Experts for women at high risk of ovarian cancer: Don’t hesitate to have your fallopian tubes removed

Dubai, United Arab Emirates (CNN) — “Education is light,” said 26-year-old Samantha Carlucci, who recently underwent a hysterectomy, which involved removing her fallopian tubes, and believes it saved her life.

The Ovarian Cancer Research Alliance is drawing attention to the role of the fallopian tubes in many cases of ovarian cancer, stating that more women, including those at moderate risk, should consider having their fallopian tubes removed to reduce their cancer risk.

According to the National Cancer Institute, about 20,000 women in the United States were diagnosed with ovarian cancer, and about 13,000 women died from it in 2022.

Experts have not yet discovered a reliable test that identifies early stages of ovarian cancer, which is why they are relying on awareness of symptoms to diagnose patients, according to the Ovarian Cancer Research Alliance.

Unfortunately, symptoms of ovarian cancer often don’t appear until the cancer is advanced, which leads to the disease going undetected and undiagnosed until it has progressed to a later stage.

“If screening were done to detect early-stage ovarian cancer, patients’ outcomes would be significantly better,” said Dr. Oliver Dorrigo, director of gynecologic oncology at Stanford University Medical Center.

Until this test becomes widely available, some researchers are proposing a different way to reduce the risks, namely, surgical removal of the fallopian tubes.

Research has found that about 70 percent of ovarian cancer cases begin in the fallopian tubes, according to the Ovarian Cancer Research Alliance.

Doctors have already advised more women at high risk to have their fallopian tubes removed.

According to the US Centers for Disease Control and Control, several factors can increase the risk of ovarian cancer, including genetic mutations, endometriosis, or a family history of ovarian or breast cancer.

If patients accept that they will no longer be able to conceive, and if they are already planning to have pelvic surgery, a fallopian tubectomy may be a “benefit”.

“We’re talking about cases where the surgeon is in the abdomen anyway,” like during a hysterectomy, said Dr. Karen Low, associate professor and chief of gynecological oncology and reproductive medicine at MD Anderson Cancer Center.

Although the Ovarian Cancer Research Alliance has changed its recommendation to include women at average risk of ovarian cancer, some experts continue to emphasize fallopian tube removal only for women at high risk. Some of them call for more research on the procedure’s effectiveness in women who are at moderate risk.

The fallopian tubes are generally between 4 and 5 inches long and about half an inch thick each, according to Dorrigo, MD, director of gynecologic oncology.

During a fallopian tubectomy, both fallopian tubes are separated from the uterus and a thin layer of tissue that runs the length of them from the uterus to the ovaries.

The procedure can be performed laparoscopically, using a thin instrument and a small incision, or through open surgery, which involves making a large incision across the abdomen.

Unlike a total hysterectomy, in which a woman’s uterus, ovaries, and fallopian tubes are removed, removing the tubes themselves does not affect the menstrual cycle and does not lead to menopause.

The risks associated with opportunistic salpingectomy are relatively low.

Many women who have had this procedure say its benefits far outweigh the risks.

Last January, American Carlucci had her fallopian tubes removed while undergoing a total hysterectomy, after it was confirmed that she had a genetic condition called Lynch syndrome that doubled her risk of developing several types of cancer, including in the ovaries.

Carlucci noted that several members of her family had died from colon and ovarian cancer, which prompted her to consider her options.

Knowing that she could opt for a fallopian tube removal, which greatly reduced her chances of developing ovarian cancer, gave her hope.

She said, “I can’t change my DNA, and neither diet nor exercise nor medication can change my destiny, which made me feel helpless. When I got the news that this surgery would 100% spare me any ovarian cancer in my body, it was such a relief.” “.

Carlucci urges any woman with an average or high risk of developing ovarian cancer to speak to their doctor about the surgical procedure.

For her part, Audra Moran, president and CEO of the Ovarian Cancer Research Alliance, has one message for women: “Know your risk.”

Moran believes that if more women were able to know their risk of ovarian cancer, it would save more lives.

“Research your family history,” she said. “Did you have a history of ovarian, breast, colorectal, or uterine cancer in the family?”

She continued, “If the answer is yes, I would recommend speaking to a doctor or speaking to a genetic counsellor.”

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