Doctors: Preventive cancer surgeries are trade-offs - Times of India

MUMBAI: Preventive cancer surgeries are so far rare among Indian women, but Hollywood actor-director Angelina Jolie may have stoked the debate about their merits once again after announcing that she had undergone surgery to remove her ovaries and fallopian tubes. She underwent a double mastectomy in 2013 after testing positive for a BRCA1 genetic mutation that increases the risk of breast and ovarian cancer.

In a Tuesday article in the New York Times, Jolie said she took the decision after several marker inflammation tests showed elevated levels, indicating a pre-cancerous state.

Indian cancer surgeons don't recommend drastic preventive surgeries. Dr Rajendra Badwe, who is the director of Tata Memorial Hospital and a breast cancer surgeon, said preventive cancer surgeries can only be viewed as trade-offs. "If a young woman discovers she has the BRCA1 or 2 mutations and decides to undergo surgeries to remove her breasts as well as ovaries before she turns 30, her chances of getting a myocardial infarction (heart attack) increases by two and a half times."

There are no studies to indicate the merits or demerits of such preventive surgeries. What is known is that if a woman with a BRCA1 or 2 mutation gets her ovaries and fallopian tubes removed, she completely eliminates her chances of getting ovarian cancer and reduces the risk of breast cancer by 50%.

Dr Hemant Tongaonkar, who is a cancer surgeon specializing in urology and gynaecology, said he wouldn't recommend such drastic surgeries to any of his patients. "There are other ways such as regular checks to prevent cancer," he said, adding the situation would differ from one individual to another.

Moreover, doctors said that a BRCA1 or 2 mutation doesn't always result in cancer. They said that if a woman with such a mutation has crossed 40, her chances of cancer are not as high as before. "If she has crossed 50, it is possible that there is something working to balance out the risk caused by BRCA1 mutation," said Dr Badwe.

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