Why I Chose to Have My Ovaries Removed – BRCA1 & Laparoscopic Prophylactic Oophorectomy Recovery

This was my deeply personal decision to undergo a significant medical procedure: the removal of my ovaries. As a young breast cancer survivor with a BRCA1-positive diagnosis, I faced tough choices. Ultimately, I chose to undergo a laparoscopic prophylactic oophorectomy, a decision rooted in my commitment to reducing the risk of ovarian cancer. I will walk you through the complexities of this choice, blending personal experience with medical insight to shed light on an often-overlooked aspect of cancer prevention.

Why I Chose to Have My Ovaries Removed – BRCA1 & Oophorectomy

I underwent an oophorectomy at MD Anderson due to my BRCA1 gene mutation. To aid others who may share my BRCA-positive status, I felt compelled to craft this article and create a video. Through these mediums, I aim to articulate my rationale behind choosing ovarian removal and offer insights into the surgical process and subsequent recovery.

What is BRCA?

The BRCA gene plays a crucial role in maintaining cellular health by encoding instructions for producing tumor suppressor proteins. These proteins are vital for repairing cell damage and ensuring proper cell function. However, this process is disrupted when a BRCA mutation occurs, leading to an elevated risk of developing certain cancers. Specifically, BRCA mutations are linked to heightened risks of breast, ovarian, prostate, and other cancers.

My BRCA Test in 2009

When I received my breast cancer diagnosis, I was already aware of a family history of the disease. My cousin’s positive test for the BRCA1 gene mutation, specifically the 187 delAG mutation, facilitated my own BRCA testing, pinpointing the exact location to investigate.

As anticipated, my test revealed a positive BRCA1 gene mutation. Given the aggressive nature of the cancer and this genetic predisposition, I opted for a bilateral mastectomy followed by four rounds of chemotherapy, along with breast implant reconstruction.

Though aware of the heightened risk of ovarian cancer associated with the BRCA1 mutation, I wasn’t prepared to undergo oophorectomy at that time.

Options for BRCA-Positive Women

For BRCA-positive women, surgery is not the sole option available. Increased surveillance and certain medications offer alternative approaches to reduce cancer risk.

Personally, I opted for heightened surveillance until the decision to undergo oophorectomy arose. Despite efforts by medical professionals, early detection of ovarian cancer remains challenging. While ultrasounds and CA-125 blood tests are utilized, not all signs of ovarian cancer may be detected through these means.

First Came the Salpingectomy

Image Credit: Canva / AI View.Three years ago, I underwent a procedure to have my fallopian tubes removed, aiming to mitigate my risk of ovarian cancer until I was prepared for oophorectomy. What was initially expected to be a routine and straightforward surgery turned into an unforeseen challenge. I encountered a complication during the procedure, leading to a prolonged recovery period lasting several months.

My Ovaries: The Ticking Time Bombs

Over the past few years, I’ve carried a constant sense of urgency regarding my ovaries, feeling as though they were a ticking time bomb. Research indicates that the risk of ovarian cancer significantly escalates for BRCA1-positive women around the age of 40, prompting my plan to undergo oophorectomy around that milestone.

Every six months, I made the journey to MD Anderson for pelvic exams, transvaginal ultrasounds, and CA125 blood tests. Despite the routine nature of these appointments, each visit was accompanied by intense anxiety. The waiting periods before, during, and after these tests were fraught with what’s commonly known as “scanxiety.”

Turning 40

This summer, I had my 40th birthday. When I was diagnosed with breast cancer at age 31, I honestly wasn’t sure I’d make it to 40. To celebrate the big 4-0, my family and I spent a few days at the beach in Galveston.

 

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Take that 4-0! Almost 9 years ago, diagnosed with breast cancer at age 31, I honestly wasn’t sure I’d make it to 40. But, here I am, on the beach, still able to do headstands. I thought about photoshopping the picture because I don’t like the way my stomach looks, but I wanted to post an honest picture of how I looked and felt today. I’m so grateful for everything I can do and the people I can spend time with. A weekend on the beach with my family was a great way to celebrate this birthday.

A post shared by Rachel | Cha Ching Queen (@chachingqueen) on Jul 22, 2018 at 5:48pm PDT

While I cherished the time spent with loved ones, thoughts of my impending surgery to remove my ovaries lingered in the background. The prospect of another surgery weighed heavily on my mind. Fears of potential cancer findings and concerns about navigating surgical menopause sent my anxiety soaring to new heights.

Oophorectomy to Reduce Ovarian Cancer Risk

This minimally invasive surgery involves small incisions, often allowing patients to return home the same day. At MD Anderson, my oophorectomy was conducted as an outpatient laparoscopic procedure.

Our day began at the hospital around 9 am and concluded around 6 pm, marking the duration of the procedure and recovery process.

Laparoscopic Oophorectomy Outpatient Surgery

The surgery itself lasted approximately an hour. Throughout the procedure, the doctor conducted a comprehensive examination to assess for cancer and any potential abnormalities. While a cyst near my diaphragm was removed, the overall findings were reassuring. The laparoscopic approach necessitated only three small incisions, with the largest measuring about an inch in length.

Laparoscopic Surgery Recovery from Having Ovaries Removed due to BRCA

Upon waking from surgery, I found myself understandably groggy from the anesthesia, yet the pain was surprisingly manageable, much to my relief. The discomfort was far less severe than I had anticipated. However, I experienced significant nausea and lightheadedness when attempting to stand up to leave the hospital, proving to be the most challenging side effect.

The doctor prescribed high-dose acetaminophen, ibuprofen, and a small amount of hydrocodone. Following the recommended guidelines, I only used hydrocodone sparingly, primarily to aid sleep. Otherwise, I effectively managed the pain using acetaminophen and ibuprofen alone.

How I Felt the Night After My Oophorectomy

The night following my oophorectomy, I experienced considerable soreness, although I was pleasantly surprised by the manageable level of discomfort. However, despite the pain being tolerable, I struggled to sleep well. It wasn’t due to the pain itself but rather a peculiar sensation of feeling simultaneously jittery and fatigued. I attribute this unusual state to the combined effects of various medications administered during the procedure.

How Was the Recovery From the Oophorectomy?

Determining the right amount of time to take off work for my oophorectomy proved challenging, as recovery varies from person to person. While there was a precaution against lifting more than 10 pounds for a few weeks, the exact timeline for returning to work remained uncertain.

As a marketing consultant and part-time teacher at a small private school, I initially decided to take a week off. During the second week, I gradually resumed work with a lighter schedule, accepting rides from a friend. However, I was capable of driving myself as I wasn’t on heavy medication. It was more about appreciating the support offered.

Week One:

Recovery during the first week after the oophorectomy was characterized by significant soreness, like the aftermath of an intense ab workout. Due to the extensive intestinal examination, I felt a bit bruised internally and bloated. Following recommendations, I incorporated light walking into my routine. Exactly a week after surgery, I attended the Celebration of Life Luncheon, and just over a week after surgery, I participated in the 2-mile Austin, Texas Race for the Cure, albeit at a walking pace.

Week Two:

By the second week, I became more mobile and engaged in daily activities, including walking my son to school on some mornings.

Week Five:

At the five-week mark post-op, I feel mostly recovered, though I still experience more fatigue than usual. Engaging in household chores such as vacuuming, laundry, and mopping triggers discomfort, particularly with twisting and bending motions. And no, it wasn’t my excuse to get out of housework—I promise!

Surgical Menopause After Prophylactic Ovary Removal

One of the side effects of an oophorectomy is surgical menopause.

Depending on your medical background and guidance from your healthcare provider, there may be options available to mitigate the effects of menopause through hormone therapy or medications.

Traditionally, hormone therapy isn’t recommended for breast cancer survivors due to potential risks, particularly for those with hormone-sensitive cancers. However, in my case, having had triple-negative breast cancer and lacking hormone-fed tumors, my oncologist deemed it appropriate to prescribe a combination birth control pill containing various hormones to ease the transition into menopause.

Thus far, I haven’t experienced any noticeable side effects of menopause. However, it’s still early days, with only five weeks having elapsed since my surgery. Time will reveal how my body adjusts in the coming weeks and months.

Overall Thoughts on My Prophylactic Oophorectomy

Up to this point, I’m confident in my decision to undergo oophorectomy. I feel like a huge burden has been lifted off my shoulders. While I know there’s still a slim chance of cancer, I take solace in knowing I’ve taken proactive steps to minimize that risk. Thankfully, the biopsy results from my surgery came back benign, providing a big relief.

If you or someone you know is grappling with the decision to undergo prophylactic oophorectomy due to BRCA+, please don’t hesitate to reach out. I’m here to offer support, share my experience, and assist in any way I can. Whether you have questions or need guidance, I’ll do my best to provide answers or direct you to relevant resources.

Read more about my breast cancer journey from 2009 to the present here.