Scientists at the John Hopkins Kimmel Cancer Center (JHKCC) and Dana Farber Cancer Institute have found that ovarian cancer may originate in the fallopian tubes.

Tissue samples studied from five women diagnosed with ovarian cancer contained “normal cells, ovarian cancers, metastases that had spread elsewhere, and small cancers found in the fallopian tubes.” Tissue samples from four women who voluntarily had their ovaries and fallopian tubes removed were also studied.

A process called whole-exome genome sequencing “catalogs the genetic blueprint of the protein coding genes in the cells’ DNA.” Without this process, already present DNA from normal cells would have made it difficult to define DNA errors often linked to cancer.

Victor Velculescu, M.D., Ph.D., a professor of oncology at JHKCC said, “If studies in larger groups of women confirm our finding that the fallopian tubes are the site of origin of most ovarian cancer, then this could result in a major change in the way we manage this disease for patients at risk.”

Ovarian cancer has long held a reputation for being difficult to detect. A fast two-year metastatic progression coincides with the cancer advancing to stage 1B or 1C by the time it reaches the ovaries and is detected.

In a controversial move, some physicians have recommended removal of both ovaries and fallopian tubes to women who are at high-risk of developing ovarian cancer. Dr. Noelle Cloven, a gynecologic oncologist with Texas Oncology in Fort Worth, Texas, said she would prefer that a patient choose that option only if participating in a clinical trial.

Birth control is one less extreme option for lowering the risk of developing ovarian cancer. Another is having the fallopian tubes removed and leaving the ovaries, which would postpone menopause.

Ongoing discussion with each other and with medical experts is highly encouraged, as we continue to uncover developments.