Most ovarian cancer patients are diagnosed with tumours spread throughout the abdomen (~70 per cent). Identifying the exact location of the first tumour without genetic tracing is challenging. For a long time, when tumours were found around the ovaries and looked epithelial under a microscope, they were assumed to be ovarian cancer.
While there were a few researchers who questioned this theory, the majority of the scientific community was shocked when a genetic assessment of tube and ovary cells revealed that the most common kind of ovarian cancer (and the deadliest), high-grade serous ovarian carcinoma, wasn’t ovarian cancer at all, it originated from the fallopian tubes.
In one study, researchers evaluated fallopian tube cells for pre-cancerous mutations and estimated the time between developing these mutations and the onset of clinical cancer. The result was SEVEN YEARS! This is huge for a disease where most individuals are diagnosed at late stages. Despite these discoveries, high-grade serous ovarian carcinoma remains a commonly used misnomer. While researchers are still trying to figure out how to detect these cells before clinical cancer develops, this knowledge is changing how prophylactic interventions are approached.
Individuals carrying mutations in the BRCA (BReast CAncer) genes increase the risk of breast cancer from 13 per cent to 70 per cent and ovarian cancer from one per cent to 25 per cent (numbers vary widely depending on the study and population). Many people who carry BRCA mutations choose to have their breasts, ovaries and fallopian tubes removed to reduce this risk. However, removing ovaries can have drastic consequences on how someone lives their life. It immediately shifts them into menopause; therefore, having the option to remove just the fallopian tubes while keeping ovaries for a more extended period might be an attractive option to some.
Those who undergo gynecologic surgery for other reasons, like delivery, can also be presented with this opportunity. A study led by Gillian Hanley at the University of British Columbia found that removing the fallopian tubes while leaving the ovaries intact rather than tubal ligation (tying of tubes) during hysterectomy significantly decreased the risk of ovarian cancer up to 65 per cent.
Comic illustration by Sarah Nersesian
