Our Summary

This research paper reviews a preventative surgery known as Risk-reducing bilateral salpingo-oophorectomy (RRSO), which is offered to women with certain genetic mutations who are at a higher risk for breast or ovarian cancer. Even though this surgery can effectively reduce the risk of these cancers, it can also lead to physical, sexual, and mental stress, which can make deciding whether to have the surgery complex and confusing.

The communication between the patient and doctor plays a crucial role in this decision-making process and how the woman adjusts to life after the surgery. Despite its importance, there are not many studies that look at the mental and emotional impact of deciding to have this surgery, and the ones that do exist often lack a solid theoretical framework. Similarly, while some qualitative studies have looked at the role of communication between the patient and doctor, there is a lack of quantitative studies on the topic.

The authors of this paper reviewed various studies and literature on the topic using a multi-disciplinary approach. They presented an updated medical background for RRSO, analyzed the mental and emotional impact of deciding to have this surgery using a theoretical model called the Health Belief Model, and discussed the role of communication between the patient and doctor in this process. Based on their review, they also suggested some changes to existing clinical guidelines and pointed out areas that needed further research.

FAQs

  1. What is a risk-reducing bilateral salpingo-oophorectomy (RRSO) and who is it recommended for?
  2. What is the role of physician-patient communication (PPC) in the decision-making process for RRSO?
  3. What are some of the psychosocial impacts of undergoing a risk-reducing bilateral salpingo-oophorectomy (RRSO)?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss the potential physical and emotional impacts of the surgery with their healthcare provider before making a decision. It is important to be informed and prepared for the changes that may occur post-surgery, and to have a support system in place for recovery and adjustment. Additionally, open communication with your healthcare team throughout the decision-making process and after the surgery can help ensure a smoother experience and better outcomes.

Suitable For

Patients who are typically recommended salpingo-oophorectomy are premenopausal women carrying BRCA1 or BRCA2 mutations and presenting an increased risk of developing breast or ovarian cancer. This procedure is considered an effective prophylactic surgery for these high-risk individuals.

Timeline

Before Salpingo-Oophorectomy:

  1. Patient undergoes genetic testing to determine if they carry BRCA1 or BRCA2 mutations.
  2. Consultation with a healthcare provider to discuss the increased risk of developing breast or ovarian cancer.
  3. Decision-making process regarding whether to undergo risk-reducing bilateral salpingo-oophorectomy (RRSO).
  4. Pre-operative preparations, including physical and psychological evaluations.
  5. Surgery to remove both fallopian tubes and ovaries.

After Salpingo-Oophorectomy:

  1. Recovery period post-surgery, including physical healing and adjusting to hormonal changes.
  2. Follow-up appointments with healthcare providers to monitor for any complications.
  3. Psychosocial adjustment to the impact of the surgery on fertility, menopausal symptoms, and overall well-being.
  4. Continued communication with healthcare providers for ongoing support and management of any concerns related to the surgery.
  5. Long-term monitoring for any potential recurrence of cancer and overall health maintenance.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a salpingo-oophorectomy for my specific situation?
  2. How will this surgery impact my hormone levels and menopausal symptoms?
  3. What are the alternatives to salpingo-oophorectomy for reducing my risk of developing breast or ovarian cancer?
  4. How will this surgery affect my fertility and options for preserving fertility?
  5. What is the recommended follow-up care after undergoing a salpingo-oophorectomy?
  6. How will this surgery impact my physical and emotional well-being?
  7. What support resources are available to me before and after the surgery?
  8. How will my healthcare team work together to provide comprehensive care throughout this process?
  9. Are there any specific lifestyle changes or precautions I should take after undergoing a salpingo-oophorectomy?
  10. What are the long-term implications of undergoing this surgery in terms of cancer risk reduction and overall health?

Reference

Authors: Alves-Nogueira AC, Melo D, Carona C, Figueiredo-Dias M. Journal: Curr Oncol. 2023 Feb 17;30(2):2429-2440. doi: 10.3390/curroncol30020185. PMID: 36826146