By Dr. Sidra Khalid
Genetic factors can increase the risk of developing ovarian cancer. Genetic testing and counseling are important in patients with ovarian cancers or with a family history of ovarian or other cancers if part of a syndrome. Commonly, testing for BRCA 1 and BRCA 2 mutations is advised.
September is ovarian cancer awareness month. Ovarian cancer symptoms are usually vague on presentation, or the cancer can present as an acute condition. Some of the symptoms include:
- abdominal bloating
- abdominal distention
- nausea
- poor appetite
- pelvic or abdominal pain
Acute presentations can include ascites (fluid in the abdomen), pleural effusions (fluid around the lining of your lungs) or a bowel obstruction due to advanced disease. Other times, ovarian cancer can be found incidentally, such as if surgery is being performed for a different condition. Also, if imaging is being performed for a different reason, an ovarian mass may be seen.
If ovarian cancer is localized, it can be treated with surgery and chemotherapy. If it is metastatic, meaning it has spread to distant organs, then chemotherapy and newer, targeted agents can be helpful to improve survival outcomes.
There has been considerable progress in ovarian cancer treatment in recent years, especially with a group of drugs known as PARP inhibitors. Genetic testing can be performed to identify BRCA mutations. If a BRCA mutation is present, then PARP inhibitors act on the cancer cells with these mutations to improve outcomes. Some PARP inhibitors can be used even if a mutation is not present, but they are less effective. Additionally, there are other newer, targeted therapies that are available to treat ovarian cancer, which gives patients more treatment options.
The risk factors associated with ovarian cancer include:
- Older age, except for patients with hereditary-related cancers
- Early menarche or late menopause
- Nulliparity (never having children)
Genetic factors also can increase the risk of developing ovarian cancer. Genetic testing and counseling are important in patients with ovarian cancers or with a family history of ovarian or other cancers if part of a syndrome. Commonly, testing for BRCA 1 and BRCA 2 mutations is advised.
Additionally, Lynch syndrome can be associated with ovarian cancer and other cancers, such as endometrial and colorectal, and can be confirmed through testing. Genetic testing is key, as it can lead to prevention if a genetic mutation is found.
For example, if BRCA 1 or 2 is present, ovaries can be removed after childbearing to decrease risk. Oral contraceptives can be considered as well to reduce the risk of ovarian cancer.
If you have a family history of cancer, particularly breast or ovarian, talk to your provider to find out if genetic testing is appropriate for you.
Dr. Sidra Khalid is a physician with Memorial Physician Clinics seeing patients in hematology and medical oncology. Reach her at (228) 575-1234
