Four UK women successfully completed a breakthrough medical treatment in which they gave birth via caesarean section (C-sec) and had surgery to minimise their risk of ovarian cancer at the same time.
The women were all carriers of BRCA1 or BRCA2 gene mutations, putting them at a greater lifelong risk of ovarian cancer. The only proven strategy to minimise ovarian cancer mortality in these women is to do a bilateral salpingo-oophorectomy (RRSO), which reduces the risk of ovarian cancer by at least 95 per cent.
First such case of a two-in-one procedure was performed in 2018
The fallopian tubes and ovaries are removed in a standalone surgery typically. A team at the University College London Hospital (UCLH) performed the first such case of a C-sec with the risk-reducing RRSO to lower ovarian cancer risk in 2018. However, the study issued in Obstetrics and Gynaecology details case reports of four women who had the BRCA gene modification and were scheduled to have a C-section.
Between March 2018 and March 2022, all four women, aged between 40 and 45, received maternity care at the UCLH. To be considered for the treatment, women had to be above 35 or 40 years old for the BRCA1 and BRCA2 mutations, respectively, and have no plans to have any more children.
All four surgeries went well
According to the experts at the UCLH, all four surgeries went well, and none of the women experienced major post-surgical issues. Patients were not required to stay in the hospital any longer than they would have if they had only had a C-sec. There is a potential possibility of increased blood loss with risk-reducing surgery after C-section delivery; however, there was no evidence that this was a problem in these individuals.
Experts suggest two-in-one surgery could be very beneficial
Professor Adam Rosenthal, consultant gynaecologist at UCLH Biomedical Research Center, said, "Offering the two-in-one surgery could be very beneficial to other women at high risk of ovarian cancer, avoiding the need for separate risk-lowering surgery. We were delighted to hear how pleased the four patients were with the combined procedure."
"The number of women who have caesarean sections is increasing across the world, as is the number of women who are aware that they have a gene mutation that increases their risk of ovarian cancer. As a result, many more women may be candidates for the combination surgery," he added.
Moreover, Rosenthal said, "There is also a potential cost saving to any health care system by avoiding the need for two separate operations." All of the women were really pleased with the two-in-one surgery.
Surgery can cause early menopause
While the risk-lowering procedure causes infertility, women who had their eggs harvested before the risk-lowering operation may still be able to benefit from assisted reproduction. It will also cause early menopause; thus, hormone replacement therapy is recommended until the age of 51 unless there are reasons not to, such as past treatment for breast cancer, asserted the researchers.
(With inputs from IANS)