Salpingo-oophorectomy, i.e., the removal of the ovaries and fallopian tubes when there is a high risk of developing ovarian cancer or a relapse in breast cancer, is usually done laparoscopically, so three incisions are made in the abdomen to extract the ovaries. Although it is not a very complicated procedure, Dr. Javier de Santiago, head of the Gynecologic Oncology Service at MD Anderson Cancer Center Madrid, points out that "these incisions can become infected, cause pain or discomfort". For this reason, the service headed by Dr. De Santiago prefers to opt for single port laparoscopic surgery, which, as he explains, "uses a natural scar, the navel, for the removal of the ovaries."
Thus, the doctor goes on to say, "a very small incision is made in the navel, between 1.5 -2 centimeters, in an ambulatory procedure taking approximately between 30-40 minutes, so the patient can go home the same day". Although, more than the length of hospital stay (sometimes, patients who undergo traditional laparoscopic surgery do not need hospital admission either), the most important thing, emphasizes the doctor, is that "recovery is much better and faster, which directly affects the quality of life of the patient". MD Anderson Madrid is one of the few hospitals in Spain that performs this type of prophylactic surgery from single port laparoscopic surgery.
When selecting patients, the specialist emphasizes that it is very important to explain the pros and cons of the procedure to the patient, taking into account certain factors. So, for example, it is important to consult a genetic counseling clinic to determine the exact genetic mutation the person carries and the percentage of risk derived from it because, as Dr. Santiago explains, "this percentage can vary from 5% to 80%, which very much determines the decision to submit or not to the procedure". In addition, the specialist also points to age as an important factor. "It is usually done in cases when the woman has already completed her desire to have children and no longer menstruates," he states.
As for the subsequent treatment of patients, it depends more on the reason for the procedure and again on age than on the technique used. "With some types of ovarian cancer it is possible to follow up with hormone replacement therapy, but we will not be able to prescribe it if the procedure was performed due to a relapse in breast cancer or a hormone-dependent tumor," says Dr. Santiago, who wanted to stress the use of hormone replacement therapy after the preventive removal of the ovaries, especially in young women, with the aim of preventing the onset of early menopause.
Encounters with patients with ovarian cancer
Aware of the importance not only of the treatments, but also of the human treatment with the patients, next Tuesday, May 22, between 10.00 and 13.00, MD Anderson Madrid will organize one of its 'Encounters with patients'. Coordinated by Dr. Marisa Argente, of the Gynecologic Oncology Service at the center, the meeting will be held at the hospital and is aimed at anyone affected by ovarian cancer, whether or not they are being treated at MD Anderson Madrid, and their families.
Together with Dr. Argente, who will talk about menopause and quality of life, Dr. Raul Marquez, head of the Gynecologic Tumors Section at MD Anderson Madrid, will also be participating in the meeting giving a more general introductory talk on ovarian cancer, and Marta de la Fuente, head of the center's Psycho-oncology Service, which will focus mainly on giving advice to family members on the best way to treat patients with ovarian cancer.