The cancer and its pre-cancer lesions are also not detectable through blood tests.
Recovery from the anesthesia—along with incision-site soreness and uncomfortable bloating from the gas the surgeon pumped into my belly so she could see her way around—slowed me down for about a week, while waiting for the internal healing kept me out of the gym for a month. But now I feel incredibly relieved about my decision.
“There’s very little in medicine that gets you an 80% risk reduction,” says study lead Gillian Hanley, associate professor of obstetrics and gynecology at the University of British Columbia. “It’s remarkable.”
So why don’t more women know about it?
Dr. Rebecca Stone, a gynecologic oncologist at Johns Hopkins Medicine, is a leader in the effort to get the word out about preventing ovarian cancer—diagnosed in about 20,000 Americans a year and killing over 12,000. Seeing so many patients die was something that kept the surgeon awake at night.
She began to truly make opportunistic salpingectomy her mission starting in 2023, when the dismal U.K. trial results prompted organizations like OCRA to make headlines with the new recommendations.
“When all that came out, I was like, ‘Oh, great. Thank God.’ But I was also like, ‘We’re not ready yet,’” Stone tells Fortune.
That’s because there was no infrastructure around making salpingectomy the norm—no educational materials for women to leaf through while waiting at the gynecologist’s office, no awareness among non-gynecological (and even some gynecological) surgeons about offering the procedure, and not even any billing codes that would make insurance coverage for the procedure possible.
“I was like, ‘Believe me, I’ve been trying. Sometimes we get lucky, but most of the time I bury my patients,’” she says. “And then I said, ‘But we do know how to prevent it.’” At that, she recalls, “People’s hair blew back.” Not even the top cancer minds on the call had heard about the effectiveness of salpingectomy.
“Remember when smoking cessation was a cancer prevention strategy that people got behind? The billboards and advertisements? That is, I think, what we need here,” says cancer biologist Tyler Jacks, Break Through Cancer’s president.
“This is a systemic problem that will take true cultural change within the medical community and beyond to solve,” adds OCRA president and CEO Audra Moran about the slow adoption of salpingectomy. “We know it’s not being adopted as widely as it could be.”
But there is another surgical prevention embraced as the norm, Stone is quick to point out. “It’s called a colonoscopy,” she says. “And the risks of the colonoscopy are much higher,” including the possibility of bowel perforation. “And then, guess what? You have to do it all again in five or 10 years.” Salpingectomy, she argues, is a one-and-done, and is “much more cost-saving” in the long run.
Plus, notes Hanley, “of course, we are not suggesting that every person with fallopian tubes needs to go and have them surgically removed. That will never be the recommendation. It is a surgical intervention, and surgery is not without risk.” But she does see the approach as “exciting,” as, “for so many years, we have not had a lot of cancer prevention that was not lifestyle-focused—revolving around diet, exercise, environmental exposure to carcinogens, and things that are really challenging to change.”
Anyone finished having children or not planning on having children who is already going to have another abdominal surgery—appendectomy, gallbladder removal, hysterectomy, for example—is a candidate for opportunistic salpingectomy.
“What we’re really saying is that if you are already having some kind of a surgery, because of some other benign disease that you’re treating, and the surgeon is there already, we have really compelling evidence that adding this to another procedure does not change your risks at all compared to what you would already risk with surgery,” Hanley says.
If you’re not having another surgery and really want your fallopian tubes removed anyway, you could opt to do it as a route to sterilization (instead of tubal ligation), which it technically is.
While the long-term risks of salpingectomy, if any, are not known, there are no short-term risks, as fallopian tubes don’t serve any known purpose beyond reproduction—as opposed to the ovaries, which still produce important hormones likely well beyond menopause, she says.
I opted to keep my ovaries. But these decisions are, of course, highly personal. I never thought I’d be someone to get elective surgery in the first place, but the statistics convinced me.
As for Stone, she says she has spent too many hours in the operating room trying to save patients “with this horrible disease” to give up on awareness.
“I am going to spend every minute of my remaining life to get this information out there,” she says, “and to reach as many people as humanly possible.”
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