FREE MEDICAL ADVICE (and worth every penny)

In our swanky Cairo hotel.

4 Star (but the toilet overflowed)

What I am about to do is probably ill advised.  I am about to give medical advice.    I am not a doctor, nor a nurse, and until about 18 months ago I actually did my very  best to avoid learning anything at all about health – on the grounds that something you never  think about won’t hurt you.  Stupid, yes, but perhaps understandable.  So, anyway, here goes.  FOR GOD’S SAKE GET A SECOND OPINION!

I have spent a good part of the last 18 months reading things about cancer in general and ovarian cancer in particular.  At times I’m lucky if I truly understand 20% of the stuff I study – but 20% of a great pile  of stuff amounts to something.  Here is what I think I know about preventing ovarian cancer.

Don’t be a woman of Ashkenazi Jewish extraction.

Ovulate as infrequently as nature and fate will allow.  This means:

                Start ovulating late.

                Start menopause early.

                Have babies

  Breast feed

                Use  the kind of birth control methods that prevent ovulation.

Don’t use talc.  

Don’t have mutations in your BRCA1/2 genes.

Don’t have mutations in any of quite a few other genes, most of which we don’t even know about yet.
              In other words, don’t be unlucky.

Don’t use hormone therapy, at least without having serious conversation with several doctors.

Don't gain too much weight

The group I try to help has a classification system for risk of ovarian cancer (ROC)

If you are an Ashkenazi Jewish woman, or have known BRCA mutations, you are in the High Risk category.

                If you have several first-degree relatives (mother, sisters) that have had ovarian OR  breast cancer you are in the Elevated Risk category

                Otherwise you are in the normal risk category, with less than a 3% lifetime chance of developing  OVCA.

So, what to do?

                Talk to a genetics counselor. 

                Try to find and join a clinical trial.  Easy if you live in a big city, hard otherwise.

If you are in either higher risk category you might consider the following.

                Have a risk-reduction procedure.  You might do this as a byproduct of some other surgery or, if you are of high risk, you might consider having it done on its own.  Some factors to consider:

                Most “ovarian” cancers originate in the fallopian tubes.  Removing your ovaries deprives your body of hormones, thus making menopause miserable (they tell me.)  Consider doing what is known as BSOR:  Bilateral Salpingectomy with Ovarian Retention.  “Salpingectomy” means removal of fallopian tubes.  BSOR is especially recommended for women in the High Risk category. 

                Of course, don’t do anything until you have had all the kids you want (or can afford.) 

Once again: for the love of Pete, don’t take my world for anything.  Get some advice from someone who is paid to know something.

On a personal note: my first great granddaughter is hovering on the brink of independent life.  Her mother has given up moose hunting until she arrives.  The scene is thick with excitement.