There’s been various discussions on here about oophorectomy, which were very useful to me when I was considering it. Anyway, I thought I’d relay my own experience of the operation.
I am 36 and after surgery, chemo and rads, was given tamoxifen and advised to have zoladex injections as well to shut off the ovaries. I asked about oophorectomy as an alternative to zoladex and decided to go ahead with this. This was after weighing up the pros and cons with my consultant. The op was on Tuesday and was a pretty straight-forward operation with quick recovery afterwards. I was discharged the evening of the op and have just been on paracetamol/ibuprofen since. The scars are teeny tiny - one in the belly button, two low down on each side and an extra one a bit higher up because one ovary didn’t want to come out.
Obviously, there are some cons to having the oophorectomy (not least of which is that it is irreversible) but for me, I felt that it was the right decision and I was very pleased with how it went.
As for menopausal symptoms, these haven’t kicked in yet so can’t comment on that side of things. At most, I’ve had “warm” flushes that wouldn’t warrant being called a hot flush! Although I am now post-menopausal, I will continue on Tamoxifen for 2 years before switching to an Aromatase Inhibitor. I think this is mainly because of my age and the bone loss risk.
Anyway, I hope this is helpful to anyone thinking about this op.
Thank you, Nicola, this is really helpful. I’m glad that the operation went well - it certainly seemed relatively painless - although, of course, I don’t doubt that you really had to think hard about whether you wanted to go through with it in the first place and if you weren’t on this site for another reason altogether you may not have needed to make the decision at all - but your description is calm and considered, which is really reassuring.
I’m intending to speak to my oncologist when I next meet him to discuss the possibility of an oophorectomy - I’m 37 - and will be on Tamoxifen for 5 years when I finish chemo in September/October. I wonder, though, if you could give me a few more ideas about what you saw as the cons of the operation - I don’t have children but I accepted a few years ago that I was unlikely to have children now.
Thanks for sharing your experience with us. I have been on Tamoxifen since Feb and when I went for my post-rads check-up last week the onc registrar was not entirely happy that I was still having periods - she says that if this is the case in 2 months time they will have to add to the medication (a monthly injection) to shut down my ovaries … now my periods are clearly determined as tey have defeated tamoxifen and a mirena coil. Short of removing my ovaries I think I would still be having periods when I was 102.
Fingers crosssed for you that you don’t progress from the warm flushes to the hot ones.
Hi Naz
the main concern is the effect on your bone density and because you are pr positive you will be unable to take any treatment for the sudden menopausal symptoms. Apparently it is much much harder than gradual menopause,
Anna
I had also had periods that were continuing every 4 weeks, entirely undaunted by chemo etc!!!
As for the pros and cons…
PROS:
Surgical removal of ovaries (unlike zoladex) would ensure that I was definitely post-menopausal and therefore able to have an aromatase inhibitor after tamoxifen.
Quoting from my consultant’s letter: “for post-menopausal women, the use of an aromatase inhibitor after Tamoxifen is superior to Tamoxifen alone. The use of an aromatase inhibitor in combination with Goserelin [Zoladex], which suppresses the ovaries is not adequately addressed, and there is some uncertainty as to what the actual levels of oestrogen in the blood are, with this combination. Therefore the removal of your ovaries would allow you to have Tamoxifen followed by an aromatase inhibitor, which is a better treatment overall for hormone receptor positive breast cancer.”
I was 8/8 for ER+ and 7/8 for PR+ by the way, so I had a breast cancer that was very much hormone-fuelled.
Continued benefit from low level of oestrogen (after injections would have finished) is “theoretically possible”
By having ovaries surgically removed, would only go through the menopause once and would avoid the need for 2 years of monthly injections.
Reduced risk of ovarian cancer (although I am not BRCA1 or BRCA2 so this was not particularly an issue for me)
CONS:
Operation required
Permanent and irreversible (but I didn’t see it as an option to stop the zoladex injections if they caused troublesome side-effects) - surgical menopause can be more severe than natural menopause and I cannot take HRT or oestrogen-based herbal remedies. However, I do now own an air-conditioning unit for the bedroom, several battery-powered fans, magicool water spray (from Boots), several paper fans that my 4 yr old loves to make and am thinking about buying a “chillow” pillow that keeps cool. Not had to use any yet though (early days) so can’t really comment on that side of things except to say that it seems to be luck of the draw whether you suffer badly or not much at all.
Long-term oestrogen deprivation hence increased risk of osteoporosis and will need to have bone scans in due course and possibly treatment to halt bone loss (biphosphates).
Increased risk of cardiovascular disease, thyroid cancer (and possibly other illnesses?) - for me, the benefits outweighed these increased risks
Not relevant to me as my family was already complete, but obviously no ovaries means no more children.
I hope this is helpful as a starting point for discussion with your own consultant - everyone is different so there may be other factors relevant to your own case.
This thread has come up at the perfect time for me, and has been really useful.
I’m 42 and had chemo from october - january, and haven’t had a period since october.
I have been suffering from horrendous night sweats and as my mum had her menopause at 45 believed that I was predisposed to an early one, and that chemo had pushed me into it.
However despite telling all this to the onc was prescribed Tamoxifen. I took it once and got a violent rash over my arms and legs, and swelling of my knees. I have had ovary function blood tests since, and been told that it’s pretty conclusive that I am menopausal, but that it may reverse itself.
The onc is exploring giving me a different brand of Tamoxifen, but if that’s not possible then it’ll be zoladex, then arimidex. I asked her about ovary removal which she hadn’t mentioned until I did. Her only negative comment about it was its permanence. But I like you have completed my family, and don’t fancy monthly injections for two years.
Lots to think about - thanks for providing so much info
You’re welcome Tracey. Ooophorectomy wasn’t suggested to me either. I asked about it and they were then happy to refer me. I wonder if this is partly because after so much other treatment they are reluctant to suggest yet another operation?
I also had my ovaries removed last month. I am really pleased and the operation was not even nearly as bad as I thought it would be. I haven’t had troublesome menopausal symptoms, just a little warm around the face sometimes. Let’s hope that keeps up!
Good luck to all ladies who are considering it. I have absolutely no regrets!
x
Quick query: has anyone around my age - 54 - who is still having regularish periods asked for, or been offered, oopherectomy? Am due to finish my 5yrs on tamoxifen next year and concerned that will still not be post menopausal and therefore won’t be able to take something else like femara.
Thanks
Great to hear from you and that your oopherectomy went well, I have just had my zoladex injection today so was really interested to read your pros and cons list.
I am definately going to have mine out too, I am going to wait until next year mainly so I can get my 40th birthday (off to London for a short beak to see Chicago and a champagne flight on the London Eye) out of the way and our trip to Italy in September and also would rather wait until next year due to taking more time off work this year. I have read on other threads you cant drive for 6 weeks due to not being insured in emergency stop situations, is that right? seems a bit drastic!!!
I have been suffering from hot flushes, or tropical moments as Phil calls them and I invested in two chillows, one for my bed and one for the back of my chair at work,
its saved me a few times from exploding!!! LOL.
Hope everything else is going well , I am back at work full time now and have been for a month. Its all pretty much same old same old.
Wishing you and yours well.
Love Shonagh xx
Hi Shonagh, it’s nice to hear your update, I was wondering how you were getting on. I like the “tropical moments” description! I’ve felt a bit warm from time to time but nothing bad and not much different to what I got from the Tamoxifen.
As for driving, I drove on Saturday (4 days post-op) and would have felt confident doing an emergency stop. I think it’s more for non-keyhole surgery with a full cut across that you have the 6 week recovery period. I’m just being careful not to bend/stretch too much. I’ve not taken any painkillers since Saturday but unfortunately on antibiotics now as one of the incisions developed a slight infection but only very minor and looking fine within a day of starting the antibiotics.
If you want to ask anything else about the op then feel free! I don’t always check here regularly but you can also find me on the bc pals forum where you can send private messages that are emailed on. My user name on there is just “Nicola”
I was able to drive 4 days after my oopherectomy too. Also went back to work 2 weeks later and I have a job that I’m on my feet all day. This op was a breeze compared to all the other treatment I’ve gone through.
Glad to join in - im 35 and widowed, just started my chemo but cos of potential family history suggested having ovaries out - didnt realise there was so much involved.
Thanks for the info
x