Ovarian tumors are difficult to screen and have a high fatality rate. World statistics show that 70% of patients receive the diagnosis when the cancer is already advanced and more than half of them die as a result of the disease.
Because of this, in recent years, the number of medical recommendations for performing prophylactic surgeries to remove the fallopian tubes – structures of the female reproductive system that make the connection between the ovaries and the uterus – has increased.
The procedure is called preventive salpingectomy and is minimally invasive: it can be done by laparoscopic, robotic or open surgery. The removal of the tubes does not bring hormonal impacts to women, as occurs when the ovaries are removed. but the operation, however, compromises the patient’s reproductive capacity.
Oncologist Wesley Pereira Andrade, holder of the Brazilian Society of Oncological Surgery (SBCO) and the Brazilian Society of Mastology (SBM), explains that the most recent research shows that ovarian cancer is, in fact, a tumor that arises in the tubes.
“Ovarian cancer is one of the most hidden cancers because the diagnostic methods available are flawed. That’s why the possibility of carrying out a preventive surgery, as long as the woman doesn’t want to have children, has been gaining strength”, explains Andrade.
Genes BRCA 1 e BRCA 2
Currently, there is already a consensus among medical organizations to perform surgery to remove the fallopian tubes, also called fallopian tubes, in patients with mutations in the BRCA1 and BRCA2 genes who have passed the reproductive period.
According to the research available, the chances of women in this group having ovarian cancer, as well as breast cancer, are much higher than those of the general population. It is estimated that 44% of women who inherit BRCA1 mutations and 17% of those who have BRCA2 mutations will develop ovarian cancer by age 80.
Recently, the Ovarian Cancer Research Alliance in the United States has advocated that any woman outside of reproductive age who is already preparing for pelvic surgery should consider having her tubes removed.
“The effect of this recommendation is to bring information to the patient and make her talk to the doctor about the possibility of preventing a cancer that is difficult to track”, explains oncologist Romualdo Barroso, leader of Research in Oncology at the DASA group.
individual decision
Barroso highlights the interval between 40 and 50 years as the most suitable period for undergoing surgery to remove the tubes, since the patients would have already passed the peak of the reproductive period and would not have entered menopause yet.
“Ovarian cancer is more common in menopause. The surgery would anticipate prevention without causing hormonal damage to the patients”, highlights Barroso.
Oncologist Gustavo Fernandes, clinical director of Oncologia Dasa, recalls the importance of a frank dialogue between patient and doctor when the subject involves preventive surgical procedures.
“In cases of BRCA1 and 2 mutations, the recommendation for surgery is very strong. In other cases, the decision is more intimate. Medical advice is restricted to analyzing the woman’s family history and her health condition. In addition, it is a decision of will, something of the patient’s intimate nature”, says Fernandes.
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