Research on cancer prevention with surgery

Annika Strandl, Lecturer at the University of Gothenburg and Chief Physician of the Women’s Health Service at Sahlgrenska University Hospital in Gothenburg, meets women who want to have their hysters or ovaries removed in their work.

The most common reason for hysterectomy is bleeding that is difficult to treat. Other women have been advised to have their ovaries removed because they have the BRCA1 or BRCA2 risk genes (read more about research on BRCA here).

It is a major and disabling procedure that causes a woman to enter menopause

­­– It is a major and crippling procedure that leads women, regardless of age, into menopause. We want to see if in some cases it could be enough to remove the fallopian tubes to reduce the risk of cancer,” she says.

The background is that tumors detected in the ovaries may originate in the fallopian tubes.

Examination of women in two studies

In two projects supported by the Cancer Foundation, Annika Strandell is investigating whether a less dramatic operation can protect against the onset of ovarian cancer. In the first step, she studied women who did not have the BRCA risk genes.

One study involved women who had their uterus removed because of heavy bleeding or a painful knot. It is pulled to remove both fallopian tubes at the same time or not.

The second study includes women who want to sterilize themselves. Normally, the fallopian tubes are “cut” so that sperm and eggs cannot pass through. Here, women are pulled over for either this procedure, or the complete removal of their fallopian tubes.

In both studies, it was measured whether extended surgery led to more complications or more menopausal symptoms. Through the records, women are also followed for a long time to see if those who have their fallopian tubes removed have survived ovarian cancer in the long term, compared to those who kept their fallopian tubes.

It is important to be able to give a woman solid advice

According to Annika Strandell, the goal is the same for both studies.

­­– Hopefully, the risk of complications and symptoms of menopause will not increase if the fallopian tubes are removed, but the results will show that it does. The most important thing is that we have to be able to give women solid advice about what to expect, so they can decide if they want to have the additional procedure, she says and adds:

­­– In the long term, in ten to twenty years, we also know if by removing the fallopian tubes we protect them from the onset of cancer in the ovaries.

They can then have children before their ovaries are removed

The women who work on these projects do not have active cancer, and do not carry the BRCA1 and BRCA2 risk genes. Hopefully, the results will still be interesting to women with cancer, according to Annika Strandell.

­­– If it turns out that removing the fallopian tubes for some time provides sufficient protection against cancer, then there is no need to immediately remove the uterus and ovaries. It can then be time to have children before the ovaries are removed when menopause approaches.