New Strategies in Ovarian Cancer: Uptake and Experience of Women at High Risk of Ovarian Cancer Who Are Considering Risk-Reducing Salpingo-Oophorectomy

Abstract

This paper reviews factors associated with uptake of risk-reducing salpingo-oophorectomy by women at increased hereditary risk for ovarian cancer, as well as quality of life issues following surgery. Forty one research studies identified through PubMed and PsychInfo met inclusion criteria. Older age, having had children, a family history of ovarian cancer, a personal history of breast cancer, prophylactic mastectomy, and BRCA1/2 mutation carrier status increase the likelihood of undergoing surgery. Psychosocial variables predictive of surgery uptake include greater perceived risk of ovarian cancer and cancer-related anxiety. Most women report satisfaction with their decision to undergo surgery and both lower perceived ovarian cancer risk and less cancer-related anxiety as benefits. Hormonal deprivation is the main disadvantage reported, particularly by premenopausal women who are not on hormonal replacement therapy (HRT). The evidence is mixed regarding satisfaction with the level of information provided prior to surgery, although generally women report receiving insufficient information regarding the pros and cons of HRT. These findings indicate that when designing decision aids, demographic, medical history, and psychosocial variables need to be addressed in order to facilitate quality decision making.

Factors Associated with Altered Long-Term Well-Being After Prophylactic Salpingo-Oophorectomy Among Women at Increased Hereditary Risk for Breast and Ovarian Cancer

“…Likewise, the anxiety level appeared to be reasonably low. This is in line with previous reports in such populations of women who opted for prophylactic surgery [5,[13][14][15]. However, this population appeared to have high endocrine symptom scores and lower sexual functioning.…”

“…However, this population appeared to have high endocrine symptom scores and lower sexual functioning. This has also been more or less described in other publications [5,7,8,15,16].…”

Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer

“…A growing body of literature has become available on the socio-demographic and family history factors predicting uptake of RRSO [21]. However, surprisingly few studies have incorporated an assessment of women's psychological characteristics as potential determinants of decision-making about RRSO.…”

Looking different, feeling different: women’s reactions to risk-reducing breast and ovarian surgery

“…A number of studies that have investigated the psychosocial sequelae of RR surgery suggest these procedures are associated with a decrease in cancer anxiety [15][16][17]. However, while many women who have RRM plus breast reconstruction are pleased with the appearance of their new breasts [18][19][20], some experience ongoing complications following reconstructive surgery [21,22]; are unhappy with the cosmetic result, particularly the lack of sensation in their breasts [22][23][24]; and report a negative impact upon sexual functioning [15,22,25,26].…”