science
How fallopian tube removal is replacing tube-tying
Science photo library
Despite the name, most ovarian cancers actually start in the fallopian tubes — those widening flumes with tentacle-like fringes at the end, as STAT’s Eric Boodman describes them, which connect someone’s ovaries to their uterus. The reasons for this aren’t entirely clear. One hypothesis says that, in order to burst out of an ovary in the first place, the egg may be equipped with some sort of tissue-eroding chemical. Which means that over the course of ovulation, fallopian tubes get a repeated dose of whatever that cocktail may be.
With possibilities like these in mind, the removal of fallopian tubes — rather than simply tying them — has emerged as a promising, effective, preventative procedure. But there are a few problems. There haven’t historically been distinct diagnostic codes for these procedures. And while some patients have found ways to utilize that opacity to get around insurance denials, other patients may not know which procedure they’ve gotten until long after the fact.
Eric first became interested in these procedures, known as salpingectomies, as he was writing about women who'd felt pressured into getting unwanted sterilizations for his “Coercive Care” series, he told me last week in a DM. “I kept hearing about the trend of taking out tubes wholesale instead of ‘tying’ them. That really piqued my curiosity — especially when some of my own doctor friends had never heard about it,” he said. Read more from Eric on where his curiosity took him.
commercial determinants of health
HHS plans ‘bold, edgy’ campaign on ultra-processed foods
The links between ultra-processed food and higher risk of diabetes will be the focus of the first wave of Kennedy’s national “Take Back Your Health” campaign, according to a notice posted on a government site for contractors inviting public relations agencies to pitch strategies for the launch of the ad campaign.
The call for pitches asks not only for “daring, viral messaging to motivate behavior change” but for campaigns that specifically “popularize technology like wearables as cool, modern tools for measuring diet impact and taking control of your health.” (Surgeon general nominee Casey Means’ health tech company, Levels, uses continuous glucose monitors and lab testing to help people track their health.) Read more from STAT’s Sarah Todd on what experts thought about the campaign.
first opinion
On IVF and full fetal personhood
We’ve got two insightful First Opinion essays on the site today that are both focused on reproductive health:
As a doctor concerned about falling fertility rates, Brian Levine appreciated the intent behind Trump’s executive order that pledged to make IVF more affordable. But at the same time, he sees the administration’s elimination of the CDC’s oversight group tasked with tracking IVF success and failure rates as a major obstacle for policymakers who are working to make greater access to the treatment a reality. Levine understands that it may be surprising to hear an argument for more regulation from the founder of a fertility clinic. But government oversight and comprehensive regulations are “critical safeguards,” he writes. Read more.
The other essay, from law professor Laura Hermer, centers on a case you may have heard of. In Georgia, physicians at Emory University Hospital have kept Adriana Smith, who is brain-dead, on life support for three months against her family’s wishes solely as a means of incubating her still-developing fetus. “This is not the first time a pregnant woman has been treated as an incubator for her fetus,” Hermer writes. The state’s law declares that an unborn product of conception at any stage of development is a “natural person,” but Hermer argues that even full fetal personhood shouldn’t end abortion rights. Read more.
