You may wonder why your gynaecologists asks you if you have a family history of breast or ovarian cancer during your routine check-up. There is in fact a hereditary element in women with certain breast cancers. These women will carry an abnormal BRCA1 or BRCA2 gene. This is more likely so if she develops breast cancer at a young age. The abnormal gene can be tested for if there is a history of breast or ovarian cancer in the family. If the defective gene is found there is a 60% chance of developing breast cancer and a 55% chance of ovarian cancer. Some women will, in such a case, opt for elective removal of their breasts and ovaries, as in my patient. She did the test as there was a strong family history of breast cancer. The test came back positive test for BRCA1 and she decided that she didnt want to take the risk and so had a bilateral mastectomy. I then performed a video laparoscopic (key-hole) removal of both her ovaries. Of course this will bring about a menopausal state. However I discussed this with her beforehand and she decided that she would rather take HRT for life then risk an ovarian cancer. Women who develop breast cancer should do the BRCA1 & 2 gene and if positive should consider having their ovaries removed as well.
Tuesday, 25 October 2011
The other day I had a patient who presented to me with vague symptoms of mental tiredness, lack of energy, mood swings and increasing weight gain. She was of course perimenopausal. So the obvious cause and treatment would be with some form of HRT. So I started her on oestrogen and progesterone. The symptoms didnt get better and she came back pleading with me to help her do something. She was already on Prozac for depression. Of course it would have been easy to have dismissed her symptoms as something cerebral. However, I gave it a shot and gave her some chelated magnesium, acetyl carnitine. Low and behold, the effect was instantaneous, she was feeling better the next day and she is ever greatful to me for helping her. Who would have guessed that it was just a deficiency in minerals!