PREVENTIVE practice for high risk of ovarian cancer includes the removal of both fallopian tubes and ovaries. This surgery may induce premature menopause, which can lead to side effects such as increased risk of heart-disease, osteoporosis, neurocognitive decline, and sexual-dysfunction and those at risk may decide to undergo surgery after they reach this stage of life despite being at a higher risk of ovarian cancer.
“Although removal of tubes and ovaries prevents ovarian cancer, it can lead to early surgical menopause which has significant detrimental consequences on long-term health. A number of women opt to delay or decline preventive surgery as a result.” This is according to Prof Ranjit Manchanda, lead researcher of a new study by a team from Queen Mary University London, London, UK, who have shown a novel two-stage surgical procedure for those at high risk of ovarian cancer with favourable results among the study participants. In the first stage of the new surgical approach, the fallopian tubes would be removed, and the ovaries would be removed at a later stage, after the individual has reached the menopause. Initial removal of the fallopian tubes offers partial risk reduction while delaying surgery to the ovaries would delay early induction of the menopause.
The study enrolled 638 participants at increased risk of ovarian cancer and assessed the acceptability of the new two-step approach. The researchers found that of those who opted for preventive surgery, 9.4% of premenopausal and 1.2% of postmenopausal people did not think they made the right decision. Of the individuals who were premenopausal and chose not to have surgery, 69% believed it was acceptable to enrol in the study with the two-step operation and 38% who had the surgery stated that in hindsight they would have potentially chosen the new approach.
The results of the investigation have even led to a new initiative, and now females in the UK can choose to join a new study: Preventing Ovarian Cancer through early Excision of Tubes and late Ovarian Removal (PROTECTOR). The new risk-reducing surgery offers individuals more choice in avoiding early menopause and the “study shows a large proportion of eligible women wish to consider this,” said Machanda.