Helping you make the decision about risk-reducing ovarian surgery

The Choice

Questions in this section:

As you have not been found to carry a faulty gene, there are different situations that might apply to you. Please find the situation below that applies to you.

What can I do to reduce my risk?

Your doctor has probably discussed with you the option of having risk-reducing ovarian surgery to reduce your ovarian cancer risk. surgery to reduce your endometrial and ovarian cancer risk. You will need to decide whether and when to have this surgery. Unfortunately, there is no medically proven screening available on the NHS for ovarian cancer at the moment.

This decision aid is designed to help you look at your options. Please refer to Options at a glance, Risk-reducing surgery and Other options for more information about surgery, screening and other alternatives.

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Why is there a choice?

Often when you go to your doctor, there is one clearly recommended treatment. However, some situations are more complicated. These are situations in which your personal preferences and feelings play an important role. In the case of cancer risk reduction, your options have very different effects on your life. This means that you need to be clear about what might happen if you choose one option over the other and how that would impact on your life.

Some health professionals may recommend surgery quite strongly; however you need to make the final decision and before you do, you should consider the possible benefits and risks, how these might affect your life and how you feel about them.

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Who should decide?

As the best choice for you is based on your preferences, you should be closely involved in the decision. You can either make the decision on your own or if you do not wish to make this decision yourself, your genetic counsellor or gynaecologist can help you. They will encourage you to think about the options and your preferences, so that the final choice is right for you. If you then don’t want to choose for yourself, just say so and they may make a recommendation.

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Who else should I involve in this decision?

Whether or not you would like to bring anyone else into this decision is your choice. Often it is helpful to speak to someone who knows you well, such as a partner, other members of your family or a friend, who could work through this decision with you. If you are in a relationship the views of your partner can be important, especially in the context of risk-reducing ovarian surgery, so it is recommended that you speak to your partner and try to reach a decision together. Your doctor will also be happy for you to bring your partner along to appointments and to answer any questions they might have.

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When should I decide?

For most women, the operation is most effective if it is done before or at 40 years of age. This is because ovarian cancer risk usually starts to rise steeply from age 40 onwards. However, you should be aware that a small minority of women will get ovarian cancer under the age of 40 years. This is especially true for women who know they carry a BRCA gene. Additionally, if done before or at 40, the surgery reduces the risk of breast cancer. However, having surgery before or at age 40 may not be ideal for everyone. So, even if you decidedecided not to have it by age 40, the operation will still decrease your ovarian cancer risk if performed after that age.

The decision you are facing is not an easy one and you should not feel under any pressure to decide quickly. Risk-reducing surgery has benefits and risks that need to be weighed carefully, so take your time and make sure you are ready before making a decision.

It is important that you understand that undergoing surgery to remove your womb and ovaries will mean you can no longer get pregnant. Therefore it is essential to consider your plans for a family and any potential future changes to these plans (for example if there is a chance you might meet a new partner / re-marry) before making a final decision.

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How can I decide?

When it comes to important decisions everyone is different. Some people like to find out as much as they can about their options, while others prefer to just know what is absolutely necessary. Some might find it helpful to talk to their family and friends. Some might like to speak to people who have made a similar decision. It really depends on you. Have a think about other important decisions in your life and how you managed to make those. That could give you an idea of how you like to decide about things.

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How can I deal with the choice?

It can be helpful to create a plan of how and when you will make this choice. If you are not ready to decide right now, it might be useful to set yourself a deadline of when you will revisit this decision. For example: “Just after my 40th 50th 55th birthday I will look at this information again.” or “Once I have completed my family I will revisit this decision.”

Once you are ready you can decide how you want to make this choice:

  1. I will decide by myself using everything I have learnt
  2. I will decide but seriously consider my doctor’s opinion
  3. The doctor and I should decide together
  4. The doctor should decide but seriously consider my opinion
  5. The doctor should decide for me

One constructive way to deal with a difficult decision is to empower yourself with information. OvDex is designed to help you to learn more about ovarian cancer risk and your options. With the wealth of information that is available on the internet, it can be difficult to find reliable and trustworthy information. The information in OvDex is supported by recent scientific findings and has been carefully reviewed by health professionals to make sure it is accurate. You should at least understand your options and their benefits and risks before making a decision. Find out more about the most important questions to ask at: Ask3Questions.co.uk. Once you have read the information in OvDex, it could help to make a note of any remaining questions and take those to your doctor or genetic counsellor for a more detailed discussion.

You may feel that you are not comfortable making decisions about your health. This is okay. You do not need to make the choice alone if you don’t want to. You can decide together with your doctor or ask them to make the choice for you. But you need to remember that you are the expert when it comes to your own life and that only you know what is important to you. So even if you decide to let the doctor make the decision for you, make sure they know about your goals and values. Tell them what is important to you.

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What if my genetic test is negative and I am from a family where a faulty gene has been found before?

In this case your risk of ovarian cancer is likely to be low, therefore you do not need to make a decision about risk-reducing surgery at this point.

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What if my genetic test is negative and I am the first person to be tested?

As your risk of ovarian cancer may be high even though your test was negative, you may still need to decide about whether or not to have risk-reducing surgery. You can come back to this website once you have had a discussion with your genetic counsellor about your risk and about whether risk-reducing surgery is still something you might want to consider. You can also go back to the main page and have a look at the general information if you wish to find out more about surgery.

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