Dr. Lu on the Challenges of Risk-Reducing Salpingo-Oophorectomy in Ovarian Cancer

Karen H. Lu, MD, professor and chair in the Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center discusses the challenges of risk-reducing salpingo-oophorectomy in women with an increased risk for hereditary ovarian cancer.

The biggest challenge with risk-reducing salpingo-oophorectomy, Lu explains, is that BRCA1 patients in their mid- to late-30s and BRCA2 patients in their early-40s are being asked to undergo menopause 10 to 15 years earlier than they would normally experience it. Even with hormone replacement therapy, there still are significant changes made to their lives with these procedures. However, clinicians educate patients on all options, and explain that these procedures are still being evaluated with regards to efficacy and safety, Lu says.

In the prospective, nonrandomized, multicenter WISP study, this patient population at high risk for ovarian cancer chose either salpingectomy with delayed oophorectomy or risk-reducing salpingo-oophorectomy, and completed questionnaires at baseline and at 6 months. Patient-reported results showed that those who underwent either procedure had a significant decrease in cancer distress. However, those who had chosen risk-reducing salpingo-oophorectomy had a significant worsening of menopausal symptoms and an increase in decision regret compared with patients who underwent salpingectomy with delayed oophorectomy.

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