Prevention research for those with an increased risk of developing ovarian cancer.

Prof Ranjit Manchanda and his team are using a new two-step approach to preventative surgery for those at a high risk of ovarian cancer.  

Women taking part in the trial are at an increased risk of ovarian cancer from either:  

• an altered gene (e.g. BRCA1, BRCA2, RAD51C, RAD51D, BRIP1)  

• or because of a strong family history of cancer. 

The trial will be assessing the impact of a new two-step surgery to prevent ovarian cancer: 

• Step 1: removal of the fallopian tubes 

• Step 2: removal of ovaries 

Most ovarian cancers begin in the fallopian tube and not in the ovary itself. The PROTECTOR trial aims to prevent cancer by removing just the fallopian tubes, then removing the ovaries later, once someone has reached menopause naturally. 

Removing just the fallopian tubes preserves fertility and avoids early menopause, which comes with symptoms and long-term health issues. 

The trial monitors the impact of this two-step prevention surgery on sexual function, hormone levels, quality of life and overall satisfaction. This new approach is being compared to the traditional surgery, which removes both the fallopian tubes and ovaries in the same operation.  

The women taking part can choose which arm of the study they wish to take part in: 

• Arm one: single operation removing both tubes and ovaries (two-step surgery)  

• Arm two: having no surgery (the control option). 

Update: PROTECTOR is expanding!  

• We are now active at 37 centres across England, Wales, Scotland and Northern Ireland.  

• To date over 420 women have participated in the study, shown below in each arm. 

• We aim to recruit 1,000 women in total (333 in each study arm) by December 2024. 

The team have recently gained permission to expand the study to include women with other conditions, including those with an alteration in the PALB2 gene, and women who are planning to conceive using IVF treatment. Women who have completed treatment for cancer (most commonly breast cancer) after 6 months can also now be included. 

Participating Sites 

• Barts Health NHS Trust 

• St George’s University Hospitals NHS Trust 

• Royal Surrey County Hospital NHS Trust 

• Brighton and Sussex University Hospitals NHS Trust 

• University Hospitals Bristol NHS Trust 

• Nottingham University Hospitals NHS Trust 

• Worcestershire Acute Hospital Trust 

• Manchester University NHS Trust 

• Guy’s and St Thomas’ NHS Trust 

• Cardiff and Vale NHS Trust 

• Ninewells Hospital, NHS Tayside 

• University College London Hospital Trust 

• Portsmouth Hospitals NHS Trust 

• Imperial College Healthcare NHS Trust 

• Liverpool Women’s Hospital NHS Trust 

• North Tees and Hartlepool NHS Trust 

• University Hospital Southampton NHS Trust 

• Norfolk and Norwich University Hospitals 

• Aberdeen Royal Infirmary, NHS Grampian 

• County Durham and Darlington NHS Trust 

• Royal Devon & Exeter NHS Foundation Trust 

• East Lancashire Hospitals NHS Trust 

• Gateshead Health NHS Foundation Trust 

• Northampton General Hospitals NHS Trust 

• Belfast Health & Social Care Trust 

• Northwick Park and St Mark’s Hospitals 

• Newcastle upon Tyne Hospitals NHS Trust 

• University Hospitals of Leicester NHS Trust 

• East Kent Hospitals University NHS Trust 

• South Tyneside and Sunderland NHS Trust 

• South Tees Hospitals NHS Foundation Trust 

• Royal Infirmary of Edinburgh, NHS Lothian 

• Maidstone and Tunbridge Wells NHS Trust 

• Royal Cornwall Hospitals NHS Trust 

• Ysbyty Gwynedd Hospital, Betsi Cadwaladr UHB 

• Royal United Hospitals Bath NHS Foundation Trust 

• Swansea Bay University Local Health Board