Tying fallopian tubes to ovarian cancer risk.

I ncreasing evidence suggests that the fallopian tubes — once seen as an extremely rare site for cancer — could be the source of the most aggressive ovarian cancer. Last April, investigators at the Dana – Farber Cancer Institute in Boston immortalized fallopian tube cells in the lab, inducing the process by which ovarian cancer progresses from these reproductive tubes to high-grade serous tumors in the ovary: the deadliest, most common form of the disease. “For all those disbelievers out there, this hopefully is the nail in the coffi n,” said Jessica McAlpine, M.D. , an assistant professor in the University of British Columbia ’ s department of gynecology and obstetrics, referring to the April article in the Proceedings of the National Academy of Sciences . “Obviously, there ’ s a need for further study, but we need to do something about it now.” In Canada, researchers have begun urging gynecologists to routinely remove the fallopian tubes in place of a tubal ligation, or during a hysterectomy, even if a woman is not at high risk for ovarian cancer. By convention, current practice leaves these tubes in place. “For a woman who wants to have her tubes tied, she ’ s already decided against having more or any children, so instead of tying the tubes, why not take them out?” McAlpine asked. “And, in a hysterectomy, it ’ s easier to remove the fallopian tubes and keep the ovaries for their hormonal function. We think that reduces the risk not only for ovarian cancer but for other [gynecologic] cancers as well.” Preserving ovarian function, especially in younger women, would also stave off premature menopause with all its attendant health risks, she said, including heart disease, osteoporosis, dementia, and stroke.