BSO SURGERY

Dear Ktmc ~

Assuming that you are the one who has had your ovaries and fallopian tubes removed, am wondering just how thorough your testing was and why only the ovaries and fallopian tubes.  At age 36, I had my uterus removed, but not my ovaries and fallopian tubes.  Now at age 73, I found myself diagnosed with Peritoneal Carcinomatosis.  I had gone to the ER thinking I had a hernia because I felt a small knot on the left side of my abdomen just below the waist.  I had no previous pain but during that same week had experienced some abdominal discomfort and groin pain.  The CT scan revealed a cancer I had never heard of. 

I went to the University of Pittsburgh Medical Center (UPMC) for a second opinion and exploratory surgery.  There it was discovered that cancer was also in my ovaries.  So for treatment purposes, since Peritoneal and Ovarian Cancers are treated in a similar fashion, I have had multiple chemo treatments with Carboplatin/Paclitaxel (Taxol).  I’ve read that rarely does Peritoneal Cancer begin in the abdominal cavity but is usually the result from metastasis from another organ.  So I now believe that the cancer spread from my ovaries first.  Now almost 6 years later, my options for treatment are dwindling, because multiple treatments are lessening the time interval between a rapid rises in my CA-125 count. 

But I say all that to say this.  Not knowing the reason for the removal of your ovaries and fallopian tubes, I’m wondering if you have had a thorough testing for Peritoneal Cancer prior to having your ovaries and tubes removed.  I’ve included a reference below just for info for others who are contemplating the same type of surgery in the future. 

For me, I first underwent chemotherapy, and then Cytoreductive Surgery in which my ovaries, tubes, spleen, gallbladder, omentum and sections of my intestines were removed.  Since that time I have had multiple treatments of chemo, plus targeted radiation to remove 3 cancerous nodes on the caudate lobe of my Liver.  Other problems have come along since then, but no need to elaborate on everything.  Am just saying that if you are the patient, and now find yourself with cancer in the Peritoneal space, just wondering if you’ve been thoroughly tested.

These were just questions that came to mind when I read your letter this morning.  So actually within a period of 3 weeks, after my first and second diagnosis, cancer was found to be both in my ovaries as well as in my Peritoneal cavity.  Just wondering, could it be that actually that cancer was already present when you had the ovaries and tubes removed and just wasn’t discovered at that time?  Have you been told that cancer has now been found to be in your Peritoneal space?

So I just thought I would share how it all began for me.

Love Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV first DX in November of 2012

_____________________________________________________________ 

1.     http://www.med.umich.edu/1libr/Gyn/BSO.pdf

“What is a Laparoscopic Bilateral Salpingo-Oophorectomy? This is a surgery where your doctor uses a thin, lighted camera and small surgical tool placed through a small (1/2 inch) incision usually in the belly button, to remove both of your ovaries and fallopian tubes. To help with the surgery, two to three other small incisions will be made on the lower abdomen.

 Why is this surgery used? If you: • are at high risk for ovarian cancer. • have certain types of breast cancer. • have certain types of ovarian masses or cysts…”

______________________________________________________ 

2.     https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/stages-and-grades

“…Staging is a way of describing where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body…”

_________________________________________________  

3.     https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq

Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)–Patient Version

_________________________________ 

 4.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999166/

 “Peritoneal carcinosis of ovarian origin

Epithelial ovarian cancer (EOC) is the second most common genital malignancy in women and is the most lethal gynecological malignancy, with an estimated five-year survival rate of 39%. Despite efforts to develop an effective ovarian cancer screening method, 60% of patients still present with advanced disease. Comprehensive management using surgical cytoreduction to decrease the tumor load to a minimum, and intraperitoneal chemotherapy to eliminate microscopic disease on peritoneal surface, has the potential to greatly improve quality of life and to have an impact on survival in ovarian cancer patients. Despite achieving clinical remission after completion of initial treatment, most patients (60%) with advanced EOC will ultimately develop recurrent disease or show drug resistance; the eventual rate of curability is less than 30%. Given the poor outcome of women with advanced EOC, it is imperative to continue to explore novel therapies…”

_____________________End of References________________