Those decisions were not easy. “I made the choice not to have any biological children, which was hard,” she said. “And I am still at risk for breast cancer.” But, she added, “I am named after my grandmother, and I believe the surgery prevented me from having the same obituary as her.”
The practice of removing the fallopian tubes while a patient is already having another pelvic surgery, called opportunistic salpingectomy, is already standard care in British Columbia, said Dr. Dianne Miller, who, until recently, was the leader of gynecologic cancer services there.
“Fifteen years ago, it became apparent that the most lethal and most common kinds of high-grade cancers actually had their origin in the fallopian tube rather than the ovary, and then spread very quickly,” Dr. Miller said.
By the time women experience symptoms like bloating or abdominal pain, she said, it is too late to do anything to save lives.
“I remember the light-bulb-going-off moment that many of these cancers are likely preventable, because a lot of women have a surgery at some point for hysterectomy, or removal of fibroids, or tubal ligation,” Dr. Miller said.
For women at average risk for ovarian cancer, removing only the tubes is a “win-win” situation, she said, because there are benefits to retaining the ovaries, which even after menopause continue to make small amounts of hormones that help keep the brain and heart healthy.
“As oncologists, we have our eyes set on curing cancer,” she said. “But if there’s one thing that’s absolutely better than curing cancer, it’s not getting it in the first place.”