Exploring the Fallopian Tube-Ovarian Cancer Link
If most women are honest, they spend very little time thinking about their reproductive organs, unless they’re pregnant or trying to become pregnant, menopause begins or an issue presents itself. In fact, you may have never considered your fallopian tubes at all. Soon, all that may soon change, thanks to recent medical research in this area.
Over the last few years, obstetricians and gynecologists have been studying the link between the fallopian tubes and ovarian cancer, which causes more deaths than any other gynecological cancer. According to the American Cancer Society (ACS), more than 22,000 American women will be diagnosed with ovarian cancer in 2017, and just over 14,000 of these will die from the disease, including approximately 920 Texas women.
Darren Tate, M.D., and OB/GYN and physician on the medical staff Texas Health Fort Worth, remembers when he first heard about the research — which reveals links between the removal of fallopian tubes to a decrease in ovarian cancer—two years ago.
“I came across a few articles about it a couple of years back, and after looking into it more, I started changing my practice within weeks,” he says. “There’s little to lose by removing the fallopian tubes versus tying them, so it really wasn’t a big change procedurally. But fallopian tube removal can potentially make a big difference. We can do it laparoscopically during a hysterectomy or C-section.”
According to research presented at the American College of Obstetricians and Gynecologists, the removal of fallopian tubes while preserving the ovaries during a hysterectomy can reduce the rate of serous ovarian carcinoma, the most common type of ovarian cancer.
Tate says the issue becomes stickier for younger patients, who may not be ready to have their fallopian tubes removed due to the permanency of the procedure.
“The regret rate for tubal [ligation] is 50 percent, depending on age, so we definitely do a lot of counseling before we make any of these decisions,” he reported. “There are doctors who can do a tubal reversal pretty easily, and it runs $5,000 instead of $20,000 for IVF (if tubes are removed). However, if a woman has a family member who died of ovarian cancer and we remove her tubes, we may have saved her life.”
According to the ACS, early ovarian cancer usually has no symptoms, but may cause swelling of the abdomen due to an accumulation of fluid. Some women may also experience persistent symptoms such as bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, or urinary urgency or frequency.
Ovarian cancer can also run in families and may result from inherited mutations in the BRCA1 and BRCA2 genes, which can be tested for. A woman’s decision to have her fallopian tubes removed will usually depend on her family history and her phase of life.
“If a younger patient is BRCA1-positive, I would recommend she have her tubes removed, but if she’s not BRCA1-positive, there’s really no professional recommendation for it,” Tate explained. “The procedure is, however, becoming more standard during C-sections for patients who are finished having children. And it’s very routine in hysterectomies because the fallopian tubes have no function without the uterus, so it’s an easy decision, clinically.”
As with all surgical procedures, complications are possible, but Tate explains that they are unlikely.
“It was initially thought that you could compromise ovarian blood flow and cause early menopause, which then creates concerns for bone loss and heart disease,” he says. “We haven’t seen this to be the case, but if further studies show it is a problem, it would change the recommendations considerably. This is why some of my colleagues are not doing the fallopian tube removal, but I am always very careful to isolate the tube during the procedure.”
Tate says that fallopian tube removal could be a game-changer, as up to 40 percent of ovarian cancer deaths may be preventable. Only time will tell, however, if the relatively new practice delivers on its potential to save lives.
“Anytime you talk about prevention, it takes time to get long-term answers, so we’ll know more for sure down the road,” Tate says. “The average age that women get ovarian cancer is in their 60s, and we’re treating some of these women now in their 20s. It should follow that they will be more protected, but it could be decades before we know for sure.”
In need of an OB/GYN? Visit TexasHealth.org or call 1-877-THR-WELL (1-877-847-9355) to find a physician near you.