Women Health – Week 10 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.CH Discussion:Discuss any “take-away” thoughts from the article.This article provided information on prophylactic hysterectomy for patients who have ahistory of first-degree and second-degree relative of ovarian cancer, and associated malignanciesthat increased their risk of acquiring this type of cancer. According to the statistics and dataobtained from this study a prophylactic hysterectomy should not be utilized to prevent ovariancancer. The proper intervention instead is benign gynecologicalscreening for those who have a family history of endometrial cancer especially the AshkenaziJewish ethnicity background. Although the study concluded that a prophylactic hysterectomy isinconclusive, there are instances when the benefits outweigh the risks.What are the ethical dilemmas to consider with prophylactic surgeries?Ethical dilemmas are the greatest challenges the provider will face if electiveprophylactic surgery is chosen by the patient. Excellent communication between the patient andthe interdisciplinary healthcare team is important. Assessment of the patient’s learning style, andknowledge of learning barriers is essential. Proper education of the pros and cons of prophylacticsurgery will give the patient the option of whether to proceed with the procedure or withdraw.Physiological as well as, psychological implications are the determining factor for prophylacticsurgeries (Jain & Somalwar, 2019).  For example, women who chose to have bilateral prophylactic salpingo-oophorectomywill experience severe vasomotor effects and require hormone replacement therapy to alleviatethe symptoms of menopause. Another dilemma the female patient will face if she is at a reproductive age, is losing the ability to become pregnant. Considerations for the proper approach to prophylactic surgeries should include a benefit versus risk (NIH, 2018).Discuss the screenings/interventions/options/education that you would provide to a patient.Screening for ovarian cancer is not currently recommended for the average patient. Thescreening method available today is the serum is the CA 125 is a marker that is produced by thecancer cells. The CA 125 levels will be elevated in women who have ovarian cancer. The testresults can also produce a false-positive or false negative. There is no accurate and reliabletesting available and research is still ongoing. If the patient is at high risk for ovarian cancer andhas a first degree relative with ovarian cancer, the provider must include: genetic counseling,ultrasound exam of the ovaries for women who carry BRCA1 and BRCA2 mutations. Otherinterventions include cervical screening for women ages 21 through 65 because of the potentialexposure to human papilloma virus through sexual contact and a pelvic exam to determine ifabnormalities are present (AGOC, 2018). Education must be stressed with the importance ofhealth maintenance screening. Factors that will increase the patient’s risk for ovarian cancer areobesity, having children late in life, use of fertility treatment to become pregnant, and hormonereplacement therapy (American Cancer Society, 2018).What if the patient has no health insurance? What resources could you offer to assist thepatient?Healthcare resources depends on the patient’s employment status. Medicaid is availableto those who meet the income guidelines. If the patient does not have medical insurance, I wouldrefer her to the social worker. There are resources available to those who are uninsured and are unable to afford healthcare services.(United States Department of Labor, 2018).ReferencesAmerican Cancer Society. (2018) Ovarian Cancer Risk Factors. Retrieved fromhttps://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.htmlJain, S. & Somalwar, S. (2019).  Analysis of prophylactic saplingo-oophorectomy at the time of hysterectomy for benign lesions.  Journal of Midlife Health 10(1).  doi: 10.4103/jmh.JMH_70_18National Cancer Institute (NIH). (2018). Surgery to reduce the risk of breast cancer. Retrievedfrom https://www.cancer.gov/types/breast/risk-reducing-surgery-fact-sheet#q5The American College of Obstetricians and Gynecologists (AGOC). (2018). BRCA-1 andBRCA-2 Mutations. Retrieved from https://www.acog.org/Patients/FAQs/BRCA1-andBRCA2-Mutations?IsMobileSet=false#ovarian

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