Fallopian tube removal to help prevent ovarian cancer? Why experts suggest it
Experts say 70% of most common and lethal ovarian cancer begins in the fallopian tubes
Removing fallopian tubes, a procedure known as opportunistic salpingectomy, may help prevent the development of ovarian cancer, according to a consensus statement from the Ovarian Cancer Research Alliance (OCRA), a nonprofit research and advocacy group based in New York.
The statement by OCRA was endorsed by the Society of Gynecological Oncology.
"Seventy percent of the most common and lethal ovarian cancer begins in the fallopian tubes," according to an OCRA report.
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"Research shows that removing the fallopian tubes when having another pelvic surgery such as a hysterectomy or tubal ligation, and leaving the ovaries intact, can prevent ovarian cancer," it also said.
Dr. Deanna Gerber, M.D., a gynecological oncologist at NYU Langone’s Perlmutter Cancer Center-Long Island, New York, told Fox News Digital, "Over the past 10+ years, there is data that has suggested that the fallopian tube may be the site of origin of many ovarian cancers."
She added, "If that is the case, then removal of the fallopian tubes would greatly reduce the risk of developing ovarian cancer."
OCRA, in its report, discussed the challenge of finding an effective tool for the early detection of the disease.
"We need to be more thoughtful about prevention."
"With no early detection test — and important research demonstrating that in most cases, detecting ovarian cancer even 18-24 months earlier, well before symptoms begin, does not improve mortality — we must focus on strategies that do work and can effect real change and save lives," the group said on its website.
While there is no cure yet for ovarian cancer, preventive strategies are in place, the group said.
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The idea of removing fallopian tubes — the hollow tubes that serve as the passageway for eggs to make their way to the uterus — is one of those strategies.
"Screening for ovarian cancer, even in high-risk populations, does not work," said Dr. Stephanie V. Blank, M.D., director of gynecologic oncology for the Mount Sinai Health System.
She's also director of women's health at the Blavatnik Family Chelsea Medical Center at Mount Sinai in New York City.
"We need to be more thoughtful about prevention," she said. "Opportunistic salpingectomy is not a new concept, but OCRA is raising awareness."
Experts are working to identify an effective screening test for ovarian cancer but have been unsuccessful.
Dr. Blank said ovarian cancer is typically diagnosed when it is already metastatic.
A large British clinical trial that used blood tests and scans to try to detect early-stage ovarian cancer showed the screening tests did not decrease deaths due to ovarian cancer.
Blank said ovarian cancer is typically diagnosed when it is already metastatic.
Also a professor of gynecologic oncology at the Icahn School of Medicine at Mount Sinai in New York City, Dr. Blank said patients who are done having children and are having gynecological surgery for another issue may want to consider this surgery to reduce their risk of developing ovarian cancer.
Blank noted, "People at increased risk for ovarian cancer due to a genetic mutation who are not yet ready to have both their tubes and ovaries removed can consider risk-reducing salpingectomy and delayed oophorectomy" (the removal of one ovary or both).
Twenty percent of ovarian cancers are caused by a genetic mutation, OCRA notes. On its website, it notes that it is imperative to know one's risk, as well as prophylactic options in case of gene mutation.
Blank said there are genetic tests available to determine if someone is at risk. Those at risk include people "with mutations in genes associated with increased risk of ovarian cancer — most commonly BRCA 1 or 2, but there are others as well — Lynch related genes, RAD51 C and D, PALB2, BRIP1."
Health experts said it's important to discuss family history and the potential risk with a physician.
Ovarian cancer is the fifth leading cause of cancer death in women in the United States.
For those with a gene mutation, removal of the fallopian tubes may be one avenue to explore to lower the chances of getting the disease, according to experts.
"We believe most of the ‘ovarian’ cancers associated with most of these mutations actually arise in the tubes,’ Blank told Fox News Digital.
Blank, who is also director of Women's Health at the Blavatnik Family Chelsea Medical Center at Mount Sinai in New York City, said removing the fallopian tubes theoretically reduces risk without bringing on menopause, which can occur with surgical removal of the ovaries.
"Removing the ovaries causes menopause, and not all people who want and need to take measures to reduce their cancer risk are willing to go into menopause at such young ages (recommend 35-49 for BRCA 1 and 40-45 for BRCA2)," she said.
"Removing tubes theoretically reduces risk without bringing on menopause," she added.
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Discussing those at risk for ovarian cancer, Gerber told Fox News Digital, "Anyone with fallopian tubes or ovaries is technically at risk. The lifetime risk of ovarian cancer in the general population is between 1-2%. In women with BRCA mutation, the risk may be as high as 45%."
The most important advice, said Gerber, is to know one's family history well and to tell a medical team about it.
Gerber said people need to be their own advocates — no one should be afraid to ask a health care provider about genetic testing and the removal of fallopian tubes.
"Your provider can let you know if it is indicated for you," Gerber said.
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Ovarian cancer is the fifth leading cause of cancer death in women in the United States, according to the American Cancer Society.