Researchers are pushing for a change to protect more women against ovarian cancer.
HAMPSTEAD COUNCILLOR vows to help women after wife dies of ovarian cancer
After his beloved wife succumbed to ovarian cancer, Hampstead councillor Abe Gonshor vowed he would help save other women from a similar fate.
It was too late for Shirley, 64, who died last year after several painful months, he said. But other women should be made aware, Gonshor told The Gazette, that Fallopian tube removal is now being touted by researchers as a way of preventing the disease in some women.
“Why do they even call it ovarian cancer? It has nothing to do with the ovaries,” said Gonshor, adding that he became a one-man awareness campaign to improve knowledge and awareness of a silent killer. “If I knew then what I know now, she would be alive today.”
Gonshor isn’t alone in his conviction.
Changes in surgical trends that are thought to protect against ovarian cancer actually stem from Canadian research, led by a team in Vancouver.
“There is no effective screening and many women unfortunately succumb despite treatment, which makes us very motivated to try to prevent it outright,” said gynecologic oncologist Sarah Finlayson of the Ovarian Cancer Research Program at Vancouver General Hospital and B.C. Cancer Agency. “And with a simple change we could prevent this terrible disease.”
Research showed that most of the high-grade “serous” cancer responsible for 90 per cent of deaths from ovarian cancer actually starts in the Fallopian tubes.
As of 2010, the Vancouver group formally urged B.C. doctors to remove the Fallopian tubes in women already scheduled for abdominal surgery, for permanent birth control or to remove the uterus or ovaries. Research- ers said it could reduce death from ovarian cancer by 50 per cent over 20 years.
“We wanted women to have that conversation with their doctors and the opportunity to decide for themselves when they are undergoing surgery anyway,” Finlayson said.
The majority of B.C. gynecologists are performing such surgery at the time of hysterectomy and tubal ligation, Finlayson added.
Research showed that about 20 per cent of women with ovarian cancer had their uterus or ovaries taken out in the past, but not their Fallopian tubes. There was no evidence-based reason for leaving the tubes in place, Finlayson explained, it was simply tradition.
“We’re not recommending that all women past childbearing age do this, only those who are undergoing surgery anyway,” she said.
Because of its potential to save lives, the Society of Gynecologic Oncology of Canada last year issued a strong recommendation that all physicians discuss the risks and benefits of tubal surgery in women already undergoing hysterectomy or considering permanent birth control. It also called for a national ovarian cancer prevention study focused on Fallopian tube removal — which Finlayson’s group is now investigating.
The approach among Canadian physicians is gaining traction, said Barry Rosen, SOG spokesperson, and head of gynecologic oncology at Princess Margaret Hospital and the University of Toronto.
For years, women who had pelvic surgery had their tubes left behind intact. “Now, the concept is leave the ovaries and take the tubes,” Rosen said.
To be sure, no one is telling women in general to have their Fallopian tubes removed to reduce the risks of ovarian cancer, Rosen said.
“That would be a big mistake,” Rosen said. “All surgery has its risks. This approach is for women having surgery for another reason and who are past child-bearing age and no longer need Fallopian tubes.”
Rosen noted that ovarian cancer is rare compared to breast or colon cancer. The lifetime risk of developing ovarian cancer is one in 70 women. “Tubes are not time bombs. That’s a complete misunderstanding of the facts,” Rosen said.
There are 2,500 new cases of ovarian cancer in Canada each year, about 1,700 will die. Ovarian cancer is extremely difficult to diagnose because it produces so few symptoms in its early stages.
“There is no cure,” said Gonshor, whose wife died June 27, 2011, five years after her cancer was detected. She had peritoneal ovarian cancer that spread to the lining of her stomach. Surgery and chemotherapy at the Montreal Jewish General Hospital kept the disease at bay for two years. And then it came back with a vengeance,
The Gonshors spent months in the intensive care unit, “waiting for a miracle,” he said. “She suffered a lot, it’s a horrible disease.”
In late June, the ICU unit was transformed into a wedding party. The couple’s son married his sweetheart at his mother’s hospital bedside. Shirley Gonshor died four days later.