By the time symptoms of ovarian cancer appear, it is usually in an advanced stage. It is very difficult to treat and unfortunately most people die. One in 78 women will develop ovarian cancer, and more than 230,000 women in the United States currently have ovarian cancer. Of these, approximately 80% have no family history of ovarian cancer and no indication that they are at risk of developing ovarian cancer.
Diagnosis is made at a late stage because, in addition to the lack of early symptoms, there are no effective methods to screen for or diagnose early-stage ovarian cancer. A recent study of hundreds of thousands of women showed that screening with ultrasounds and blood tests did not save as many lives as expected. Indeed, ineffective screening leading to false reassurance (due to false-negative results) is a serious concern, even in high-risk patients.
Despite the name “ovarian cancer,” scientific discoveries over the past two decades have shown that the fallopian tubes (two thin tubes that allow eggs to travel from the ovaries to the uterus) are the most common. It has been shown to be the site of origin for the most lethal form of ovarian cancer. Ovarian cancer, high-grade serous carcinoma. Researchers have found that the cells that line the fallopian tubes are particularly susceptible to mutations in cancer-suppressing genes. p53. These mutations cause cancer cells to grow uncontrolled and spread throughout the body.During study p53 Scientists who discovered mutations in ovarian cancer traced them to tiny precancerous cells in the fallopian tubes.
Since most ovarian cancers originate in the fallopian tubes, researchers believe that people who have their tubes removed, which is done to remove an ectopic pregnancy, treat the inflammatory process in the fallopian tubes and, in some cases, prevent pregnancy. I decided to investigate whether it could be treated as a form. It reduces the risk of developing ovarian cancer. Large-scale epidemiological studies have shown this to be the case, and it has been eye-opening for doctors like us. Given the seemingly insurmountable challenge of developing a screening test, clinicians are advising women who have given birth or who have already undergone elective surgery to have their fallopian tubes removed to prevent ovarian cancer. We are starting to offer options. This strategy, called “opportunistic salpingectomy,” is safe, and early data suggests it can reduce the risk of ovarian cancer by at least 65%. Also, as part of another gynecological procedure, prophylactic removal of the fallopian tubes is supported by the American College of Obstetricians and Gynecologists and many professional societies around the world.
Removing the fallopian tubes may sound like a radical idea, especially given the risks associated with elective surgery, but in the United States alone, more than one million women each year have a hysterectomy or egg. have undergone ductal ligation and these are considered elective as well. The two most common gynecological changes, due to the simple surgical technique of removing the fallopian tubes along with the uterus during a hysterectomy and removing the fallopian tubes instead of “tying them” if surgical contraception is chosen The preventive effect of ovarian cancer is added to surgery. Separate medical intervention. As a surgeon, this is a move that I believe is in the patient’s best interest.
Surgery is currently the best option for reducing the risk of ovarian cancer. Ultrasound and other pelvic imaging techniques help visualize the uterus and ovaries, but cannot reliably show the fallopian tubes. Additionally, cancer cells from the fallopian tubes can spread while still visible under a microscope. Effective screening requires techniques that can both “see” the tube and identify precancerous cells under the microscope.
Finding biomarkers for early disease has been similarly difficult. Known biomarkers usually become detectable in the bloodstream only after cancer has progressed well beyond the fallopian tubes and adjacent ovaries. Testing for blood biomarkers has never proven useful because early disease progression occurs through the direct spread of microscopic cells from the fallopian tubes to the surface of organs and tissues in the abdominal cavity, rather than through the blood. may not be
Unlike removal of the ovaries, which causes menopause, removal of the fallopian tubes has no known adverse health effects after childbirth is complete, although there are nominal risks to original surgical performance and recovery. and time is added. It was introduced into routine practice in British Columbia more than a decade ago as an alternative to salpingectomy during hysterectomy and tubal ligation for surgical contraception. Researchers recently published preliminary data showing that this practice reduces the incidence of ovarian cancer in the general population. The potential for reducing the number of people contracting this deadly cancer by changing surgical techniques that do not have lasting effects after birth is game-changing. Extending this option to non-gynecologic surgeries would dramatically increase the number of people who could receive surgical prevention of ovarian cancer, and is the culmination of ongoing implementation research.
It is important for people to take greater ownership of their health, especially when it comes to cancer prevention for which there is no adequate screening or reliable treatment. Efforts are underway to ensure that opportunistic salpingectomy is offered to all patients who desire surgical contraception or undergo a hysterectomy. In addition, there are increasing efforts to extend this beyond gynecological procedures to operations such as gallbladder surgery and hernia repair. Saving lives from ovarian cancer could become a reality in our lifetime if we offer the hundreds of thousands of people who undergo laparotomy in the US each year a chance to have a salpingectomy. .
This is an opinion and analysis article and the views expressed by the author are not necessarily those of the author. Scientific American.
