A young, cancer-free Toronto woman says her decision to have both ovaries and both breasts removed was daunting, but not difficult.
After learning two years ago that she tested positive for a genetic mutation that predisposed her to cancer, opting to undergo the surgeries to lessen her risk of getting the disease was a “no-brainer,” says Leela Goldhar-Waxman, 38.
Today, she is even more convinced she made the right decision. Goldhar-Waxman participated in a clinical trial — the results of which were published Monday in the Journal of Clinical Oncology — that showed that women like her who get both ovaries removed reduce their risk of death from any cause, including cancer, by 77 per cent.
“I feel so lucky and so blessed. I really feel like I have been given a golden ticket,” said the mother of three.
The study by Women’s College Hospital looked at the impact of preventative oophorectomies — removal of ovaries — on women who carry a BRCA1 or BRCA2 genetic mutation. The BRCA1/2 genes belong to a class of genes that typically act to protect individuals from acquiring cancer, yet women who inherit a mutated form of the genes have a high risk of developing breast and ovarian cancers.
While there has been some research showing that having oophorectomies can help prevent both ovarian and breast cancers, this is the largest and most conclusive study to date.
It followed 5,783 women over six years and found an 80 per cent reduction in the risk of ovarian, Fallopian tube and peritoneal cancers. As well, it found a 68 per cent lower risk of death from all causes in women who had previously had breast cancer.
The study also provides some guidance about when women should have surgery. It found that for those who wait until age 40 or 50 for surgery instead of having it at 35, chances of developing ovarian, fallopian or peritoneal cancers jump to 4 and 14.2 per cent, respectively.
Actor Angelina Jolie grabbed headlines last year when she announced that she had had a double mastectomy and planned on having an oophorectomy. She inherited the BRCA gene mutation from her mother, who died of ovarian cancer at age 56.
Co-author Dr. Steven Narod, a senior scientist at the Women’s College Research Institute, said he expects oophorectomies will become the standard of care for at-risk women because of studies like this.
“I hope the proportion of women who have this mutation who get an oophorectomy will go to 100 per cent. Starting next week, I think women are going to start booking appointments,” he said.
Women’s College is a leader in studying BRCA mutations. Earlier this month, it produced another study that showed that women with the mutation who have double mastectomies are nearly 50 per cent less likely to die of the disease within 20 years of diagnosis than those who have only one breast removed.
Dr Jamie Bakkum-Gamez, a gynecologic cancer surgeon at the Mayo Clinic, said the findings will help her and other health professionals answer the many questions patients have when tying to decide whether to have this kind of surgery.
“It is the largest study that I am aware of in women with BRCA 1 and 2 mutations (on) the impact of surgical risk reduction for ovarian cancer,” she said.
“It provides several tools for care providers of women with the mutation, as far as risk prediction based on age …. That is something we didn’t really have before,” Bakkum-Gamez said.
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