possible oopherectomy

Is ovarian cancer one of the cancers this genetic mutation predisposes you to? And have you ever had periods or other signs of ovulation while on Zoladex?

If not, I think you are fine to continue with ovarian suppression and not have the ooph until you feel 100 percent certain about it.

I am also Stage IV hormone positive, will be 31 at the end of the month and have tested for a variant of unknown significance for a mutation that increase risk for small cell ovarian cancer (I know that's very different from testing positive). But I'm keeping the ovaries until I either find an alternative way to have children ie surrogacy or adoption or until I fully make peace with not having children.

I know ILC likes to go to the ovaries but if you already have lung mets, how big a deal would the risk of ovarian mets be?

I really think for women as young as ourselves, the psychological aspect of removing the ovaries should not be ignored. If ovarian suppression is working, why pile on extra heartbreak? Besides, cancer treatment is getting better all the time and we might see the day when our disease can be controlled well enough that we can have babies. But once the ovaries are gone, they can't exactly be put back in, you know???

Hi Melp,

I was diagnosed with breast cancer at 34 and recurrence within a few months. Because I was premenopausal and have a genetic condition that predisposes me to many cancers (Peutz-Jeghers syndrome), I considered having my ovaries out because my breast cancer was hormone positive.

If I'd had cancer there, I certainly would have. But when I got a large ovarian tumor at 39, I chose to keep one scrap of one ovary, just because I didn't want more menopause on top of everything else right then. And my breast cancer was hormone negative then.

You are in a different place, because you still want your own biological children, even if there's a risk of passing on your genetic condition to them.

There is no easy or right answer for anyone, especially because you have a variety of needs - to stay alive, to lower cancer burden in your body, to possibly bear your own biological children, but not pass on the mutation. You may also think that removing your ovaries would be easier on your body than ovarian suppression through drugs.

In the old days, ovarian removal in pre-menopausal women with hormone positive cancer was quite usual. Now it's done with drugs.

What about talking this through with a genetic counselor? Mine really helped me decide to keep my scrap of ovary, in spite of the opinions of my gynecological oncologist's opinion and medical oncologist. They so greatly respect informed consent and freedom of choice.

Sending a warm hug from California, Stephanie

Hi Melp,

Yes, a consult with a specialist gynecologist is wise...and if you decide to have the surgery, do engage the gyn-onc for it.

If you have ovarian, reproductive tract or abdominal cancerous involvement, there are specialized surgical techniques for debulking disease from the region that they can do. An average gynecologist, maybe not so much.

I didn't mention this, but it's possible to bank your eggs before surgery to be used in assisted reproduction later. Even if you can't carry a child in your own womb (maybe not so wise because pregnancy hormones affect breast cancer behavior?), you could consider having a surrogate carry your biological child. It might not be your first choice and maybe not available in Australia, but it's common for women with cancer in the States.

Just a thought and something else to consider before losing your ovaries.

warm healing loving kindness, Stephanie