New recommendations aim to prevent ovarian cancer

Saving women from an often silent killer is at the heart of new recommendations for ovarian cancer prevention from a top researcher and clinician at the Stephenson Cancer Center at the University of Oklahoma as well as counterparts nationwide.
It’s estimated that almost 22,000 women in this country will learn they have ovarian cancer this year alone, and more than 14,000 women will die of the disease. The disease often is not detected until it is in an advanced stage because there seldom are symptoms until it has already spread. Since early detection through screening and symptom detection has failed to reduce mortality, top cancer researchers and clinicians nationwide now have issued a list of recommendations aimed at stopping the cancer before it starts.
Joan Walker, M.D., gynecologic oncologist with the Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, is lead author on the commentary published in Cancer. Walker also holds the George Lynn Cross Research Professorship in Gynecology and Oncology with the OU College of Medicine.
“These new recommendations are aimed at helping save lives,” Walker said. “ Recent scientific breakthroughs have provided new insights into ovarian cancer? how it forms, how it spreads and who is at greatest risk. With that knowledge, we felt it was important to make a strong recommendation to both the public and health care providers about how to best prevent ovarian cancer.”
The new recommendations include the use of oral contraceptives and instead of tubal sterilization, they recommend the removal of the fallopian tubes. For women at high hereditary or genetic risk of breast and ovarian cancer, risk-reducing removal of the fallopian tubes and ovaries is recommended. Finally, they recommend genetic counseling and testing for women with ovarian cancer and other high-risk family members. Women identified with excess risk of ovarian cancer can reduce that risk to almost zero with the removal of the fallopian tubes and ovaries, but they experience premature menopause.
“For women with an average risk of developing ovarian cancer, we know that the use of oral contraceptives can cut their lifetime risk for ovarian cancer by 40 to 50 percent. The longer oral contraceptives are used, the greater the benefit and that benefit can last up to 15 years after a woman has stopped using oral contraceptives,” Walker said.
Tubal ligation, a procedure in which a woman’s fallopian tubes are blocked, tied or cut, has been associated with a 34 percent reduction in the risk of ovarian cancer in women at average risk for ovarian cancer. With the new scientific evidence, the authors indicated they prefer the removal of the fallopian tubes as a preventive measure.
“Studies have reported a 70 to 85 percent reduction in ovarian cancer as well as a 37 to 54 percent reduction in breast cancer in women at high hereditary risk with the removal of both the ovaries and fallopian tubes,” Walker said. “Growing evidence shows that most type 2 ovarian cancers develop as a result of cellular changes in cells within the fallopian tubes.”

“This information is especially important for women at increased risk for breast and ovarian cancer. These recommendations are intended to help encourage an open discussion between women and their health care providers,” Walker said.