Would you consider a prophylactic hysterectomy/oophorectomy?

[slyspyder]

I am 32 years old, have no children and have zero interest in ever having any.  My mother died at age 38 of ovarian cancer. My maternal grandmother has had uterine cancer (along with breast and others).  

Given this information, would you consider a prophylactic hysterectomy and oophorectomy?  I have considered it in the past, but have been thinking about it more lately. I recently have had a scare with a mass in my breast (significant breast cancer in family, too). I had one physician recommend a prophylactic bilateral mastectomy as well. I don't think I am even willing to consider that at this point, but the hysterectomy/oophorectomy has my attention.

What are your thoughts?

[ozhelen]

Thanks for your post. I have just been dx with BRCA1 mutation, so all the responses to your query were very helpful to me as I am myself facing the choice of oophorectomy or TAH (thanks all).
I would agree with gah_70's recommendation that you consider getting tested for genetic mutation due to your family history. I had much less family history, but what prompted my test was a first cousin who had BC in her 30s subsequently being tested positive.
I was reading in another post on this site (related to BRCA1 - can't remember which) that only 10% of OCs are genetic. If this is correct, and you find out you have a negative test, you may not need to worry so much? And if your test is positive, believe me, the stats on the risks are very compelling.

[gah_70]

There is some research you should look into regarding how hereditary OvCa/Breast Cancer is.  It is BRCA 1/2 testing.  OvCa is only 10% genetic, and 90% NOT.  BRCA testing is usually costly, though, and some insurances may not pay for it.  I am going to direct you to a link on research being done on this at M.D. Anderson in Houston.  It's called "Advanced-Stage Ovarian Cancer Patients with BRCA Live Longer, May Respond Better to Standard Treatment"  You can find it at:
  
http://www.mdanderson.org/departments/newsroom/display.cfm?id=6290B233-42E4-494B-98C40B6BF8B6CEC7&method=displayFull&pn=00c8a30f-c468-11d4-80fb00508b603a14

This may give you an idea about what your chances of developing either cancer may be.  When you speak with your physician, bring along the research you have done, along with your reasons for wanting it done.  A doctor will be more likely to take your wishes into consideration if he/she knows you are an active participant in your health.  Good luck with whichever option you choose.

Gail

[slyspyder]

Thank you for the opinions. I agree that it is a personal choice, but wanted to see what other angles people might look at the situation from. In response to chelan3, asking about what type of Dr. is recommending these things, it is an OB/GYN who is also a Phd who spent most of her career at an academic center, so she is a bit more liberal with thinking than some physicians are.  I am not returning to her and am going to see what my "new" OB thinks. It hasn't been decided what type of procedure I would have, so it likely wouldn't be a TAH, more likely a LAVH so the trauma would be less to the body.  

It is an  interesting point about not having symptoms if something would occur, though, because the parts are gone. Hadn't heard that angle before.  

Thanks again to everyone.....any other thoughts? I am always open to hearing other points of view.

[chelan3]

Although a TAH certainly reduces your risk, you still can get peritonial cancer and peritional cancer is pretty much always diagonsised stage 4.  If you haven't you might want to talk to a gyn-onc about this decision first - I'm not sure what type of dr is recommending the TAH.  Some women don't have many problems with menapause after a TAH even without hormones, but each women is different.  
I had a TAH at age 32 after a Stage 1 LMP Borderline ovca diagonosis and refused to take hormones and I'm doing ok.  My gyn recommended the hysterectomy a second opinion was 50-50 about it.  I chose the TAH.  I still wonder if I made the right decision, if mine comes back as aggressive ovarian/peritional cancer it will likely be advanced as there will be no signs like I had last time, since those parts are gone.  The CA125 was never a good marker for me.  
It's definititely a personal decision that shouldn't be taken lightly.  
Good luck with your decision.  

Debbie

[Jan214]

My mom died of this at 38 also.  I BEGGED my Drs to take everything out after I had my youngest daughter, but I was only 28 and they refused.  I wasn't having any more children and they knew my family history with this nitemare.  I would go for it now if I were you, but I would learn everything you could about bios first.  Menopause is no cake walk, but it is a walk in the park compared to having advanced cancer.  Good luck.  It is not an easy choice.
Jan

[survivor_susie]

Since this recommendation is coming from a doctor, insurance should cover it (please check into this.)  If I knew then what I know now, I'd have had a hysterectomy decades ago, after I was done having children.  I never dreamed I'd have ovarian cancer.

I'd say, go for it, girl!  Most of your friends and family *will* still recognize you without your uterus!  : )

Best of luck to you.

[msjazz]

I would do  now if you are sure you do not want children. I had no family history of ovca, and I have no children, but I do have stage 3c ovca. Best wishes,  Donna

[marie3B]

At age 35 it was recommended to me to have it done due to strong family hx of ovarian cancer.  I got other opinions that said it was too drastic.  Now I have late stage ovca in spite of regular check ups, CA125s and ultra sounds.  It is a personal decision, but I wish I had done it instead of waiting for diagnosis at 46.  Marie