Remove Your Tubes to Prevent Ovarian Cancer?

by Lauren Streicher, MD

The fallopian tubes are the sperm’s highway to the egg. Unfortunately the fallopian tubes can also potentially be a source of cancer cells  and a  road for cancer cells to travel down leading to ovarian cancer. In fact, most ovarian cancer is now  believed to originate in the tube. 

While ovarian cancer is not the most common gynecologic cancer, it is the most lethal gynecologic cancer. Screening and early detection are limited and in the majority of cases, it is discovered only after it has spread. While 10-15% of ovarian cancers are genetic, most women that develop ovarian cancer have no family history and no risk factors.

Since screening doesn’t seem to be the answer, the best strategy is to try and not get it in the first place. And yes, there are things you can do that really make a difference.

Gynecologists have known for some time that taking hormonal contraception will lower the risk of ovarian cancer. You only need to take the pill for 5 years to reduce your risk by 20%. After 15 years of use,  the risk is cut in half. It’s always been a mystery to me why the pill companies go on and on about the pill getting rid of acne and PMS, but never bother to mention that taking birth control pills can prevent a life threatening cancer. Seems to me they would not only be doing a service to women, but would sell a lot more pills.

Another little known fact is that a tubal sterilization can reduce  ovarian cancer risk by as much as 34%!

But instead of just blocking the tube, what will happen if the tube is completely removed? In 2009 a paper was published in the International Journal of Gynecologic Cancer suggesting that the majority of ovarian cancers originate from the tube and that removal of the tube has a major impact on cancer frequency. As a result of that study, the Canadian government  issued an official recommendation that tubal removal should be performed instead of tubal ligation.

It’s not practical for everywoman to remove her tubes, but if you are not planning a future pregnancy and one of the following circumstances fits you, it’s something to consider:

  • If you are scheduled to have a hysterectomy and are not removing your ovaries, ask your doctor to remove your tubes along with your uterus.
  • If you are having a tubal ligation, ask your doctor to remove the entire tube rather than just destroying a portion of the tube.
  • If you are having pelvic surgery for any reason (ovarian cyst, fibroids, etc.), ask your doctor to remove your tubes even if your husband had a vasectomy and you don’t need the contraception.
  • If you have a BRCA mutation and are at very high risk for ovarian cancer, the recommendation is to remove the ovaries and tubes. If you are not ready to remove your ovaries, or choose not to, consider fallopian tube removal as a “next best” option. This is particularly important since many women with BRCA mutations are reluctant to take hormonal contraception due to their high risk of breast cancer.

What’s involved with fallopian tube removal? In the hands of an experienced laparoscopic surgeon the procedure takes less than 30 minutes and can be performed using a couple of tiny incisions (essentially one stitch). Most women go home an hour or so later and are back to normal activities in a day or two. If your surgeon is already “in there” doing something else, tube removal takes no more than an additional 10 minutes and there is no additional recovery time. There will be no change in menstruation or hormones since the fallopian tubes have no function other than getting an egg and sperm together. The bonus? If you still need contraception, you won’t anymore

Posted on 10/25/2010 |