Genetic testing is key to early detection of ovarian cancer

Genetic testing is key to early detection of ovarian cancer

According to the American Cancer Society, this year approximately 19,880 women will be newly diagnosed with ovarian cancer and 12,810 women will die from it. It is the fifth deadliest cancer in women and the deadliest that affects the female reproductive system.

For Ovarian Cancer Awareness Month in September, University of Minnesota Medical School expert Colleen Rivard, MD, talks about the subtle signs and risk factors of ovarian cancer .

Q: What is ovarian cancer?

Ovarian cancer is the second most common and deadliest gynecological malignancy in the United States. It is a malignant tumor that arises from the ovary or the fallopian tube.

There are three main types of ovarian cancer:

  • Germ cell tumors arise from the cells that give rise to oocytes in the ovary.
  • Stromal tumors arise from the supporting cells of the ovary surrounding the oocytes.
  • Epithelial tumors, which are by far the most common and deadliest, and which we are going to focus on today. Among epithelial tumors, the most common are serous carcinomas, which we further divide into low-grade and high-grade.

Q: What are the subtle symptoms of ovarian cancer?

One of the biggest problems with ovarian cancer, and why it’s so deadly, is that there are often no symptoms in the early stages, and by the time women develop subtle symptoms, the cancer s has already spread. The majority of ovarian cancers are diagnosed at stages three and four, when it is very difficult to cure.

The most common symptoms are abdominal symptoms, including pain, bloating or distention, changes in appetite or early satiety, and changes in bowel or bladder habits. These symptoms are often nonspecific and can mimic other health issues, such as digestive upset, esophageal reflux, or urinary problems.

Q: What are the risk factors for developing ovarian cancer and what treatment options are currently available?

In general, the main risk factor for ovarian cancer is age, with the vast majority of epithelial tumors occurring in women aged 60 and over.

Other risk factors include infertility, endometriosis, polycystic ovary syndrome, nulliparity, early menarche or late menopause.

There are also several genetic mutations and syndromes associated with a significantly increased risk of developing ovarian cancer. These include hereditary breast and ovarian cancer syndrome and Lynch syndrome.

There are also a number of other genetic mutations that we know lead to an increased risk of ovarian cancer. In fact, these genetic mutations result in up to 25% of ovarian cancer diagnoses, so it is recommended that all women diagnosed with ovarian cancer receive genetic counseling and testing. These mutations can also impact the treatment a patient receives.

The mainstay of initial treatment for ovarian cancer is currently a combination of surgery and chemotherapy. Unfortunately, in 85% of patients, their cancers recur and in these situations the mainstay of treatment is chemotherapy or enrollment in a clinical trial.

Q: If a person is diagnosed with ovarian cancer, what should they know about the diagnosis?

A diagnosis of ovarian cancer can be very overwhelming for a patient, and I think it can be helpful to take diagnosis and treatment one step at a time. I think it is also very important for a patient to have an advocate who is a family member or friend who can attend visits with them to help them remember and understand all the information they are question. We also have the Minnesota Ovarian Cancer Alliance (mnovarian.org), which has great resources for patients, families, and providers. September is also National Ovarian Cancer Awareness Month, and we just hosted the MOCA Run/Walk to raise money for research into the early detection and treatment of ovarian cancer.

Q: What are you doing in your research and practice to deepen our understanding of ovarian cancer and patient relationships?

We have made many important discoveries in the treatment of ovarian cancer over the past 10 years, including PARP inhibitors and immunotherapy. As a division of gynecologic oncology, we are committed to accessing and enrolling patients in clinical trials because it is the best way to improve outcomes for patients with ovarian cancer.

Colleen Rivard, MD, is a gynecologist-oncologist at the U of M School of Medicine and M Health Fairview. She is also a member of the Masonic Cancer Center.


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