Why do doctors differ so much?

tangandchris

I've noticed here and even with my doctors that there are different approaches to whether premenopausal women with hormone positive cancer should have oopherectomy. I was told by on MO that standard of care was not surgery, now my new MO says yes it can be done. Gynecologist says yes without hesitation. What's the deal on this?

rozem

I wish I knew this as well...I know that it depends on patient history but why 2 doctors are telling you 2 different things I have no idea. Are you at the same center? sometimes different centers have different protocols. I find younger doctors are also more willing to adopt the latest findings whereas older doctors want to see more studies, hard evidence etc before making recommendations

I hope someone else has more to add

WinningSoFar

I suppose you could say that the differences in opinion means there is no clear evidence either way. I had my ovaries out though after my preventative care doc said 'at least that is one place where you no longer can get cancer'. That convinced me.

SummerAngel

When I stopped Tamoxifen my MO offered me the option of oopherectomy or ovarian suppression plus an AI. He told me that he didn't think my body would be very pleased with that, though, considering the terrible SEs I had on Tamoxifen. He also didn't push it and said he supported my decision to not do anything more because my chances of recurrence are low. I think some of it is the doctor's personal opinion, some of it is whether the risk of recurrence is low or high.

tangandchris

It's frustrating and is another example of how much uncertainty is involved with this. Both MO's are with the same center, Texas Oncology is really all we have in this area. I went to 2 different gynos who said I should do surgery. I'm certain that I do have a high rate of recorrance given my staging so maybe this does come into play. It's just that I would think this part would be more standard ya know? My 2nd and current MO did tell me that they performed oopherectomy in Europe for BC in years past.

lisa-e

tangandchri, you should remember that gyns will make money if you have your ovaries removed. On the other hand, performing an oopherectomy is not that uncommon when treating estrogen positive breast cancer. My oncologist said I could either take a drug to suppress ovarian function or have my ovaries out so I could take an AI, as an alternative to taking tamoxifen. I decided to put up with the tamoxifen side effects.

I don't know if your stage has that much to do with the recommendations. I would ask your onc.

coraleliz

Sometimes it's frustrating & sometimes I'm glad I have options.

It's seems like whatever I do(or can do) , both medically & lifestyle changes can only help "a little". At least at this point in time for me. My guess is that an oopherectomy will only decrease your chances of a reoccurence by a small amount. Ask your doctors what that number is. I didn't consider an ooph because I think people often take the risks of surgery to lightly.

ShetlandPony

When I was looking into this question, all three medical oncologists recommended just drugs, and all three gynecologists recommended surgery. Now the SOFT trial results do offer some guidance on this question. When the standard of care allows different options, you need an oncologist you have faith in.