I underwent simple surgery to reduce my deadliest risk of cancer for women. Here is why you probably don’t know – but should

I woke up from groggy surgery, with three tiny incisions in my abdomen and a huge peace of mind. I had just had my fallated tubes removed laparoscopically, because it is the best defense against ovary cancer – and perhaps only – which, although rare, is the most deadly gynecological cancer there is.

There is no detection method for ovary cancer (a common misunderstanding is that it is the pottis pap, but it is for cervical cancer). It is largely because of something discovered relatively recently: that ovary cancer is formed, about 80% of the time, in the tubes of Fallopists, which are not easily reached or biopsied. Thus, cancer is not found before spreading beyond the tubes, at that time, it generally reached a later stage and is more difficult to treat, with healing rates as low as 15%.

Cancer and its pre-cancer lesions are not detectable by blood tests either.

I myself had no idea of ​​all this until 2023, when I wrote on the Ovarian Cancer Research Alliance (OCRA) making radical recommendations: that all women are genetically tested to know their risk of illness, and that all women, whatever their risk factor, plan to have what is called an opportunistic salpingctomy – the prophylactic assumption of the hits. abdominal surgery.

The strategy – approved by the American College of Obstetrics & Gynecology since 2015 – was supposed to reduce the risk of ovarian cancer up to 60%. It has been adopted as a wide recommendation after a clinical trial based on the SOBER UK followed 200,000 women for more than 20 years and found that screening and awareness of symptoms do not save lives.

As a survivor of breast cancer, the idea of ​​ovarian cancer that perhaps hanging in my fallopian tubes was haunting. So when I had the opportunity to remove them during a recent minor abdominal surgery, I seized it.

The recovery of anesthesia – as well as pain in the incision site and uncomfortable bloating of the gas that the surgeon has pumped in my belly so that she could see his way – made me switch to for about a week, while waiting for the internal healing which prevented the gymnasium for a month. But now I feel incredibly relieved of my decision.

This is particularly true in the light of the new major conclusions of Vancouver, British Columbia, which launched a public campaign on prophylactic salingectomy in 2010 and followed around 80,000 people – the jurisdiction that opted for the procedure and half that have not done so since. The results, announced in March 2024 at a meeting of the American Association for Cancer Research and again during a recent annual meeting of the Society of Gynecologic Oncology, were major: that salingectomy reduces its risk of ovarian cancer by 80%.

“There are very few drugs that allow you to reduce risks of 80%,” explains Gillian Hanley, led by the study, an associate professor of obstetrics and gynecology at the University of British Columbia. “It’s remarkable.”

So why don’t more women know it?

The effort to raise awareness of opportunistic salingectomy

Dr. Rebecca Stone, a gynecological oncologist at John Hopkins Medicine, is a leader in the effort to publicize ovarian cancer – diagnosed in around 20,000 Americans per year and killing more than 12,000. See so many patients die was something that kept the waked surgeon at night.

She began to really do opportunistic salingectomy her mission from 2023, when the lemeal results in the United Kingdom prompted organizations like Ocra to make the headlines with new recommendations.

“When it all came out, I said to myself:” Oh, big. Thank God. But I also said to myself: “We are not yet ready,” says Stone Fortune.

Indeed, there was no infrastructure on the Saltingctomy of the Standard – no educational material for women to leaf through while waiting for the gynecologist’s office, no conscience of non -gynecological surgeons (and even certain gynecological) to the offer of the procedure, and even to billing codes that would make insurance coverage for the possible procedure.

Above the same time, Stone was invited to join a meeting of the scientific advisory council to break cancer, an effort of collaboration between the best researchers and doctors to prevent and cure the deadliest cancers. Someone asked her if she knew how to cure ovarian cancer.

“I said to myself:” Believe me, I was trying. Sometimes we are lucky, but most of the time, I deer my patients, ”she says. “And then I said,” But we know how to prevent it. “” To that, she remembers: “people’s hair jumped.” Even the best minds of call cancer had not heard of the efficiency of salingectomy.

This call has led to the creation of a new break through cancer, intercepting ovary cancer, which aims both to improve the detection of pre-cancer of fallangers and to extend salingectomy as a prevention tool within the general population. Stone has already managed to work with the centers for Disease Control and Prevention to create specific invoicing codes for the procedure, and is now preparing to launch the Outmart ovary cancer campaign with a gynecological surgeon in Kettering Sloan Memorial.

“Remember when the smoking cessation was a cancer prevention strategy that people have resulted?” Display panels and advertisements?

“This is a systemic problem that will take a real cultural change within the medical community and beyond to resolve,” adds the president and chief executive officer of the Ocra, Audra Mora, on the slow adoption of salingectomy. “We know that it is not adopted as largely as possible.”

Indeed, there are still obstacles to effort, including how to present the problem with sensitivity in certain colored communities, which carry the American historical burden on coercive sterilization; convince some surgeons that there is enough evidence behind it, because all this until Vancouver’s results have been based on historical data; And also the idea of ​​surgical prevention itself, which can be off-putting.

But there is another surgical prevention adopted as the standard, the stone is quick to emphasize. “This is called a colonoscopy,” she says, “and the risks of colonoscopy are much higher”, including the possibility of intestinal perforation. “And then, guess what? You have to start all over in five or 10 years.” Salpingectomy, she maintains, is only one-and-fring, and is “much more economical” in the long term.

In addition, notes Hanley, “of course, we do not suggest that each person with fallopian tubes must go and have them surgically removed. It will never be the recommendation. It is surgery, and surgery is not without risk. ” But she considers that the approach as “exciting”, as “for so many years, we did not have much prevention of cancer which was not focused on life, which concerns the diet, the exercise, the environmental exhibition for carcinogens and things that are really difficult to change.”

Does Salpingectomy suit you?

Anyone who has finished having children or not intended to have children who will already undergo another abdominal surgery – cancellation, the elimination of gallbladder, hysterectomy, for example – is a candidate for opportunistic salingectomy.

“What we really say is that if you are already undergoing a kind of surgery, due to another benign disease that you treat, and the surgeon is already there, we have really convincing evidence that adding to another procedure does not change your risk at all that you would already risk surgery,” said Hanley.

If you do not undergo another surgical intervention and you really want to remove your fallopian tubes, you can choose to do it as a sterilization path (instead of the tubal ligature), which is technically.

Women at high risk – like the fewer than 1% that have a genetic mutation such as BRCA1 or BRCA 2, which increases the risk of ovarian cancer from 1% to 5% – “must be recommended for autonomous salpingpectomy for risk reduction,” explains Stone. They could also consider an ovariectomy – the abotry of the ovaries – depending on their age, she adds.

Although the long-term risks of salingectomy, if applicable, are not known, there is no short-term risks, because the fallopian tubes do not serve any known objective beyond reproduction-unlike the ovaries, which always produce important hormones probably far beyond the menopause, she says.

I chose to keep my ovaries. But these decisions are, of course, very personal. I never thought that I would be someone to undergo elective surgery in the first place, but statistics convinced me.

As for Stone, she says that she spent too many hours in the operating room trying to save patients “with this horrible disease” to give up consciousness.

“I’m going to spend every minute of my remaining life to disseminate this information,” she says, “and to reach as many people as possible humanly.”

More about women and cancer:

• 3 in 4 women jump a routine appointment and put themselves more at risk of cancer
• With ovary cancer, there is no early detection. Here is what to learn from the battle of great tennis Chris Evert with the disease
• Women will now be informed of breast density after mammograms. Here is what should happen next

This story was initially presented on Fortune.com