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Risk Factors and Ovarian Cancer

February 19, 2015

Risk Factors and Ovarian Cancer

Written by Board Member and Medical Advisor Sarah Adams, MD

Ovarian cancer is characterized by presentation at late stages, usually when women have tumors throughout the abdomen and pelvis. This is due in part to the lack of effective screening strategies, but may also be due to the early spread of cancer cells in the abdominal cavity and to rapid tumor growth. It has long been hoped that a better understanding of the causes of ovarian cancer and factors that promote tumor development would lead to earlier detection and better outcomes for women with this disease.

The best understood risk factor for ovarian cancer development is a family history of breast or ovarian cancer, and specifically the presence of mutations in the BRCA1 or BRCA2 genes. Women who inherit a dysfunctional copy of BRCA1 or BRCA2 are more likely to develop ovarian cancer– with a lifetime risk as high as 40%. Fortunately women who are found to have a BRCA gene mutation can significantly reduce their risk either by having their ovaries removed if they have completed child-bearing, or by taking birth control pills. Currently genetic testing is recommended for all women diagnosed with ovarian cancer, and genetic counseling to assess cancer risk is recommended for women with a family member who has had breast or ovarian cancer. Importantly, additional genes that are often dysfunctional in ovarian cancers have recently been identified. As the impact of these mutations on cancer risk is evaluated, additional women with inherited susceptibility can be identified and offered risk-reduction options.

talcum powder

Other factors that have been associated with ovarian cancer development are less well understood. An early theory suggesting a link with the use of talc powder has recently been disproven in a large study of over 60,000 women (Houghton SC et al, J Natl Cancer Inst 2014). A more established factor that modulates risk of ovarian cancer is a woman’s reproductive history. Women who have never had children, or who have early onset of menstrual periods or late menopause have been shown to have a higher rate of ovarian cancer development. This increased risk of cancer is associated with increases in the number of ovulatory cycles a woman has in her lifetime – each ovulation event induces local inflammation and requires tissue repair, which could result in cells acquiring cancer-causing mutations. Conversely, pregnancy, breastfeeding, and the use of oral contraceptive pills, which interrupt ovulation cycles, all reduce the risk of ovarian cancer.

Interestingly, recent studies suggest that a significant proportion of ovarian cancers actually originate in the fallopian tubes, with early cancers seeding the ovaries before spreading beyond the pelvis. This data derives from careful examination of the ovaries and fallopian tubes removed from women with BRCA gene mutations for cancer risk reduction. This shift in the understanding of the origin of ovarian cancer has led to a new interest in the impact of ovulation on local conditions that could affect both the ovarian surface cells and the nearby fallopian tube. As a result, physicians have begun to evaluate whether removing just the fallopian tubes, and not the ovaries, in young women would provide protection from cancer development without rendering women prematurely menopausal. Ongoing studies are expected to clarify the risks and benefits of this approach, which will allow women and clinicians to make decisions that will best prevent ovarian cancer development.

Women should talk with their health care providers to determine whether genetic counseling or risk reduction procedures are indicated for them. Additional information about ovarian cancer risk and genetic testing is available at the following sites:

http://www.cancer.net/cancer-types/hereditary-breast-and-ovarian-cancer

http://www.facingourrisk.org/understanding-brca-and-hboc/index.php

National Cancer Institute: Cancer Genetics Services Directory www.cancer.gov/cancertopics/genetics/directory

Dr. Sarah Adams is the Victor and Ruby Hansen Surface Professor in Ovarian Cancer Research and the Assistant Professor, Gynecologic Oncology at the University of New Mexico Cancer Center

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Flying Pigs and HERA Climb4Life

January 29, 2015

If you’ve ever come to a Climb4Life, or just been part of HERA Women’s Cancer Foundation for a while, you’ve probably heard the name “Stanley.” He’s coveted, he’s contested, and he’s cherished.

You’ve heard the lore before, but, just who is Stanley anyway?

Stanley_in_his_new_homeThe Stanley Award was created by HERA founder, Sean Patrick. When she started Climb4Life in 2002, she was told that people would donate to a rock climbing event when pigs flew. Thirteen years later, the Climb4Life events are still going strong by raising lots of funds to eliminate ovarian cancer through scientific research while also raising awareness about the signs and symptoms of ovarian cancer.

And, Stanley, the flying pig award? He’s still going strong, too. The top fundraising team at the Climb4Life weekends get to take Stanley home, and the competition is fierce!

With our 2015 Climb4Life Series gearing up for an all-time awesome year and Climb4Life Boston just around the corner…it is time for you to start thinking about pulling together your team to strategize on how to raise the most funds and bring Stanley home.

Who’s going to be the top fundraising team at the 2015 Climb4Life Boston? So far over $5,000 has been raised by the Boston Climb4Life participants, but teams who win Stanley know that it takes over three times that amount to bring him home and keep him.

In the past people have done crazy things to raise funds, even shaving their heads! In addition to Stanley, the top fundraising team will win some fantastic prizes.

It’s not too late to register. Climb4Life Boston is right around the corner, March 7, and teams are still forming.

New to climbing? No problem – we offer clinics. Experienced? Watch for exciting pro athletes to join the mix and challenge you to new heights. Prefer yoga and fitness classes? We’ve got you covered.

Click here to register now and get in on the fun.

Or, donate to your favorite participant and help their team give Stanley a new home.

Stanley Award

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Real Men Wear Teal

October 3, 2014

Our good friends at Sportrock Climbing Center in Alexandria, VA helped raise awareness about ovarian cancer at their “Feel the Teal” event on October 2.  Folks lined up for manicures and pedicures, bought some cool swag, and made donations to HERA.  What a fun event!  Even the guys got involved because ovarian cancer affects them, too.  Check it out:

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