Doctors have identified a pioneering procedure that could prevent nearly 80% of deadly ovarian cancers, often referred to as a 'silent killer.' Research indicates that the vast majority of ovarian cancers, particularly the most lethal forms, actually originate in the fallopian tubes. By removing these 10cm-long ducts, which carry eggs from the ovaries to the uterus, the risk of developing these cancers could be significantly reduced.
Ovarian cancer is a significant concern, causing over 4,000 deaths annually in the UK alone, with one in 50 women developing the disease in their lifetime. The disease often presents few symptoms until it has spread, leading to late-stage diagnoses when it is frequently incurable. Currently, only about 17% of women diagnosed with stage four ovarian cancer survive for five years or more.
The five-minute procedure to remove the fallopian tubes can be integrated into various abdominal surgeries, including hysterectomies, tubal ligations, gallbladder removals, hernia repairs, and cesarean sections. This approach is gaining traction as a future strategy for ovarian cancer prevention.
In the UK, women identified as high-risk due to family history or genetic mutations like BRCA1 or BRCA2 are already offered preventative surgeries. Standard National Health Service (NHS) guidance has typically involved removing both the ovaries and fallopian tubes. However, this can induce early menopause, bringing its own set of health risks, such as osteoporosis, cognitive decline, and heart disease.
A new nationwide trial in Britain, the PROTECTOR trial, is investigating a two-tiered approach for high-risk women. This strategy involves offering fallopian tube removal alone, with the option to remove ovaries at a later stage, potentially after menopause. While full results are pending, initial findings suggest this method can significantly improve quality of life by avoiding premature menopause while still reducing cancer risk by 80% to 96%.
Experts are increasingly advocating for this procedure to be offered to women at average risk as well. Studies suggest that removing fallopian tubes in all women, irrespective of their risk level, can reduce the likelihood of developing common and lethal forms of ovarian cancer by as much as 80%. Cancers that do originate in the ovaries, accounting for about 20% of cases, are generally more treatable.
While standalone surgery for tube removal is typically reserved for high-risk individuals, experts believe it should be an option for women already undergoing pelvic operations who have completed their childbearing. Health organizations in the U.S. now recommend that women over 45, who are less likely to conceive, and are undergoing abdominal surgery, be offered the option of fallopian tube removal. Professional bodies such as the American College of Surgeons, the American Cancer Society, and the European Society of Gynaecological Oncology have issued statements encouraging doctors to offer this procedure during other abdominal surgeries.
The American Cancer Society is also spearheading a national campaign to raise awareness among women and medical professionals about the preventative benefits of fallopian tube removal. In Britain, the procedure is already being offered to women at average risk during routine abdominal surgeries. However, Dr. Ranjit Manchanda, a professor of gynecological oncology at Queen Mary University of London and chief investigator of the PROTECTOR trial, emphasizes the need for greater awareness. "This is a huge and important finding. But there needs to be more awareness of the procedure," he stated. "It's something where practice is gradually changing as data emerges. Over the next few years we should see it more embedded in practice."