To or Not To have surgery, this is the question
Hello All
I really need some help and guidance. I have a high maternal family history of multiple cancers. My mother past May 2012 from ovarian CA after a few months of being diagnosed. We also have close family members with breast, liver, colon, prostate, leukemia, lung and stomach cancers all on my mother's side. With this being said, I had brac testing Nov 14th and am waiting for my results. I have been followed by a gyn/onc because of my mom's history as well of my own history of uterine fibroids, polycystic ovarian syndrome with painful heavy irregular cycles (when I have them) and pelvic pain. So far my biopsies all have been negitve.
I have been advised to have a prophylatic salpingo-oophorectomy (removal of both tubes & ovaries) even without the test results because I am at high risk according to my onc/gyn, my regular gyn, and the geneticist. It is recommended for me to have them removed before I enter menopause. It will decrease my risk of both ovarian and breast CA to less than 3% but it puts me in higher risk of heart disease. Well I do not have any children. My husband's viewpoint is that everything can be fixed with diet and exercise. My father passed from heart disease and my mother from ovarian cancer 20 months apart. Heart disease runs heavy on my father's side while cancer runs heavy on my mom's side. I get my transvag ultra sound every 3 months. I am not a fan of surgery because I have had 2 laps when my ovarian cysts ruptured. I also do not want to die
So what should I do?
Thanks in Advance
Babyg1rl
Comments
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Hello Babyg1rl
I would wait for the results of BRCA testing. If you are BRCA positive, close to menopausal age and don't have plans to have children, have your ovaries and fallopian tubes (maybe uterus too) removed asap to significantly reduce your risk of ovarian (and uterine) cancer. Your risk of breast cancer will be reduced by 50%, but still rather high unless you have prophilactic mastectomy. You could manage BC risk with frequent breast exams, mammo and MRI.
If your BRCA test comes back negative, your probablity of getting ovarian cancer is the same as general population (very low). If you don't want to keep thinking about it and driving yourself crazy, get the surgery anyways. Transvaginal ultrasound is not the best tool to diagnose ovarian cancer. In my case it took 6 weeks from a 2mm ovarian cyst on the ultrasound till full-blown stage 3C metastasized ovarian cancer caught by the CT scan. But keep in mind that surgical menopause is much more severe than natural one; overnight you will be faced with hot flashes, night sweats, mood swings, vaginal dryness and other lovely side effects of no estrogen. I don't know much about heart disease, but I'm sure there are ways to manage this risk too, maybe with low-dose Aspirin, watching your blood pressure and cholesterol or your husband's favorites - diet and excercise.
Check out website http://www.hystersisters.com/, they have a lot of discussions and useful info.
Good luck with your decision and best regards,
Alexandra
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