Twenty-Seven Years After Oophorectomy, She Was Diagnosed with Ovarian Cancer

Yesterday, after I published the article “Under What Circumstances Is Prophylactic Cancer Removal Surgery Necessary?” on my blog and WeChat official account, the child of an ovarian cancer patient contacted me. She told me that when her mother was 44, because of torsion of the ovarian pedicle and because her grandmother had uterine cancer, the uterus and adnexa (including the ovaries) were removed—both to treat the condition and to prevent uterine cancer. But unfortunately, at age 71, she was still diagnosed with ovarian cancer.

The patient’s daughter therefore asked me: does removing tissues and organs really prevent cancer? She herself is skeptical. This is the first time I have encountered a real case in which tissue and organs were removed to prevent cancer, yet cancer still occurred. I believe most doctors rarely see such real cases in a lifetime.

After more than a decade of writing, I have some influence in the cancer field; currently about 100,000 cancer patients or their families, and around 10,000 doctors, follow my writing. So I am always exposed to all kinds of rare cancer cases, which have broadened my perspective.

The attending Western doctor who treated this patient explained that the original hysterectomy and adnexectomy had not completely removed the ovaries; some residual ovarian cells remained, which is why the patient developed ovarian cancer.

But on further research, I found that even if the ovaries are completely removed with no residual ovarian cells, peritoneal cancer—pathologically very similar to ovarian cancer—can still occur. Its root cause remains the same mutated genes that cause ovarian cancer; the risk is simply significantly reduced.

So whether this patient’s cancer was caused by residual ovarian cells undergoing malignant transformation, or by peritoneal carcinoma arising from the peritoneum adjacent to the ovaries, is still hard to say.

This case shows that removing tissues and organs that might become cancerous cannot 100% prevent the associated cancerous transformation. To achieve more thorough cancer prevention, humanity still needs much more exploration.

I find it hard to give a scientific explanation for this phenomenon. I can only remind friends at risk of cancer that we need to work from multiple angles to prevent cancer.

At the same time, one should undergo regular, targeted early cancer screening. For example, hepatitis B patients should regularly screen for liver cancer; HBV-positive individuals should regularly screen for reproductive system tumors, and so on. If cancerous change is detected at the carcinoma in situ stage, the cure rate after surgical resection can basically reach over 95%. Early invasive cancer also has a relatively high cure rate. But if detection is late, then even after prophylactic removal, the prognosis remains poor—in fact, worse than in those who undergo regular follow-up and close observation.