Ovarian cancer, the number one enemy of women 1:26
(CNN) --
"Knowledge is power," says Samantha Carlucci, 26.
The Ravenna, New York, resident recently underwent a hysterectomy that included removal of her fallopian tubes, and she believes she saved her life.
Experts seek to raise awareness about the role of the fallopian tubes in many cases of ovarian cancer and say that more women should consider having them removed to reduce cancer risk.
According to the National Cancer Institute, in 2022, about 20,000 women in the US were diagnosed with ovarian cancer, and nearly 13,000 died.
Experts have not discovered a reliable screening test to detect the early stages of ovarian cancer, leading them to rely on knowledge of symptoms to diagnose patients, according to the Ovarian Cancer Research Alliance.
Unfortunately, the symptoms of ovarian cancer often do not appear until the cancer has advanced, leaving the disease unrecognized and undiagnosed until it has progressed to a more advanced stage.
"If we had a test to detect ovarian cancer at an early stage, the prognosis for patients would be significantly better," says Oliver Dorigo, MD, director of the division of Gynecologic Oncology in the Department of Obstetrics and Gynecology at New York Medical Center. Stanford University.
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Until such a test becomes widely available, researchers and advocates suggest another way to reduce risk: opportunistic salpingectomy.
Surgical removal of both fallopian tubes, known as a salpingectomy, may be a good option for women at high risk of ovarian cancer.
According to the US Centers for Disease Control and Prevention (CDC), there are several factors that can increase this risk, such as genetic mutations, endometriosis, or a family history of ovarian cancer. or mom.
According to the Alliance for Ovarian Cancer Research, almost 70% of ovarian cancers originate in the fallopian tubes.
Doctors are now advising more high-risk women to have a salpingectomy if they accept that they will not be able to become pregnant afterward and if they already plan to have pelvic surgery, making it "opportunistic."
"We're really talking about cases where a surgeon would already be [working] on the abdomen anyway," such as during a hysterectomy, said Karen Lu, MD, professor and chief of the Department of Gynecologic Oncology and Reproductive Medicine at MD Anderson Cancer. Center.
According to Dorigo, the fallopian tubes are usually between 10 and 12 centimeters long and about one centimeter thick.
During an opportunistic salpingectomy, both tubes are separated from the uterus and a thin layer of tissue that runs along the tubes from the uterus to the ovary.
The intervention can be done laparoscopically, with a fine instrument and a small incision, or by open surgery, which involves a large incision through the abdomen.
The intervention adds about 15 minutes to any pelvic surgery, explains Dorigo.
Unlike a total hysterectomy, in which the uterus, ovaries, and fallopian tubes are removed, tube removal does not affect the menstrual cycle or initiate menopause.
The risks associated with an opportunistic salpingectomy are also relatively low.
"Any surgical intervention carries a risk... so you should not undergo any surgery without consideration," Lu said.
"The risk of a salpingectomy for someone who is going to be operated on, though, I would say is minimal."
Cancer affects more people between the ages of 30 and 40.
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"It can be a great relief"
Many women who have had the procedure say that the benefits far outweigh the risks.
Carlucci had her fallopian tubes removed in January during a total hysterectomy after testing positive for a genetic disease called Lynch syndrome that multiplies her risk of many cancers, including ovarian cancer.
Several members of her family have died of colon and ovarian cancer, she says, and that prompted her to explore the options available.
Samantha Carlucci recently underwent a hysterectomy that included removal of her fallopian tubes.
Courtesy of Samantha Carlucci
Knowing that she could opt for an opportunistic salpingectomy, which greatly reduced her chances of developing ovarian cancer, gave her hope.
As part of the total hysterectomy, it eliminated her risk of ovarian cancer.
"You can't change DNA, and no amount of diet, exercise, or medication is going to change it, and I felt awful," Carlucci says.
"When I got the news that this would 100% save me from having to deal with any ovarian cancer in my body, it was good to hear."
Carlucci urges any woman with a medium or high risk of ovarian cancer to talk to her doctor about the procedure.
"I know it's scary, but it's something you have to do, or at least consider," he says.
"It can be a great relief to know that you have made up your mind to stay here as long as possible."
Monica Monfre Scantlebury, 45, of St. Paul, Minnesota, underwent a salpingectomy in March 2021 after witnessing a breast and ovarian cancer-related death in her family.
In 2018, Scantlebury's sister was diagnosed with stage IV breast cancer, aged 27.
"She continued to fight breast cancer," Scantlebury said.
"During the beginning of the pandemic, in March 2020, she lost her battle with breast cancer, at the age of 29."
During this period, Scantlebury herself discovered that she was positive for BRCA1, a genetic mutation that increases a person's risk of breast cancer by 45-85% and ovarian cancer risk by 39-46%. %.
After meeting with her doctor and discussing her options, she decided to have a salpingectomy.
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Her doctor told her that he would remove her fallopian tubes and anything else concerning that was found during the procedure.
"When I woke up from the operation, he told me that I had something on my left ovary and that he had removed my left ovary and my fallopian tubes," Scantlebury says.
Her doctor called her a week later and told her that there were cancer cells in her left fallopian tube.
The salpingectomy had saved his life.
"We don't have an easy way to get diagnosed until it's almost too late," said Scantlebury, who underwent a full hysterectomy.
"This really saved my life and has potentially given me back decades I might not have had."
"Examine your family history"
Audra Moran, president and CEO of the Ovarian Cancer Research Alliance, sends a message to women: Know your risk.
Moran believes that if more women had the power to know their ovarian cancer risk, more lives would be saved.
"Examine your family history. Has there been a history of ovarian, breast, colorectal, or uterine cancer in your family? From either side, male or female, father or mother?"
Moran says.
"If the answer is yes, then I would recommend talking to a doctor or a genetic counselor."
The Alliance offers resources on genetic testing on its website.
According to the US Bureau of Labor Statistics (BLS), genetic counselors assess the risk of different types of cancer based on hereditary diseases.
Carlucci and Scantlebury agree that knowing the risks is key to preventing deaths among women.
"It's my story. It's her story. It's my sister's story... It's every woman's story," Scantlebury said.
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