WOMEN with so-called cancer genes should consider having their fallopian tubes removed to guard against a heightened risk of ovarian cancer, an expert says.
Providing they have had children, women who are found to be carrying the BRCA1 or 2 genes, such as actress Angelina Jolie, should think about such a course of action, says Professor Sean Kehoe, one of the UK's leading gynaecological oncologists.
Professor Kehoe, of the University of Birmingham, pointed to "a groundswell of evidence" suggesting the disease often starts in the fallopian tubes of women carrying the genes and not the ovaries as previously thought.
"Women who carry the BRCA1 gene are currently advised to have their ovaries removed by the time they are 40; whilst carriers of the BRCA2 gene are advised to have them removed no later than 50. This procedure normally includes removal of the fallopian tubes," he said.
"There may be certain situations whereby removal of the fallopian tube at an earlier age than that recommended for the ovaries be deemed appropriate - but there is a need to investigate this further.
"More research is needed to show that this approach would provide a worthwhile reduction in their risk of developing ovarian cancer, but based on recent findings there is evidence to support this concept.
"One disadvantage would be the need for two operations, hence the need to research this in much more detail."
Ovarian cancer is known as the silent killer because its symptoms often present too late for effective intervention. Up to 7000 women a year are diagnosed with the disease and 4500 die. One in 10 ovarian cancers are caused by an inherited faulty gene.
Jolie is the latest and most high-profile star to highlight the dilemma facing women at high risk of developing breast cancer.
The star revealed in May that she had undergone a preventative double mastectomy to reduce her risk of developing the disease.
Her mother Marcheline Bertrand died of cancer in 2007.
Jolie, a mother of six and partner of Brad Pitt, said she took the decision to have the procedure because she found she carries BRCA1, which sharply increases her risk of developing breast cancer and ovarian cancer.
"Recent studies suggest that the fallopian tubes may be the source of up to 50 per cent of so-called ovarian cancers though research is ongoing," Prof Kehoe said.
"Pre-cancerous changes have certainly been noted in the fallopian tubes of BRCA carriers when carefully examined.
"Unfortunately there are no diagnostic tests for identifying pre-cancerous or early cancerous cells in the fallopian tubes which would explain why the disease so often goes undetected until it has spilled out of the end of the tubes on to the ovaries and around the abdomen. Only then do symptoms develop. Tragically, by this time, the outcome is poor.
"Blood tests may one day help in screening or early diagnosis of cancer in the fallopian tubes in the future but the technology is not yet that advanced."
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