Treatment Options

Prophylactic Oophorectomy

Moderate Value

Prophylactic oophorectomy is the surgical removal of the ovaries in an attempt to significantly reduce the risk of ovarian cancer. In addition, it can reduce the risk of breast cancer if performed before menopause by decreasing estrogen in the body. The surgery is performed through three or four small incisions in the lower abdomen. The ovaries and the fallopian tubes, which are also susceptible to cancer, are removed with special instruments through a small scope. This procedure does not usually require an over-night stay in the hospital.

Before making a decision regarding this surgery, you need to talk with your health care provider to learn about your actual risk of developing ovarian and breast cancer. Determine the type of surgical or treatment options available to you as well as the advantages and the disadvantages of each option. You need to know the physical and emotional consequences of your decision. If you decide to have the prophylactic oophorectomy, you need to prepare for the assistance you will require while recovering from the surgery.

 

Things to Consider

  • Only women with a very high risk of ovarian or breast cancer due to a personal history, a high-risk family history or abnormal genes known as BRCA1 or BRCA2 should consider prophylactic oophorectomy.
  • Prophylactic oophorectomy results in an inability to become pregnant.
  • Women 35 years of age or older who have completed their families are the best candidates for this surgery.
  • Ovarian cancer is much more difficult than breast cancer to detect and treat at an early stage.

Results

Moderate Value

Will I live longer if I have this procedure?

I If you have a very high risk of ovarian cancer, the prophylactic oophorectomy may dramatically reduce your risk of ovarian cancer. If you are premenopausal, the prophylactic oophorectomy may also reduce your risk of breast cancer. It will not guarantee that you will never get ovarian or breast cancer.

Will prophylactic oophorectomy improve my quality of life?

Removal of your ovaries may reduce the feelings of risk and fear of ovarian or breast cancer. After the oophorectomy, some women regret the inability to become pregnant. Prophylactic oophorectomy may lead to an early onset of menopause. The symptoms of menopause could include osteoporosis or bone thinning, hot flashes, vaginal dryness, sexual problems, and sleep disturbances.

Will prophylactic oophorectomy make my symptoms better?

Prophylactic oophorectomy would take place before the development of symptoms of ovarian or breast cancer.

Safety

Moderate Value

How safe is this procedure?

Oophorectomies are generally safe and free of complications, however any surgical procedure involves some risks and may result in complications or death.

Minor reported complications:

  • Minor pain

Major reported complications:

  • Infection
  • Injury to internal organs
  • Intestinal blockage
  • Severe pain

Comparison

Moderate Value

Women who want to aggressively deal with their risk of ovarian cancer may choose prophylactic surgery. For women who want to be less aggressive, there are alternative treatments. No matter what the choice, a woman with BRCA1 or BRCA2 gene abnormality should follow closely with her health care specialist and discuss their best screening plan.

Alternative treatments include:

  • Watch and wait

Preventative measures that have been associated with a reduced risk of ovarian cancer in high-risk women include the following:

  • Avoidance of estrogen
  • Avoidance of smoking
  • Birth control pills
  • Delivery of one or more children and breast feeding for at least one year
  • Healthy diet and life style
  • Hysterectomy
  • Limited alcohol intake
  • Regular exercise
  • Tubal ligation (cut or seal the fallopian tubes)
  • Weight control

Cost

Moderate Value

The appropriate cost for prophylactic oophorectomy including the physician and facility charges is over $7,000. The costs could vary depending on the physician, the facility, the geographic location, as well as any special needs or complications that you may experience.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

American Cancer Society. (2013, March). Ovarian cancer. Retrieved January 9, 2014 from http://www.cancer.org/Cancer/OvarianCancer/DetailedGuide/ovarian-cancer-prevention.

Mayo Clinic. (2011, April). Prophylactic oophorectomy: Preventing cancer by surgically removing your ovaries.  Retrieved January 9, 2014 from http://www.mayoclinic.com/health/breast-cancer/WO00095.

National Cancer Institute. (2013, December). Ovarian cancer prevention. Retrieved January 9, 2014 from http://www.cancer.gov/cancertopics/pdq/prevention/ovarian/Patient/page2.

Next Review Date

1/23/2015

This document has been classified as public information.

Table of Findings

results:  moderate value

safety:  moderate value

comparison:  moderate value

cost: moderate value


total: moderate value

legend

scale

Page modified:January 31, 2014