosed can lower risk by at least 80 percent. In premenopausal women, however, oophorectomy greatly reduces estrogen production, which can lead to one loss.
Some degree of bone thinning occurs naturally as we age. Health care providers categorize the results of bone density tests as “normal,” “osteopenia” or “osteoporosis” when compared to others of the same age and gender. Osteopenia refers to a loss of bone mass that falls below normal levels. It is not sufficiently severe to be considered osteoporosis, a condition characterized by porous, brittle bones that may easily fracture. Left untreated, osteopenia can lead to osteoporosis. Health care providers often recommend a baseline bone density test before prophylactic oophorectomy or soon after, with annual or biennial follow-up after menopause.
The Gynecologic Oncology Group (GOG) is sponsoring the multi center GOG-0215 clinical trial to study whether a medication called zoledronic acid (Zometa®) can reduce bone loss in women who have risk-reducing oophorectomy. Participants will be randomized to two groups. Both groups will take calcium and vitamin D supplements, give blood samples, and undergo bone density testing. In addition, one group will receive an intravenous injection of Zometa® every six months for a total of three treatments.
Eligible study participants must be at least 30 years old, have genetic risk of ovarian cancer, plan to have a prophylactic oophorectomy, and must not be taking certain medications, including hormones and bisphosphonates (such as Fosamax®). The study is open to women who have never had cancer and those who have previously been diagnosed.
Possible risks (such as side effects from Zometa®) and possible benefits (such as free bone-density screening) of participating in this study should be assessed and discussed with a primary physician before enrolling. The information gained about bone loss in women undergoing early surgical menopause may well help high-risk women make informed choices in the future.
For more information on GOG-0215, please visit the study website.
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