Alexandre Mehida, Black Jonathan, Whicker Margaret, Minkin Mary Jane, Ratner Elena
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT, USA.
Maturitas. 2017 Nov;105:46-51. doi: 10.1016/j.maturitas.2017.06.003. Epub 2017 Jun 3.
"Previvors", or "pre-survivors", are individuals who do not have cancer but have a genetic predisposition to cancer. One such example is women with BRCA mutations. As a result of their predisposition to cancer, many will undergo a bilateral salpingo-oophorectomy when they are premenopausal. For premenopausal women, the removal of ovaries results in the depletion of estrogen, immediate menopause, and, in many cases, resultant Sexuality, Intimacy, and Menopausal Symptoms (SIMS). Furthermore, they may undergo changes in body image. SIMS are underreported by patients and underdiagnosed by practitioners. At the time of diagnosis or at preoperative visits, women should be informed of the potential physiologic, hormonal, and psychosocial effects of their risk-reducing surgery. There are many modalities for management of these symptoms. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it.
“癌症易感者”，或“癌症前幸存者”，是指那些没有患癌症但有患癌遗传倾向的个体。一个例子是携带BRCA突变的女性。由于她们的癌症易感性，许多人在绝经前会接受双侧输卵管卵巢切除术。对于绝经前女性来说，卵巢切除会导致雌激素减少、立即绝经，而且在很多情况下，会引发性、亲密关系和绝经症状（SIMS）。此外，她们的身体形象可能会发生变化。患者对SIMS的报告不足，而医生的诊断也不充分。在诊断时或术前访视时，应告知女性她们的降低风险手术可能产生的生理、激素和心理社会影响。有许多方法可以管理这些症状。成功的治疗需要医生意识到这个问题、有能力识别它并愿意进行治疗。
