Study: Women with BRCA1 mutations should remove ovaries by 35


#1

Population Control at its finest, via Susan G. Komen foundation:

Study: Women with BRCA1 mutations should remove ovaries by 35

Researchers found that women with BRCA1 and BRCA2 mutations who protectively had their ovaries removed reduced their risk of ovarian, fallopian tube, or peritoneal cancer by 80%, and their overall risk of death by 77%.

BRCA stands for breast cancer susceptibility genes, a class of genes known as tumor suppressors. Mutations of the BRCA1 and BRCA2 genes have been linked to hereditary breast and ovarian cancer.

According to Monday’s study, women with BRCA1 mutations should have preventive ovarian surgery-- known as prophylactic oophorectomy – by age 35, as waiting appears to increase the risk of ovarian cancer. In contrast, women with BRCA2 mutations can safely delay surgery until their 40s, the study suggests, as their risk of ovarian cancer is not as strong.


#2

Wouldn’t having anything removed reduce the chance of it becoming cancerous by 100%? I mean if you don’t have it how can it develop cancer.

I’d like to point out how they don’t let women know that hormonal birth control while reducing the risk cervical cancer increase the risk of breast cancer. That’s just trading once cancer for another. :shrug:


#3

Couldn’t a woman just get a mastectomy if the gene is there? IIRC that’s what Angelina Jolie did because she had said gene.


#4

Now, let’s not politicize everything. The role of the BRCA genes in cancer has been known for a long time (they taught us a bit about them during our first year of medical college, way back in 1997), and even the Church isn’t opposed to such a procedure when the intent is saving lives rather than sterilization. (For example, if I developed testicular cancer, I’m sure the Church would have no problem with radiation therapy or even orchidectomy as a life-saving measure.) And given that they’re recommending the procedure only after the age of 35 (by which most women in most of the world have already had several children) this isn’t a very effective means of “Population Control”.

That said, given the sponsors involved, I’d like to have a closer look at that paper and the claimed efficacy of the procedure. Bad science is endemic in today’s world. :wink:


#5

I don’t recall seeing any mention of the Komen Foundation in the news article. Am I missing something?

As for the study, it seems consistent with past studies, at least according to the article.


#6

Bad form! The word “Komen” doesn’t appear anywhere on the web page. Shall I report you for detraction?


#7

:thumbsup:

It’s at moments like these that I realize the wisdom of Pope Francis’ words that we cannot focus exclusively on certain things.

As Catholics, we are bound to oppose all moral evils, especially those that destroy lives and souls.

However, when this becomes a witch-hunt and a searching for devils behind every door, the Enemy has a good chuckle at us.


#8

Would removing ovaries because they might become cancerous be compatible with Catholic teaching? I mean, you’d effectively be sterilizing yourself simply because you might get cancer.


#9

This is the heart of the matter. :thumbsup:

I think the burden of proof would be on those claiming that it was an effective prevention method. If the odds were, say, 50/50, I’d still hold my breath. But if the risk was high and consistently replicated across studies (in medical science, generalizing from a single study is very dangerous), and was, say 90% or 95%, then it might be permissible. Looking forward to what the Catholic Bioethics Quarterly has to say on the issue. :wink:


#10

I decided to look up an answer. :blush:

There wasn’t any information (that I could find) in the Ask an Apologist forum. However, I did see a referral to the National Catholic Bioethics Center. So I went there,

Fr. Tad Pachocyzk wrote an article which dealt precisely with the recommendation to remove ovaries to prevent breast cancer. Here is what he wrote:

*[C]ontroversy exists regarding this recommendation. Precautionary surgery of this kind has been termed “mutilating” and “extreme” and some question whether it is, in fact, justifiable, given that the organs appear to be healthy (no cancer is yet detectable), and there is a limited probability that the disease may one day appear. Some medical professionals instead encourage frequent monitoring and screening of patients with the BRCA mutation, so that if cancer appears, and as soon as it appears, aggressive surgery could then be pursued.

On one side, then, are those who stress that the integrity and order of the human body should be respected and not unduly violated (the “Principle of Integrity”), while on the other are those who stress that an individual organ or a part of the human body may be sacrificed if that sacrifice means continued survival for the whole person (the “Principle of Totality”). The solution to the dilemma of preventative surgery will lie somewhere in the middle, with emphasis being placed upon the weightier Principle of Totality. The decision to undergo preventative surgery will thus be ethically justifiable and reasonable in certain cases.*

The real costs of this kind of surgery remind us of the importance of making a right and ethical decision for our circumstances. Although there is a heightened probability of disease, there is never any guarantee that a particular woman with the BRCA mutation will develop cancer. Some women will go on to develop cancer; others will not. So while the surgical removal of ovaries and/or breasts will prevent the disease from developing in some women, in others, it will make no difference, since they were never going to get the disease in the first place

*Even in the face of several known risk factors, however, a woman may still wish to delay such preventative surgery until she has had the opportunity to have children, or she may freely choose against it altogether.

To sum up then, even though a woman with multiple risk factors can never categorically prove that she will develop cancer in the future, she may nevertheless arrive at prudential certitude that she will develop the disease after carefully assessing the various risk factors. Insofar as she achieves that prudential certitude within herself, she not only may, but ought to consider seriously the possibility of undergoing risk-reduction surgery.
ncbcenter.org/page.aspx?pid=1101*

I simply excepted the most relevant parts of his article. You may wish to read the entirety.

Rev. Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, MA, and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia.


#11

[quote=DaveBj] Quote:

Originally Posted by Elizium23

Population Control at its finest, via Susan G. Komen foundation:

Study: Women with BRCA1 mutations should remove ovaries by 35

Bad form! The word “Komen” doesn’t appear anywhere on the web page. Shall I report you for detraction?
[/quote]

I doubt much anyone would care if you did report them for “detraction.”

Perhaps you could adopt a more Christian worldview and give her the benefit of the doubt that she made a mistake conflating Planned Parenthood with Moment?

Posted from Catholic.com App for Android


#12

It makes as little sense as someone cutting off their arms and legs because they are afraid they might get cancer one day. They are encouraging the mental illness called hypochondria.


#13

The difference is that here, there is (at least, it is claimed) objective genetic and clinical evidence that these women have a high risk of getting cancer. But, again, I’d like to look at the original results, and not the media digest. In hypochondriasis, people still feel they are ill even when their laboratory tests are completely negative. :slight_smile:


#14

Shared on their Facebook page.

That’s how I heard of it. Now calm down.


#15

Okay, thanks for explaining. I was confused by your reference, and figured you had some kind of outside conversation or reference

:confused:
[/quote]


#16

Alas, this study is being over-hyped.

You can read it here yourself:

jco.ascopubs.org/content/early/2014/02/24/JCO.2013.53.2820.full.pdf+html

Now, I’m not an oncologist (psychiatry is my field), but I do know a bit about statistics*, so let’s wade into this:

The study looked at 5,783 women who carried the genes in question, and who were followed up for over 5 years.

2,270 of these chose not to undergo the oophorectomy.
2,123 did so at baseline.
1,390 did so at some point during the follow-up.

46% of these women already had breast cancer at baseline, so we’re already talking about a high-risk population.

36.6% of them used oral contraceptives, which can bollix up your results (it’s a “confounding factor” to use the jargon.)

Now let’s look at results:

Of the 2,270 who didn’t undergo surgery, 4.8% (108) developed cancer. (Let’s call them Group A.)
Of the 2,123 who did at baseline, 1.1% (23) developed cancer. (Let’s call them Group B.)
Of the 1,390 who did so later, 4% (55) developed cancer. (Let’s call them Group C.)

In other words, the 5-year risk of cancer is only 4.8% even if you don’t undergo the surgery.

Of course, when you compare Group A and Group B and do some high-powered statistics, you will find that the surgery has reduced the risk of cancer by around 80% (you can work this out roughly just by looking at the percentages.) This difference is large enough that it isn’t due to chance alone - i.e., it is “statistically significant”. By way of comparison, though Group C seemed to do better than Group A, the difference (4 vs 4.8%) could just be a chance variation; it is not “statistically significant”.

The authors have used a standard trick - presenting relative risks - to make the surgery look better than it does. 80% sounds impressive. In reality, we’re talking of a drop in odds from 4.8% to 1.1% over 5 years, nothing more, nothing less. The majority of women who didn’t undergo the surgery - 2162 of the 2270 women - did not develop cancer.

Bottom line: 80% reduction from 4.8% isn’t really that big a deal.

Based on this study, I wouldn’t recommend the procedure to anyone (regular monitoring and checking for signs of early cancer would do as well, but I’m not an oncologist, so I’ll stop there.) This is what happens when the media reports results that are disingenuously presented by a research group seeking attention.

(And yes, I do this for a living.)


#17

:confused:

:hug1: The paper isn’t worth fighting over, amigo. Look at my other post.


#18

You should heed your own advice. The oncology research has nothing to do with Komen or “population control.”

jco.ascopubs.org/content/early/2014/02/24/JCO.2013.53.2820.full.pdf


#19

Having a hysterectomy and one’s ovaries removed due to the presence of this mutation is not about population control as one poster indicated. This is about preventing cancer in a person before it has a chance to take hold.

Someone else seemed to be confused by this, as if the cancer had to be present in the first place. What is present is a much higher than normal risk for the disease(s). If I had this mutation I would have had a hysterectomy and removal of my ovaries by the time I was 35, and I would get a double mastectomy as well.

Not everything is about some clandestine effort to prevent pregnancy or control the population. Watching just one person die from any kind of cancer would be enough for most people to understand how women could easily chose this surgery option if provided. Same for men in the case of breast cancer and things like prostate and testicular cancer.


#20

That is also true. :slight_smile:

Moral panic, bad stats - ah, that’s a dream combination.

This is a study of some relevance to women who are at a high risk of getting cancer, and even then, it’s iffy. It certainly has nothing to do with population control. In fact, less than half those women were contracepting, which is pretty good. :smiley:


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