Risk-reducing surgery (prophylactic surgery) involves removing the ovaries and fallopian tubes (bilateral salpingo-oophorectomy) to lower the chance of developing ovarian cancer. It is recommended for individuals at high risk due to genetic factors or family history.
Who should consider this surgery?
You may be a candidate if you have:
- Genetic mutations (e.g., BRCA1, BRCA2, Lynch syndrome).
- Strong family history of ovarian, breast, or related cancers.
- Completed childbearing and wish to reduce cancer risk.
Genetic testing and counselling are essential first steps.
Benefits of surgery
- Lowers ovarian cancer risk by up to 90%.
- May reduce breast cancer risk (for BRCA1/2 carriers).
- Peace of mind from proactive risk management.
Risks and considerations
- Surgical Risks: Infection, bleeding, or anaesthesia complications (rare).
- Early Menopause (if premenopausal): Triggers hot flashes, bone loss, and heart health risks.
- Emotional Impact: Feelings of loss or anxiety about surgery.
- Hormone Replacement Therapy (HRT): May be recommended for menopausal symptoms in some cases (discuss with your doctor).
What to expect
Before Surgery
- Genetic counselling to confirm risk.
- Pre-surgery tests (blood tests, imaging).
- Discuss HRT options if needed.
During Surgery
- Performed laparoscopically or via open surgery (1–3 hours under general anaesthesia).
- Ovaries and fallopian tubes are removed; uterus may stay unless otherwise planned.
After Surgery
- Recovery: 2–6 weeks (avoid heavy lifting).
- Menopause Management: HRT, lifestyle changes, or non-hormonal therapies.
- Follow-up: Regular check-ups to monitor health.
Alternatives to surgery
- Surveillance:
- Pelvic ultrasounds, HE4 and CA-125 blood tests (less effective than surgery).
- Chemoprevention:
- Birth control pills (may lower risk for some).
Surgery offers the greatest risk reduction.
- Birth control pills (may lower risk for some).
eGynaecologist Advice
- Risk reducing surgery for prevention of ovarian cancer is a personal choice however, surgery significantly reduces ovarian cancer risk for high-risk individuals and should consult a gynaecologist for further discussion.
- Early menopause after risk reducing surgery is manageable with medical and lifestyle support and should speak to your gynaecologist for post treatment support.
Frequently Asked Questions
Does surgery eliminate all risk?
No—there’s still a small risk of primary peritoneal cancer (similar to ovarian cancer).
Can I delay surgery if I want children?
Yes – discuss fertility preservation options (e.g., egg freezing) with your doctor.
Will I need HRT after surgery?
If premenopausal, HRT can ease menopause symptoms but may not be advised for BRCA1/2 carriers (varies by case).
Are my fallopian tubes always removed?
Yes – emerging research shows some cancers including high grade ovarian cancers start from precursor lesion called STIC lesions in fallopian tubes.
