In an unprecedented medical event, four women have simultaneously undergone Caesarean birth and undergone preventative surgery to reduce their risk of ovarian cancer. This multifaceted treatment took place at a London hospital and has been hailed as a medical breakthrough.
However, the medical community asserts that this major decision requires careful consideration, noting that the removal of the ovaries instigates an artificially early onset of menopause. In addition, performing this invasive surgery concurrently with a Caesarean delivery could lead to significant blood loss due to physiological alterations associated with pregnancy. Despite the risks, integrating these procedures can alleviate anxiety and circumvent the waiting period typical of separate operations to reduce the risk of cancer by removing fallopian tubes and ovaries, typically standalone procedures.
The clinical expert behind this approach, Prof. Adam Rosenthal, from University College London Hospital, asserted that this unique dual surgery had not been documented previously in medical literature. The findings have since been published in the latest Journal of Obstetrics and Gynaecology.
Among the four women to experience this innovative dual surgical approach was Claire Rodrigues Lee, a 45-year old Londoner. Awake but numbed by spinal anaesthesia, Lee underwent the twin operations that took around sixty minutes to complete. This revolutionary operation was undertaken during the birth of her second child when she was 41.
Detailing her remarkable experience, Lee recalls the surreal moment when she was handed her newborn son for an intimate first connection, right before the commencement of the second procedure. While she held him, the doctors turned their focus towards the next phase – a surgical intervention designed to drastically reduce her chances of developing ovarian cancer.
Prof. Rosenthal explained the intricacies of the procedure, highlighting the challenges and caution required due to the enlarged blood vessels during pregnancy. He described how the uterus is lifted from the abdomen to expose the ovaries and tubes for removal, all the while taking caution to protect the enlarged blood vessels.
Aware of her heightened risk of ovarian cancer due to her genetic disposition, Lee was proactive in electing to undergo this risk-preventing surgery as soon as she was done with childbearing. Lee wholeheartedly believes her decision was the right one, expressing relief at not enduring two separate surgeries and alleviating her fear of ovarian cancer. Speaking from personal experience, Lee shared that her recovery was no different from her previous Caesarean.
Women inheriting the BRCA1 and BRCA2 gene variants face heightened risks of developing breast and ovarian cancer. While this does not guarantee a cancer diagnosis, these women have higher than average chances. For instance, the odds of developing ovarian cancer before age 80 stands at two out of 100 for the general female population, while it elevates to 11 to 25 and 36 to 53 out of 100 for those with BRCA2 and BRCA1 variants respectively.
Lee, herself a carrier of the BRCA2 variant, made the decision to also get a preventative double mastectomy to reduce her risk of breast cancer. When her children are older, they will have the choice to get tested for the gene. Regardless of the results, they will have choices, just like their mother.
These case studies have been praised by Athena Lamnisos, from The Eve Appeal charity dedicated to raising awareness about women’s cancers. She emphasized the potential of prior preventative surgeries for women at high risk of developing ovarian cancer.