Preventative surgeries are rare and only the highest risk people typically consider elective surgeries for disease prevention. However, with celebrities like Angelina Jolie, Kelly Osbourne, and Christina Applegate opening up about their choices surrounding preventative surgery, the idea that surgery could be used for more than curing diseases is being brought to the public eye.
Preventative surgery typically removes certain organs or tissues in order to reduce the risk of disease, like cancer. Although, it is important to remember that preventative surgery does not eliminate cancer risk – it decreases cancer risk. Depending on the risk of different types of cancer, some people make the decision to undergo multiple surgeries.
Deciding whether or not to undergo a preventative surgery is a highly personal choice. Surgery may or may not be right for you depending on your family history, lifestyle and personal beliefs. You can discuss whether or not preventative surgery may be an option for you with your healthcare provider and if you choose to undergo preventative surgery, you can learn about how to prepare yourself.
A mastectomy is the removal of the breast tissue from one breast (called a unilateral mastectomy) or both breasts (called a bilateral mastectomy). This procedure is used to prevent or treat breast cancer.
Preventative mastectomy, called a prophylactic mastectomy, is typically only considered an option in women with a very high risk of breast cancer. Women with a high risk of breast cancer may have a very strong family history of cancer or a known genetic predisposition, like an inherited DNA change in the BRCA1 or BRCA2 gene. In these high-risk women, prophylactic mastectomy can help reduce the risk of breast cancer by as much as 90%.
Oophorectomy is a procedure to remove one or more ovaries, the organs in a woman’s body that secrete hormones and contain eggs. Similar to a mastectomy, an oophorectomy can remove one ovary (unilateral oophorectomy) or both ovaries (bilateral oophorectomy) and is used to treat or prevent ovarian cancer.
A prophylactic oophorectomy reduces the risk of ovarian cancer, but is typically only performed in women with a substantial risk of ovarian cancer, such as those who have a DNA variant in the BRCA1 or BRCA2 gene. In these women, prophylactic oophorectomy can reduce the risk of ovarian cancer by as much as 80-90%.
The decision about whether or not to undergo oophorectomy is complex. If possible, many women choose to wait until they finish having children to have an oophorectomy. In addition, your ovaries produce many different hormones, and removing the ovaries dramatically decreases the body’s supply of estrogen and progesterone. Oophorectomy can induce sudden menopause in women who have yet to go through menopause.
A salpingo-oophorectomy is the removal of both the ovaries and the fallopian tubes. Some who have an increased risk of cancer choose to remove their fallopian tubes in addition to removing their ovaries in order to reduce their risk of cancer even more.
Phrophylactic salpingo-oophorectomy not only reduces the risk of ovarian and fallopian tube cancer, it also reduces the risk of breast cancer. In women with a BRCA1 or BRCA2 variant, one study estimated that removing the ovaries and fallopian tubes reduced the risk of breast cancer by 53%.
Hysterectomy is the removal of the uterus. It is used to treat many different conditions, including uterine fibroids, endometriosis, gynecologic cancer, and other problems and is a very common surgery among US women.
Prophylactic hysterectomy however is somewhat rare and is recommended in women with a high risk of endometrial (uterine) cancer. Women who have a genetic variant that causes a rare disease called Lynch syndrome have an increased risk of colon, uterine and ovarian cancer. Prophylactic hysterectomy can reduce the risk of uterine cancer in women with this disease.
A colectomy is the removal of the colon (large intestine). Colectomy can remove all (total colectomy) or part of the colon (partial colectomy) and can be used to treat colorectal cancer in patients who are already diagnosed, treat other diseases of the colon, or prevent colon cancer in people with a very high risk.
There are several different inherited cancer syndromes that increase the risk of colorectal cancer. Familial adenomatous polyposis, Lynch syndrome and other diseases are rare, but increase the risk of colorectal cancer in people who have these conditions. Although preventative colectomy is a dramatic procedure, it may be an option in certain very high-risk patients.
TapGenes Take Away: Preventative surgery is a drastic measure that is not for everyone. If you have a very high risk of certain kinds of cancer, talk with your doctor about whether or not preventative surgery may be the right option for you.
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