Salpingectomy Reduces Ovarian Cancer Risk by 80%

I underwent a simple surgery to remove my fallopian tubes, a procedure known as a salpingectomy, which significantly reduces the risk of ovarian cancer, the deadliest gynecological cancer. This surgery is particularly effective because ovarian cancer often originates in the fallopian tubes, making early detection challenging. The lack of effective screening methods for ovarian cancer means that by the time it is detected, it has often spread, leading to lower cure rates.

My decision to undergo this surgery was influenced by recent recommendations from the Ovarian Cancer Research Alliance (OCRA), which advised all women to get genetically tested for ovarian cancer risk and consider opportunistic salpingectomy during other abdominal surgeries. This strategy, endorsed by the American College of Obstetrics & Gynecology since 2015, was found to reduce the risk of ovarian cancer by up to 60% in a U.K.-based clinical trial. The trial followed 200,000 women for over 20 years and concluded that screening and symptom awareness do not save lives.

As a breast cancer survivor, the possibility of ovarian cancer in my fallopian tubes was a significant concern. When I had the opportunity to remove them during a minor abdominal surgery, I decided to proceed. The recovery process involved dealing with anesthesia, incision-site soreness, and bloating from the gas used during the surgery, but overall, it was manageable. The relief I felt after the surgery was immense, especially in light of new findings from Vancouver, British Columbia. The study, which followed about 80,000 people, found that salpingectomy reduces the risk of ovarian cancer by 80%.

Despite the significant benefits of salpingectomy, awareness of this procedure remains low. Dr. Rebecca Stone, a gynecologic oncologist, has been a leading advocate for increasing awareness about preventing ovarian cancer. She noted that there was no infrastructure in place to make salpingectomy a standard practice, including educational materials, awareness among surgeons, and billing codes for insurance coverage. This lack of infrastructure has hindered the widespread adoption of the procedure.

Stone's efforts led to the creation of the Intercepting Ovarian Cancer initiative by Break Through Cancer, which aims to improve the detection of fallopian tube pre-cancers and expand salpingectomy as a prevention tool. The initiative has already succeeded in creating specific billing codes for the procedure and is launching the Outsmart Ovarian Cancer Campaign. The goal is to raise awareness and encourage more women to consider salpingectomy as a preventive measure.

However, there are still barriers to the widespread adoption of salpingectomy, including sensitivity in communities of color with a history of coercive sterilization, convincing surgeons of the evidence, and the general acceptance of surgical prevention. Dr. Stone compares salpingectomy to colonoscopies, which are widely accepted despite higher risks, and argues that salpingectomy is a one-time procedure that is more cost-effective in the long run. Dr. Gillian Hanley, who led the Vancouver study, emphasizes that salpingectomy is a surgical intervention and should be considered carefully, but it offers a significant reduction in cancer risk without the need for lifestyle changes.

Opportunistic salpingectomy is recommended for women who have completed childbearing or are not planning to have children and are already undergoing another abdominal surgery. For those at high risk, such as those with genetic mutations like BRCA1 or BRCA2, a standalone salpingectomy or oophorectomy (removal of the ovaries) may be recommended. The long-term risks of salpingectomy are not fully known, but there are no short-term risks, as fallopian tubes serve no known purpose beyond reproduction.

My decision to undergo salpingectomy was driven by the compelling evidence of its benefits. While the surgery was elective, the statistics and personal experiences of others convinced me of its importance. Dr. Stone, who has spent countless hours in the operating room trying to save patients from ovarian cancer, is committed to raising awareness about this preventive measure. She plans to continue her efforts to reach as many people as possible with this life-saving information.