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Familial Ovarian Cancer Clinic (FOCC) and FOCC-Aftercare Clinic

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.

  • 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.

  • 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.

  • Patient Resources
  • FAQs

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.

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