Can You Help Prevent Ovarian Cancer?
The doctors behind Outsmart Ovarian Cancer say “interception” begins with the fallopian tube, not the ovary as traditionally thought.
https://www.webmd.com/ovarian-cancer/cancer-in-context/video/ovarian-cancer-prevention?src=soc_yt
— TRANSCRIPT —
[MUSIC PLAYING]
JOHN WHYTE: Welcome, everyone. I’m Dr. John Whyte. I’m the Chief Medical Officer at WebMD. And you’re watching Cancer in Context. When we talk about cancer, we often don’t talk about ovarian cancer. Yet, someone is diagnosed every 40 minutes. And within 5 years, most people diagnosed have died.
Yet, where are we in terms of screening, treatment, and what about prevention? Is there a way to prevent ovarian cancer? My guests today say there may be. Joining me is Dr. Rebecca Stone. She is director of GYN Oncology at Johns Hopkins. And Dr. Kara Long Roche. She is associate professor at Sloan Kettering. Doctors, thanks for joining me.
KARA LONG ROCHE: Thank you so much for having us.
REBECCA STONE: Of course.
JOHN WHYTE: Well, let’s start off with describing to our audience what are we talking about when we say ovarian cancer.
KARA LONG ROCHE: Well, ovarian cancer is actually many different diseases that are lumped under the heading ovarian cancer. The most common type of ovarian cancer, which accounts for about 75%, is called high-grade serous carcinoma.
And the most important things about high-grade serous carcinoma is that there are no symptoms of this disease when it is in its early forms, and there is absolutely no available screening or early detection test. And so, most patients come in when the disease is already widely metastatic and spread throughout the abdomen. And at that point, treatment is very difficult and often unsuccessful.
JOHN WHYTE: And Dr. Stone, what about people that are saying, “Oh, hey, can’t you get a blood test to detect this?” We’re not quite there yet, are we?
REBECCA STONE: Yeah, unfortunately, that’s right. You know, we’ve had a blood test that many people may have heard of called CA 125, but it’s not a specific or sensitive marker for ovarian cancer. It’s more a marker of inflammation in general, and it hasn’t been shown to detect ovarian cancer in a sensitive enough way. For instance, it may be negative in a large number of patients who have ovarian cancer.
And so, it’s just not reliable. And the reason that that is because ovarian cancer, really, at the end of the day, the vast majority of cases actually don’t come from the ovary. We think they more likely come from the fallopian tube, and that has really proved to be a challenge when you think about screening.
Because we don’t have any imaging that can even image the fallopian tube. And when cancer spreads from the fallopian tube, it more exfoliates in the abdomen, like dandruff, so to speak, instead of being in the bloodstream early on. And so we just haven’t been able to detect it using traditional modalities of cancer detection.
JOHN WHYTE: And we all talked a while back about ovarian cancer and how it’s so important to discuss the fallopian tube. And most people aren’t familiar with it. I know, Dr. Stone, you have a picture of it in your background, if you want to come to that. And we don’t want to do an anatomy lesson. But maybe help women and others understand why, Dr. Long Roche, is the fallopian tube so important when we talk about ovarian cancer.
KARA LONG ROCHE: Well, about 20 years ago, someone really started looking in the fallopian tubes of patients who are undergoing preventative surgery for various high-risk situations. And what they found is in the little fingerlike ends of the fallopian tube, that sit right near the ovary and are exposed to the surfaces in the pelvis, they found little tiny precancers, which we now call stic lesions or serous tubal intraepithelial carcinomas.
And 20 years of science amassed, and we now see that those stic lesions are really the source of the subsequent metastatic high-grade serous carcinoma. And it actually was a huge light bulb moment because we understood, finally, why screening wasn’t working.
Transcript in its entirety can be found by clicking here:
https://www.webmd.com/ovarian-cancer/cancer-in-context/video/ovarian-cancer-prevention?src=soc_yt