A groundbreaking discovery in the field of cancer research has emerged from Canada, offering a glimmer of hope in the fight against ovarian cancer. This innovative surgical approach, known as Opportunistic Salpingectomy (OS), has the potential to revolutionize the way we prevent and treat this deadly disease.
But here's where it gets controversial: the strategy involves a proactive removal of the fallopian tubes during routine gynecological surgeries, such as hysterectomies or tubal ligations. This approach, initially developed by a team of researchers from UBC, BC Cancer, and Vancouver Coastal Health, challenges traditional understandings of ovarian cancer's origins.
Most ovarian cancers, it turns out, originate in the fallopian tubes rather than the ovaries themselves. By removing the fallopian tubes, OS leaves the ovaries intact, preserving crucial hormone production and minimizing side effects.
The impact of this innovation is nothing short of remarkable. A recent study, led by the Ovarian Cancer Observatory, a B.C.-based international collaboration, provides compelling evidence that OS saves lives. The study, published in JAMA Network Open, demonstrates that OS reduces the risk of the most lethal type of ovarian cancer by nearly 80 percent.
Dr. Gillian Hanley, an associate professor of obstetrics and gynecology at UBC and co-senior author of the study, emphasizes the life-saving impact of this simple surgical change.
"This study clearly shows that adding the removal of fallopian tubes during routine surgery can prevent the most deadly form of ovarian cancer," she said.
Ovarian cancer is the most lethal gynecological cancer, with approximately 3,100 Canadians diagnosed annually, and sadly, about 2,000 deaths resulting from the disease each year. The lack of a reliable screening test means most cases are diagnosed at advanced stages, limiting treatment options and survival rates.
Dr. Dianne Miller, an associate professor emerita at UBC and a co-founder of B.C.'s multidisciplinary ovarian cancer research team, OVCARE, puts it simply: "If there's one thing better than curing cancer, it's never getting it in the first place."
The new study quantifies the risk reduction of serous ovarian cancer, the most common and deadly subtype, building on previous research demonstrating the safety, cost-effectiveness, and minimal impact on menopause onset of OS.
The researchers analyzed health data from over 85,000 individuals who underwent gynecological surgeries in B.C. between 2008 and 2020. The results showed that those who had OS were 78 percent less likely to develop serous ovarian cancer. Even in the rare cases where cancer occurred after OS, it was found to be less biologically aggressive.
Since its introduction in B.C. in 2010, OS has gained widespread adoption, with approximately 80 percent of hysterectomies and tubal ligation procedures in the province now including fallopian tube removal. The impact of this innovation has reached global scales, with professional medical organizations in 24 countries now recommending OS as an ovarian cancer prevention strategy.
Dr. David Huntsman, a co-senior author of the study, professor of pathology and laboratory medicine and obstetrics and gynecology at UBC, and a distinguished scientist at BC Cancer, emphasizes the far-reaching impact of this B.C.-born innovation.
"The impact of OS is even greater than we expected," he said. "It's the culmination of more than a decade of work that started right here in B.C."
The researchers believe that expanding the global adoption of OS could prevent thousands of ovarian cancer cases worldwide each year.
Dr. Sharmila Anandasabapathy, dean of the faculty of medicine and vice-president, health, at UBC, highlights the significance of this research.
"This is a powerful example of how UBC research is changing clinical practice worldwide and saving lives," she said. "It speaks to the strength of our researchers and clinicians working together to translate discovery into real-world impact for patients here at home and around the globe."
The potential for OS to be extended to other abdominal and pelvic surgeries where appropriate could further increase the number of people who benefit from this prevention strategy. B.C. has already taken the lead in this expansion, becoming the first province to offer OS during routine surgeries performed by general and urologic surgeons through a project supported by the Government of B.C. and Doctors of BC.
Dr. Huntsman expresses his hope that more clinicians will adopt this proven approach.
"Not offering this surgical add-on may leave patients unnecessarily vulnerable to this cancer," he said.
This innovative surgical strategy offers a beacon of hope in the battle against ovarian cancer, and its impact is a testament to the power of scientific discovery and collaboration.
