Overview
PROTECTOR is a research study for women (people assigned female at birth) who are at an increased risk of developing ovarian cancer. Individuals may have an increased risk of developing ovarian cancer for several reasons, for example:

• They carry an alteration in certain genes such as BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, or PALB2.
• They have a strong family history of ovarian cancer.

We currently have 42 hospitals across England, Wales, Scotland and Northern Ireland which are recruiting participants to PROTECTOR. We aim to recruit 1250 participants in total (416 in each study arm).

Risk-Reducing Salpingo-Oophorectomy (RRSO)
The most effective method to prevent ovarian cancer is surgery to remove both the fallopian tubes (‘tubes’) and ovaries. This procedure is called ‘risk reducing salpingo-oophorectomy’ (RRSO). This significantly reduces the risk of ovarian cancer by up to 96%. However, in premenopausal women, removing the ovaries causes early menopause, which causes symptoms and may have long-term consequences for general health.

An Alternative “Two-Step” Procedure
PROTECTOR offers women a new alternative two-step surgery to prevent ovarian cancer. This procedure is called ‘risk reducing early salpingectomy with delayed oophorectomy’ (RRESDO). The ‘first’ step involves an operation to remove the  fallopian tubes only. This may somewhat reduce ovarian cancer risk without causing early menopause. The ‘second’ step involves removing the ovaries in a second operation. This can take place at any time after the first operation, at a time up to the individual’s choosing. Alternatively, individuals can have the second operation once they have reached menopause naturally (which on average is 51 years in the UK).

Aims and Objectives
The study assesses women’s views and the impact of this two-step surgery to prevent ovarian cancer on sexual function, hormone levels, quality of life and overall satisfaction. Outcomes from this new approach are compared to the traditional approach of removal of both tubes and ovaries in the same operation (RRSO). We will also compare this to the well-being of women who choose not to have surgery. Women will be able to choose which arm of the study they wish to take part in:

• RRSO: A single operation removing both fallopian tubes and ovaries.
• RRESDO: The two-step surgery involving removal of the fallopian tubes first followed by the ovaries at a later time
• Control: No surgery

How To Take Part
If you would like to take part, please ask your GP to refer you to your nearest recruitment centre which can be found using our interactive map. Alternatively, you may contact our team for further details on how to take part.