Today, I’d like to share three major things that B.C.’s OVCARE team has contributed in the last decade:
1) TAKING STEPS TOWARD PERSONALIZED MEDICINE: A woman diagnosed with ovarian cancer today will be managed according to the SPECIFIC type of cancer she has. This may mean she can be spared toxic therapies that may not help her, or receive better therapies with higher success. (Message: Just because many cancers grow in the ovary(ies) does not mean it is one disease…they are distinct).
2) PREVENTION in women at HIGH RISK: The SPECIFIC subtype can also be a flag for inherited or familial cancer syndromes that, if known about (through referral to a genetic counselor and a blood test), allows the patient to screen for other cancers. It also allows her family members to undertake risk-reducing steps (e.g., surgery or screening) that may prevent them from ever actually getting cancer!
Our pathology reports now automatically suggest that women with specific types of ovarian cancer should be tested and we believe this step will identify many more women than ever before (Message: family history is not enough. Cancer subtype is a better way to refer and identify at-risk individuals).
3) PREVENTION in the GENERAL POPULATION: In 2010, OVCARE launched a prevention campaign led by Dr. Dianne Miller that capitalized on the new understanding of the role of the fallopian tube in ‘ovarian’ cancers. It recommended to physicians and patients that when undergoing gynecologic surgical procedures (such as removal of the uterus—hysterectomy—or getting their “tubes tied” for contraception), they consider removal of the fallopian tubes at the same time.
We know the most common type of ‘ovarian’ cancer originates in the fallopian tube and that the next two most common types originate in the uterus and travel along the fallopian tube. Thus, removal of the tube should have a major protective effect on these cancer types. Termed “Opportunistic Salpingectomy,” we believe this intervention, along with increased identification of high-risk women (see point 2, above) will reduce ovarian cancer cases by approximately 30%. (Message: Ask your doctor about your tubes. Educate your friends. There is no recommended way to screen for ovarian cancer. Prevention is the key).
Alas, despite these exciting advances we have a long way to go. We still lose far too many women to gynecologic cancers every year in B.C. and I am often very frustrated with what we can offer them.
I am, however, encouraged by an evolving intelligent approach to the management of gynecologic tumors, using good science to drive appropriate care. As a surgeon and a translational researcher I am honoured to be part of this B.C. team! Many thanks to the Foundation and the community for supporting our ongoing work.