Better informed consent needed

Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes

https://tinyurl.com/3z46f2tp

Premature menopause is a health hazard. It has long-term implications for the quality of life and health including adverse effects on cardiovascular well-being.

For women with inherited genetic mutations such as BRCA1&2 this means a dilemma. They have a choice of reducing the risk of ovarian cancer by surgical resection of Fallopian tubes and ovaries but need to understand the possible long-term adverse effects.

This review article shows the benefits of risk reduction surgery with a decreased risk of ovarian cancer of up to 96%. After surgery there is an immediate menopause. This has been shown to significantly increase the likelihood of cardiovascular disease which is the leading cause of death for women. The risk has been shown to be 2 to 3 times greater when compared to women who experience a normal menopause at the usual age.

Other side effects of premature menopause such as osteoporosis, dementia, and loss of libido are well known. Cardiovascular adverse effect does not have the same prominence and has only recently been acknowledged by the American College of Cardiology as a “risk enhancing factor”. This lack of understanding has resulted in poor informed consent, with many women not being told of the risk before surgery.