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Quality of Life After Prophylactic Oophorectomy

Principal Investigator: DALY, MARY B
Institution Receiving Award: FOX CHASE CANCER CENTER
Program: OCRP
Proposal Number: OC990156
Award Number: DAMD17-00-1-0568
Funding Mechanism: Idea Award
Partnering Awards:
Award Amount: $490,753.00


PUBLIC ABSTRACT

Ovarian cancer continues to be the number one cause of death from gynecologic cancer in the United States. Over 14,500 women die from the disease each year. Over the past 10 years, both the number of new cases and the number of deaths have shown a consistent rise. Because ovarian cancer is difficult to diagnose in the early stages, most patients are diagnosed with advanced disease when the chances of being cured are much lower. Researchers have identified a number of risk factors that may increase a woman¿s chance of developing ovarian cancer. Among them, it is clear that a family history of ovarian cancer, often in combination with breast cancer, significantly increases a woman¿s risk for the disease. Recently, medical research has been focusing on genetic causes of cancer. Scientists have found two genes related to ovarian and breast cancer. Alterations or mutations in these genes appear to be associated with a hereditary pattern of ovarian cancer, and now that we know the locations of these genes, it is possible to test individuals to see if they are carrying an altered form of one of the genes. Women are increasingly seeking information and counseling regarding their risk for ovarian cancer and the management options available to them. Because effective methods for early detection are so limited, primary prevention options have become more important. Primary prevention is an attempt to avoid cancer before it occurs. A primary preventive choice being considered by increasing numbers of women is surgical removal of healthy ovaries, or prophylactic oophorectomy. This procedure now can be performed laparoscopically, which reduces surgical complications. This new procedure removes the ovaries through tiny incisions with the use of a tool called a laparoscope. Past research studies have suggested a significant reduction in risk of ovarian cancer, particularly in premenopausal women, who have had their ovaries removed. However, many unresolved issues related to the use of surgical removal of both ovaries as an option to prevent ovarian cancer remain. The surgical removal of both ovaries will cause an abrupt and often severe menopause. There is very little information on the effects of early surgical menopause or on the role of estrogen replacement among women who have a genetic predisposition to breast and ovarian cancer, or on the emotional repercussions following surgery. Also, there is not much known about the health-related behaviors and psychological well-being of women who, faced with an increased risk of ovarian cancer, make the decision not to surgically remove their ovaries. Alternative and/or complementary coping strategies used by women dealing with a risk of ovarian cancer have never been reported. This pilot study is designed to begin to understand the complex process experienced by women in this situation in order to be able to address their needs and to help them as they face difficult choices for reducing their risk for ovarian cancer.