Experts Say This Simple Surgery Could Decrease Rates Of Ovarian Cancer In Canada

Lindsay Mazepa had never heard of an opportunistic salpingectomy.

But when Mazepa was discussing a caesarean section for her twins, her obstetrician-gynecologist suggested it instead of a tubal ligation, which she had already considered for family planning.

A 43-year-old mother of three from Port Coquitlam, British Columbia, said doctors at the time told her the surgery would “significantly reduce” her chances of developing ovarian cancer in the future.

Opportunistic salpingectomy is the removal of the fallopian tubes in average-risk women who have given birth and have already undergone gynecological surgery, such as caesarean section or surgery for endometriosis. The ovaries are left intact.

Tubal ligation, which is done only as a permanent method of contraception, usually cuts the fallopian tubes and clamps or seals them, but does not remove them.

“Considering that I had already had surgery and she literally only had 10 minutes of extra surgery, the recovery period would be exactly the same, which I hear would reduce my risk. It was really all I needed.” [ovarian] It could be cancer in the future,” said Mazepa, a neurodiagnostic technologist. white coat, black art.

The surgery is considered one of the few ways to reduce the risk of ovarian cancer, which doctors say is difficult to detect.there is There are no effective screening tests for the disease.

According to the Canadian Ovarian Cancer Society, approximately 1 in 75 Canadian women will be diagnosed with ovarian cancer.

quick Studies have shown Opportunistic salpingectomy may reduce the risk of ovarian cancer.

“It is now recognized that the majority of ovarian cancers are of a specific subtype called high-grade serous carcinoma, and that the majority of these cancers actually arise in the fallopian tubes rather than the ovaries. ,” said Dr. Janis Kwon, a gynecologic oncologist at Vancouver General Hospital. Director of Hospital and BC Cancer and Deputy Chief of Obstetrics and Gynecology at the University of British Columbia.

Opportunistic salpingectomy In Canada, it has been used for more than 10 years for women who have given birth and have already undergone gynecological surgery.

British Columbia leads the nation in the number of opportunistic salpingectomies performed.

Preliminary data analyzed by Gillian Hanley, an associate professor of obstetrics and gynecology at the University of British Columbia, and her colleagues show that intake has increased since the study began. Before Look at data for all provinces except Quebec from 2011 to 2016.

“Other states seem to be raising rates, which is great,” Hanley said. white coat, black art. “But there is definitely room for improvement.”

Previously, interest rates were very low in some Primorye provinces, less than one tenth. Hanley, now in Nova Scotia, said nearly half of tubal sterilizations are opportunistic salpingectomies.

Hanley said he hopes to see increased coverage in PEI, Newfoundland and Labrador, Ontario and Manitoba, where life-saving opportunities are being lost.

Discovery of Canada

Dr. Diane Miller, Associate Professor Emeritus of UBC Obstetrics and Gynecology, was the first professor. Developing and naming opportunistic salpingectomy As a preventive strategy for ovarian cancer.

In 2010, an education campaign was developed in British Columbia to explain the benefits of opportunistic salpingectomy.

Before 2010, Kwon said, “a small percentage of women” had their fallopian tubes removed during a hysterectomy to prevent unintended pregnancies or for reasons other than cancer, such as abnormal bleeding or endometriosis. It is said that it was done.

Since then, several groups, including those in Canada, have issued recommendations to consider having opportunistic salpingectomy for those at average risk of ovarian cancer.

Most recently, in February, the US global non-profit Ovarian Cancer Research Alliance and the Society of Gynecologic Oncology announced. issued a joint statement Women undergoing pelvic surgery are encouraged to have their fallopian tubes removed as well.

Hanley said B.C.’s approach to opportunistic salpingectomy is recommended in nine other countries.researchers in Netherlands When medical professionals suggested the procedure to their patients, they found that nearly 96 percent chose to continue.

See | Why Experts Advise Physicians to Talk to Patients About Surgery:

Kootenay Lake Hospital-based obstetrician-gynecologist Dr Raz Moolah said the procedure takes less than 15 minutes and is “very safe.” He has regular surgeries, but he said he’s been upfront with his patients about what they can and can’t do.

“From my point of view, it’s important to make it clear to the patient that the surgery is ideally aimed at preventing something from happening, but it may or may not happen.” Fallopian tube cancer is one of about 20 different types of ovarian cancer, he said.

Possibility to mitigate risk

Donna Pepin was diagnosed with ovarian cancer in 2006 and had a recurrence ten years later.

Pepin remembers attending the 2010 event. BC Gynecologist encouraged average-risk women to undergo opportunistic salpingectomy.

“I remember being very emotional at the time, because I thought you knew the lives that could be saved, the suffering that could be avoided. It was a really big moment of understanding for me who went through “cancer. “

Pepin entered clinical trials, underwent several rounds of chemotherapy and had surgery.

For nine years she was healthy. However, in 2016 she was diagnosed with a rare type of low-grade serous ovarian cancer.

The 65-year-old is on medication and is in stable condition.

A Canadian ovarian cancer volunteer said she was excited to see the medical community making progress in preventing ovarian cancer.

“As an ovarian cancer patient, everyone in our community would agree that it is amazing that the lack of cervical cytology can stop ovarian cancer from developing. There is no way to detect it, there is no way for us to prevent it.Apart from this, we also know about opportunistic salpingectomies.”

Besides that, other health conditions can cause the same symptoms It is believed to be ovarian cancer, according to the Canadian Cancer Society website.

Kwon also notes that the majority of women are diagnosed with ovarian cancer at an advanced stage, when the cancer has spread to other parts of the body (also called metastasis).

“This makes it difficult to treat and hard to cure,” she says.

Opportunistic salpingectomy education campaigns began just over a decade ago, so it’s too early to say what the surgery’s real benefits are, Kwon said.

But she added that early research is “exciting news.”

Research by Hanley, Kwon, and colleagues Published with peer review Last year, the Journal of the American Medical Association found that opportunistic salpingectomy could help reduce the number of ovarian cancer cases.

Ovarian cancer is a disease I see almost every day, and every opportunity to prevent it is certainly worth it.– Janice Kwon

The researchers found that approximately 26,000 women who underwent opportunistic salpingectomy had serous ovarian cancer and epithelial ovarian cancer compared with the incidence of controls who underwent hysterectomy or tubal ligation alone. found that the prevalence of cancer was significantly lower than expected.

Specifically, when looking at high-grade serous carcinomas, none were found among patients who had their fallopian tubes removed.

“Ovarian cancer is a disease that I see almost every day. I have treated hundreds of women with the disease, and every opportunity to prevent it is certainly worth it,” said Kwon. said Mr.