Patients with an elevated risk of ovarian, fallopian tube or uterine cancer may consider undergoing risk-reducing surgery (removal of the ovaries and tubes, or of the ovaries, tubes and uterus) to minimise their risk of developing gynaecological cancer.
Patients with a strong family or personal history of breast and/or ovarian cancer, particularly in close relatives or multiple family members, will also have an elevated risk, and after appropriate review and counseling, may consider risk-reducing surgery.
Women who are found to have a high risk of gynaecological cancer due to hereditary mutations in genes (eg: BRCA 1 / 2, Lynch Syndrome) may be recommended to undergo risk reducing surgery by the Hereditary Cancer team.
Risk-reducing salpingo-oophorectomy (RRSO) is a surgical procedure that includes the complete removal of both fallopian tubes and ovaries. RRSO provides a substantial reduction in the risk of developing ovarian and fallopian tube cancers in women with a BRCA1/2 gene mutation. This surgery is almost always performed with a laparoscope (keyhole) and has proven to be the single biggest factor in reducing the risk of progression to develop these cancers. It may also reduce the risk of breast cancer, particularly in younger women.
In women with Lynch syndrome, the increased risk of uterine cancer in addition to ovarian cancer means that a hysterectomy (removal of the uterus) is also necessary. Again, this can almost always be performed with keyhole surgery.
The lack of a good screening test and the silent nature of ovarian cancer in early stages are driving forces for this rationale of risk-reducing surgery.
Dr Farrell works closely with the Hereditary Cancer Clinic at Prince of Wales, St George and Wollongong Hospitals to ensure that you have the best standards of counseling and advice about your risk of developing gynaecological cancer, prior to your decision to undergo risk-reducing surgery.
Dr Farrell will also discuss in detail the benefits and risks of this surgery to your overall health and well-being. She is experienced in managing the possible side-effects such as menopausal symptoms and long-term effects of this surgery, particularly in younger women.