Tag Archives: HRT

Saying NOPE to Ovarian Cancer too

A week after my prophylactic bilateral salpingo-oophorectomy (BSO) and total hysterectomy, I’m happy to report that I also said NOPE to ovarian cancer .. and uterine cancer and cervical cancer.

When my then-28-year-old sister was diagnosed with aggressive breast cancer in 2001, and died less than a year later, my world was rocked, but I had no idea just how rocky it would get. Since then there have been countless doctor’s visits, screenings, blood tests, anxious days and nights, and a few (!) surgeries. We’ve lost not only my sister, but my mom too, who was diagnosed with late-stage ovarian cancer and died in a year. 20 years later, I feel like I can finally breathe easier, like I’ve exhausted all the options available to me to greatly reduce my own risk of developing hereditary breast and ovarian cancer (HBOC).

I already made a decision to take some kind of action at 40. There were many options to be weighed and paths I could take. There’s an overwhelming amount of resources related to ovarian cancer testing, screening, treatment, and risk-reducing surgeries. Some are informative, others are eye-opening, and there are those that are terrifying. There were multiple questions to be answered if I was to move forward the surgical route:

  • QuestionDo we take out both ovaries? Or just one and both fallopian tubes?
  • If two ovaries, will I use hormone replacement therapy (HRT) after?
  • Should I also give the boot to my uterus?
  • And if yes, what about the cervix?

In consulting with my husband, doctors and surgeons, including the gynecologic oncologist I have been seeing for years, we came to a decision and scheduled the surgery. On July 15, 2021 I underwent a procedure that removed both my ovaries and fallopian tubes as well as my whole uterus, including the cervix (so all of the above!). It was a robotic-assisted surgery, using the da Vinci system.

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Artist: jcorres (redbubble.com)

It was a quick outpatient procedure, so I went home same day with four tiny incisions and an HRT patch. Since my surgery did include removal of ovaries, HRT will keep surgical menopause at bay. It delivers .1 mg/day of bio-identical estrogen. I’m only one week post-op, but so far so good – zero hot flashes to report! My body is still in shock, I think, and it may not all be peachy down the road, but I’ll deal as it comes. The recovery is not exactly a breeze (OMG, the gas pains!), but doesn’t even compare to that of the mastectomy, which was rough and long. I’m already off narcotics and back to doing some mobility workouts (easy peasy to start).

What’s next?

Over the coming days/months/years I will continue to visit my gynecologic oncologist for regular exams. We will work together to plan for the future and adjust as needed. And of course: eat healthy, exercise and meditate regularly, live clean, wear sunblock, and lay off the booze! At this point, I have some peace-of-mind in taking another step towards reducing my risk of the gynecological cancers that have affected my family. I’m doing what I can to say NOPE to breast and ovarian cancer!

FORCE Conference, BSO, HRT, and more

This past weekend, I attended the 9th Annual Joining FORCEs Against Hereditary Breast and Ovarian Cancer Conference in Philadelphia. This is the only event of its kind; created by and for the members of the HBOC community. To say that this event was awesome is a gross understatement. It was an amazing weekend packed with relevant content and activities.

Leading researchers and experts in related fields presented on latest research. I learned about newest options for cancer screening and prevention. Most interesting to me were the sessions related to ovarian cancer, since I am currently considering a risk-reducing bilateral salpingo-oophorectomy (BSO).

My personal takeaways on the topic of Ovarian Cancer: Early Detection and Prevention, presented by Dr. Beth Karlan, Cedars-Sinai (slides):

  • Taking tubes only (salpingectomy) and sparing the ovaries is a reasonable intermediate step for younger women (I’m 34). It is still recommended to remove the ovaries in natural menopausal age (early 50s).
  • Taking one ovary does not change age of menopause.
  • In general, there is no need to remove uterus at time of BSO or salpingectomy alone, based on current info and this varies by individual.

The tube-only and one ovary option is very attractive to me at this point. However, if I choose the BSO, surgical menopause will very shortly follow, so I also attended a session about Managing Menopause Without Hormones by Dr. Ann Steiner, Penn (slides) and Dr. Diljeet Singh, Permanente (slides). If you’ve been reading my blog for a bit, you may have noticed that I maintain a plant-based lifestyle and stay away from processed or synthetic products. When it comes to managing menopause symptoms with hormone replacement therapy (HRT), I am hesitant. I understand there are bio-identical hormones available and Premarin is an option, but I am uncomfortable with the idea of any HRT, because essentially I will be introducing something my body didn’t produce itself naturally/synthetic. After this great session about other options for managing symptoms, I stuck around to ask each of these experts their opinion on HRT for someone like me, who will need to be on it for 10+ years. Would they recommend HRT to manage long-term issues (osteoporosis, heart disease, loss of cognitive function, etc.) or can these symptoms be successfully managed without HRT? I didn’t get a clear answer and the advice was conflicting, so the jury is still out. If I choose to spare an ovary or both, this will be a non-issue, but nonetheless it was great to learn about the non-HRT options.

I will be discussing this topic again with my gyn onc in October, when it is time for my bi-annual screening (TVU and CA-125). At this time, I know I will be having some risk-reducing surgery in the future, but have not yet decided which type and when.

dinnerOne of tbeBRCAwarehe other awesome things about the conference is that many other women (and men) from our relatively small HBOC community attend (650 this year), so it’s an opportunity to finally meet in-person some individuals I’ve been chatting with online. Also, got a chance to catch up with those that were there last year. Loved spending time with my FORCE buds!

And lastly, THANK YOU FOR YOUR SUPPORT to all those that came to visit nope2BC and bought jewelry. All the proceeds are donated to FORCE and with your help, we raised a lot of money! Hope you enjoy your pieces.

Will you join us next year? The 10th Annual Joining FORCEs Against Hereditary Breast and Ovarian Cancer Conference will take place in Orlando, FL, October 6-8, 2016. I’ll be there!

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