The Familial Ovarian Cancer Clinic (FOCC) and FOCC-Aftercare clinics at Women’s College Hospital provide expert and evidence based clinical care for women at elevated risk for hereditary ovarian and fallopian tube cancers. Clinical care includes the full spectrum of gynecologic care specific to our population: patient centered contraception counselling, liaison with fertility specialists, counselling on ovarian cancer risk reduction, risk reduction surgery, and menopausal aftercare. Patients seen in the FOCC clinic will be followed until the first post-operative appointment. Any additional follow-up will take place in the FOCC-Aftercare clinic.
The FOCC-Aftercare clinic offers services for patients affected by premature menopause or struggling with menopausal symptoms, providing ongoing support for symptom control and health promotion. Patients seen in the FOCC-Aftercare clinic are monitored for diseases of estrogen deficiency and receive counseling on menopausal expectations. Care plans are catered to individualized needs and built to improve quality of life.
In collaboration with the Department of Gynecologic Oncology at Princess Margaret Hospital, the Women’s College Research Institute, and the WCH High Risk Breast Clinic, the clinic utilizes an interdisciplinary model of care to provide counseling, risk reducing surgery, and comprehensive menopause management to women who are at risk for ovarian or fallopian tube cancer. Our clinic staff currently includes a gynecologic oncologist, 2 minimally invasive gynecologic surgeons, and a menopause specialist, as well as a full complement of nursing, allied health and administrative support staff. The program is directed by Drs. Bernardini and Jacobson.
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Your Care
Patient Population
The majority of our patients include those with a deleterious mutation in the BRCA1/2,BRIP1, STK11 and RAD51C/D genes. As our understanding of hereditary ovarian cancer expands, we are beginning to see patients with other genetic mutations.
Below are some of the services that we provide in the FOCC and FOCC-Aftercare Clinic
- Contraception counselling
- Liaison with fertility specialist
- Counselling on ovarian cancer risk reduction
- Risk reduction surgery
- Menopausal aftercare
- Social Work support
What To Expect
The FOCC and FOCC-Aftercare clinics work as collaborative clinics that include a team of gynecologic physicians and specialists, nurses, allied health professionals and a genetic counsellor to meet unique patient needs. Appointment visits are built around the idea of consultation, with the provision of information and patient-centered options that align with a patient’s presentation.
As part of an academic teaching hospital, patients may also meet with students and trainees in various disciplines from nursing, allied health and medical residents and fellows. These individuals receive specialized and hands-on training with direct supervision and expertise from our team.
There are several surgeons who range in specialization from menopause, oncology and general gynecology. In line with our shared practice model, you may meet one surgeon in consultation and have a different surgeon who performs your surgery or facilitates your follow-up. Together we align our practices to ensure a streamlined transition across all care trajectories for our patients.
Patient Pre-Visit Requirements
We would ask that you plan to arrive at least 10-15 minutes before your scheduled appointment time so that we can complete your registration.
Please remember to bring your Ontario Health Card with you to this appointment. Please Note: f you do not have a valid Ontario Health Card, you will be required to pay directly for the clinical service(s) provided at the time of your visit. Details are available from any of our program secretaries who can be contacted at 416-323-7744
To prepare for all your visits, we recommend that you gather a list of your current medications, review your health history including cancer history and treatment, and write down your concerns or questions. Though not required, we recommend that a family member, friend or advocate accompanies you to your appointment. Should interpreter services be required for your appointment, please advise us as early as possible to ensure accommodations can be made in time for your appointment, test or procedure.
If you are unable to keep your appointment, please notify us at 416-323-7744 to cancel and/or re-schedule your appointment as soon as possible.
We require 48 hours’ notice of a cancellation so we can fill your appointment with another patient -
Our Team
Menopause Specialist
- Michelle Jacobson
Gynecologic Oncologist
- Marcus Bernardini
Minimally invasive Gynecologic Surgeons
- Mara Sobel
- Lisa Allen
Registered Nurses (RN) and Registered Practical Nurses (RPN)
The nurses work closely with our patients to provide expert health teaching and education around both pre and post-operative care.
Genetic Counsellor
Genetic Counsellors can assess personal and/or family medical history to determine if an individual might have an increased risk for developing certain types of cancers. A Genetic Counsellor will discuss whether the cancer in a family may be hereditary, and if genetic testing is appropriate. Where warranted, genetic testing will be arranged, and results and implications discussed. Genetic Counsellors can provide information and support to an individual and their family, regarding the different options on how to best manage and reduce the risk of developing certain types of cancers.
Social Worker
The Social Worker will assist individuals and families to address and manage their emotional and social wellbeing. The Social Worker works together with other members of the health care team to provide education, counselling, support and therapy to individuals and families throughout the cancer and BRCA diagnosis and care journey. The Social Worker offers brief therapy, group therapy and connects individuals/families with community resources and programs. Speak with your doctor or nurse about getting a referral for social worker or contact 416-323-7330
Available for appointments: Face-to-face interaction/Telephone call/Virtual communication
Onsite Breast Centre/Gynecology 5th floor (Monday-Friday 8:30 am-4:30 pm)
Clinic Secretaries
The Medical Secretary provides clerical support including telecommunications and customer service functions. The Medical Secretary facilitates efficient and timely access to specialty services by receiving and processing referrals and scheduling and confirming of appointments.
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Procedures
Below are the types of surgical options provide to patients of the FOCC.
- Laparoscopic Bilateral Salpingo-oophorectomy
- Salpingectomy
- Hysterectomy
Click on the following link from the Canadian Cancer Society for more information about each procedure.
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Patient Resources
Patient Resources
There are resources available for both patients and health care professionals. The following are websites that will provide the answer to many questions you may have about your gynecological health and general well-being.
Gynecologic Cancer Resources
Ovarian Cancer, Canadian Cancer Society
Cervical Cancer, Canadian Cancer Society
Uterine Cancer, Canadian Cancer Society
Hereditary Breast Ovarian Cancer Society
Community Supports
Facing Our Risk of Cancer Empowered
Exercise Programs for Cancer Survivors
Wellspring Cancer Exercise Program
Nutrition Resources
Sexual Health Resources
Sexuality and Cancer, Canadian Cancer Society
Mental Health Resources
Emotions and Cancer, Canadian Cancer Society
Canadian Association of Psychosocial Oncology
Children and Families Resources
Coping Within a Family, Canadian Cancer Society
Start The Talk, Canadian Association of Psychosocial Oncology (CAPO)
Adult and Children Support Groups, Gilda’s Club
When A Parent Has Cancer, Wellsprings
Fertility Resources
Work and Finance
Wellspring programs (Money Matters, Returning to Work, Back at Work)
WCH Resources
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FAQs
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Do I need a referral completed by my family doctor before I am seen in the FOCC?
A referral form must be completed by a primary care practitioner and faxed to 416-323-6330.
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Who are the physicians in the clinic and who can I see?
Please refer to Our Team for more information on the physicians, surgeons and specialists who work in the FOCC and FOCC-Aftercare clinics.
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I am a current patient of the FOCC clinic and I cannot locate my requisition for testing, what do I do?
Please contact the FOCC clinic directly to best assist you with providing an additional copy of the requisition form at 416-323-7744.
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What can I expect after recovery from Surgery?
Recovery will take approximately 2 weeks. Patients may have some bleeding and experience pain that is controlled with oral medication. After surgery, patients may also experience menopause symptoms (e.g. hot flashes, night sweats, etc.) depending on their preoperative status.
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What happens if cancer is found?
If a cancer diagnosis is confirmed, patients will be seen in the clinic by the specialist and other health care providers to discuss a plan of care. If patients require additional surgery or chemotherapy, they will be referred to the Princess Margaret Hospital (PMH) for care.
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What can I expect after Menopause
Menopause symptoms may include hot flashes, night sweats, vaginal dryness and changes in weight, skin condition, mood and sexual functioning. Silent changes include changes in the cardiovascular system (CVS), bones and cognition function. Many of these symptoms can be alleviated with medication.
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How do I speak with my children about my diagnosis?
We have a trained Social Worker that will be able to assist. The Social Worker can be reached 416-323-7330 or by completing the Social Worker referral form.For more information please refer to Start The Talk
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Do I need a referral completed by my family doctor before I am seen in the FOCC?
Referral
Please fax your referral to the FOCC at 416-323-6330
Patient Referral
Patient Referral Form (.pdf) - FOR PHYSICIANS ONLY -Social Work Referral Form
Social Work Referral Form (.pdf)Please note that appointment notification will be sent to a referring provider within 2-4 weeks. Confirmation of genetic mutation must be received prior to this appointment.
