To prevent cancer, more women should consider removing fallopian tubes, say experts in US
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Ovarian cancer ranks fifth in cancer deaths among women.
PHOTO: ST FILE
NEW YORK – There is no reliable screening test for ovarian cancer, so doctors urge women at high genetic risk for the disease to have their ovaries and fallopian tubes removed once they are done having children, usually around the age of 40.
In January, a leading research and advocacy organisation broadened that recommendation in ways that may surprise many women.
Building on evidence that most of these cancers originate in the fallopian tubes, not the ovaries, the Ovarian Cancer Research Alliance (Ocra) is urging even women who do not have mutations – that is, most women – to have their fallopian tubes surgically removed if they are finished having children and are planning a gynaecologic operation anyway.
In such a procedure, surgeons remove the tubes, which lead from the ovaries to the uterus, but leave the ovaries intact. The ovaries produce hormones that are beneficial even later in life, reducing the risk of heart disease, osteoporosis and sexual dysfunction. Sparing the organs has been linked to lower mortality overall.
“Ovarian cancer is a relatively rare disease and we typically don’t message to the general population,” said Ocra president and chief executive Audra Moran. “We want everyone with ovaries to know their risk level and the actions they can take to help prevent ovarian cancer.”
To that end, the group has begun offering free at-home testing kits to qualifying women who want to find out if they carry genetic mutations such as BRCA1 and BRCA2, which confer an elevated risk for developing both ovarian and breast cancers.
Younger carriers of the mutations might consider removing only the fallopian tubes as an interim step to protect against ovarian cancer and to avoid abrupt early menopause, said Ms Moran, even though the gold standard treatment for carriers is to remove the ovaries too.
While women with BRCA1 and BRCA2 mutations have a high risk for ovarian cancer, a majority of women with the disease do not carry the mutations.
Ovarian cancer ranks fifth in cancer deaths among women, according to the American Cancer Society, and accounts for more deaths than any other cancer of the female reproductive system.
Every year, about 19,710 women in the United States have ovarian cancer diagnosed, and about 13,000 women die of it.
The disease is a particularly stealthy malignancy and is often diagnosed at a very advanced stage as a result. NYTIMES
