WOMENS-HEALTH Messages for August, 1999: Re: Ovarian Cancer--questions

Re: Ovarian Cancer--questions

From: dr. (anonymous@obgyn.net)
Sun, 8 Aug 1999 10:22:53 -0500 (CDT)

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In reply to: Leslie: "Ovarian Cancer--questions"

At Fri, 6 Aug 1999, Leslie wrote: >My Mom was diagnosed at the age of 43 (1988) with either Stage III or IV
>Ovarian Cancer. She has since passed away (age 48.) I have written down
>that she had a "Brenner Tumor" also "Papillary Adenocarcinoma"
>"Moderately Differential."
>I am 34 years old now and wondering about a preventative Hysterectomy. I
>had always said I would do it when I was 35, but now that the time is so
>close I am just trying to sort through the pro's and con's of such a
>decision.
>
>I am the Mother of one child (she's 4) who has been on Clomid treatments
>(once to conceive my daughter, and about 9 cycles in the last 2 1/2
>years). I have also undergone Lupron Depot treatment for Endometriosis
>(1993) and been on the B/C pill maybe a total of 2 years my adult life.
>My Maternal Grandmother passed away before I was born at the age of 52
>from complications with Breast Cancer and an un-named abdominal cancer.
>
>I was just wondering with the information that I am offering you if you
>have any additional information you could offer me? I do get CA-125
>tests and Trans-Vaginal U/S just about yearly. Thank you very much!
>
>Is there genetic tesing one can have done?

Dear Leslie,

Compared to patients without affected relative, patients with 2 or 3 affected relative do have a greater chance of getting ovarian cancer (about 7%). Therefore, some experts suggested prophylactic oophorectomy for a woman with a hereditary ovarian cancer syndrome. But, the fact that ONLY 3% of women with two affected relatives ACTUALLY have an inherited susceptibility for ovarian cancer, had made some experts disagree with prophylactic oophorectomy.

Seeing your parity status, prior exposure to clomiphene citrate (Clomid), and your family history, I think you'd better have prophylactic oophorectomy plus hysterectomy (considering your fibroid). However, you need to understand that although prophylactic oophorectomy is presently the only effective method of ovarian cancer prevention, there have been case reports of patients with hereditary ovarian cancer syndromes who have undergone prophylactic oophorectomy and subsequently developed peritoneal carcinomatosis similar to that seen with ovarian cancer. The exact mechanism is unknown, but the most accepted explanation is that, in certain patients, the entire peritoneum is at risk of malignant transformation, and removal of the ovaries does not eliminate this risk. You also need to understand the importance of compliance with hormonal replacement therapy to reduce your risk of cardiovascular disease and osteoporosis.

Next message: Jade: "Pap Smear"
Previous message: Alice: "Fibroid options"
In reply to: Leslie: "Ovarian Cancer--questions"

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