Ovarian cancer preven­tion: Practice changes

Issue: BCMJ, vol. 52, No. 10, December 2010, Page 532 News

Gynecologic oncologists with the Ovar­ian Cancer Research Program at Vancouver General Hospital (VGH) and the BC Cancer Agency (BCCA) have begun a campaign to reduce deaths from ovarian cancer. 

They are asking all BC gynecologists to change surgical practice to fully remove the fallopian tube when performing hysterectomy or tubal ligation. Current practice leaves the fallopian tube in place for many types of hysterectomy and tubal ligation. This is a matter of convention, not need. 

The request stems from new re­search by the Ovarian Cancer Research Program at VGH and BCCA. The BC research team and others have recently discovered that the majority of high-grade serous tumors, the most deadly form of ovarian cancer, actually arise in the fallopian tube, not the ovary. The British Columbia data were published in 2009 in the International Journal of Gynecological Cancer. 

The importance of the discovery was furthered by information contained in the Cheryl Brown Ovarian Cancer Outcome Unit at VGH and BCCA. The data demonstrated that 18% of women who developed ovarian cancer had a prior hysterectomy. 

The research team, which is made up of surgeons, oncologists, and pathologists, also made a related discovery. They found one in five ser­ous cancer tumors occur because of a germline BRCA genetic mutation, meaning that in 20% of cases they are discovering the index case—a woman may have no prior history of ovarian cancer in her family, but will now know that her children and their children could be at risk. Physicians will have the ability to screen them genetically and act proactively.

The research team is translating their findings to benefit patient care. With a donation from a private donor to VGH and the UBC Hospital Foundation, they developed and produced an educational DVD, which has been delivered to all gynecologists in BC. The message is twofold: remove the fallopian tube during surgery, and refer ovarian cancer patients who have a serous tumor to the Hereditary Cancer Program at the BCCA. 

The education outreach program is led by Dr Sarah Finlayson, gynecologic oncologist, Ovarian Cancer Re­search Program, and assistant professor, University of British Columbia Faculty of Medicine.

. Ovarian cancer preven­tion: Practice changes . BCMJ, Vol. 52, No. 10, December, 2010, Page(s) 532 - News.

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