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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.  

TB Discussion:

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Ethics is based on moral principles that guide how we conduct our practices. Prophylactic surgeries for prevention of cancer is a very personal and sensitive subject. Providing the patients with unbiased knowledge as to the risks and benefits to each procedure option they have, cancer risks and insight into what those choices might hold. The patient-provider interaction can directly affect the patient’s decision, therefore enhanced well researched education should be provided. Evidence based practice and guidelines should be discussed. Providers “may need be more aware of their multifaceted roles, and gauge sensitively each patient’s desires (i.e., for information and paternalism vs. autonomy), rather than adopt a generic “one size fits all” approach” (Klitzman & Chung, 2010, pg. 62).

Genetic screening for the BRCA 1 and 2 gene, transvaginal ultrasound, family history and personal history should all be taken into account with these patients. A medical group should be caring for these patients including a genetic counselor and gynecologic oncologist. Education should include the risks of ovarian cancer for each individual patient that is tailored to them specifically and the benefits of a salpingo-oophorectomy. Each carrier of the BRCA 1 and BRCA 2 have different risks, BRCA 1 carriers’ risks start to increase in their late 30’s whereas the BRCA 2 increases at a later stage (AlHilli & Al-Hilli, 2019).

Education about the possibilities of carcinoma being found during the prophylactic procedures and need to fully investigate the patients risk. Having the procedure before baring children will also need to be discussed and options for creating a family through other outlets. The ovaries precipitate in the production of hormones that are important for normal functioning of the bodies. Hormone therapy should be discussed with specific options for the patient. If the patient has no health insurance, information about options and ways to obtain help with the procedure should be included in their education (AlHilli & Al-Hilli, 2019).

AlHilli, M. M., & Al-Hilli, Z. (2019). Perioperative management of women Undergoing RISK-REDUCING surgery for Hereditary breast and ovarian cancer. Journal of Minimally Invasive Gynecology, 26(2), 253–265. https://doi.org/10.1016/j.jmig.2018.09.767 

Klitzman, R., & Chung, W. (2010). The process of deciding about prophylactic surgery for breast and ovarian cancer: Patient questions, uncertainties, and communication. American journal of medical genetics. Part A, 152A(1), 52–66. https://doi.org/10.1002/ajmg.a.33068

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