Never be embarrassed to speak up about down-there
discomforts.
Cancer Center in New York. “ In contrast, a
false positive on an ovarian cancer screening test might lead to surgery. “
Hope
on the Horizon
It’s hard to gild the current picture of
ovarian cancer, but potential breakthroughs are in the works, including better
screening strategies, says Karen Lu, M.D., a professor of gynaecologic oncology
at the MD Anderson Cancer Center in Houston. And researchers are hard at work
developing a number of vaccines designed to prevent the recurrence of ovarian
cancer in diagnosed patients. Research also shows that high-risk women might be
better off than was initially thought. (See “ Assess Your Risk. “ on the
opposite page.)
Researchers are also looking at the
fallopian tubes for answers, Some scientists propose that the majority of
aggressive ovarian tumors may actually begin in the tube, then spread to the
ovary. That’s potentially good news for younger patients. Since ovarian removal
in premenopausal women cuts off a hefty estrogen supply, which can lead to
increased long-term risk for heart disease and osteoporosis. While studies have
yet to confirm it, “ we’re intrigued by this possibility, because we could
theoretically.
ASSESS
YOUR RISK
As
usual, genetics plays a part. Learn what other factors matter.
Endometriosis, infertility, and early
menstruation can all increase a woman’s chances of developing ovarian cancer,
as can a family history of breast or ovarian cancer. But the best high-risk
assessment lies in your DNA: Some 10 percent of cases are hereditary.
Women who inherit mutations on their BRCA1
and BRCA2 genes-both of which are normally involved in DNA repair- are at a
much higher risk for ovarian cancer. The BRCA2 mutation points to a 15 to 27
percent lifetime risk; the BRCA1 mutation skyrockets that number as high as 40
percent. In both cases, carries typically fall ill around or after age 40 (the
average patient has a 1.4 percent lifetime risk and is diagnosed after age 60).
“ When a woman has one of these mutations
we’ll monitor her every six months with the CA125 test and a transvaginal
ultrasound, “ says Colleen Feltmate, M.D.” We’ll wait for her to finish having
kids, then suggest removing the ovaries and fallopian tubes, which cuts her
risk for ovarian cancer by nearly 96 percent.”
Research indicates the surgery should
happen ASAP after a patient turns 35, but science suggests there might be ways
to fine-tune your risk assessment-and possibly put off the surgery. For
example, doctors now know that the BRCA1 and BRCA2 genes are very large, and
that the mutations can occur anywhere along them. Pinpointing the exact spots
could help further define your risk and aid your M.D. in coming up with a
personalized prevention plan.
What’s more, promising new research in the Journal
of the American Medical Association shows that carriers of the BRCA
mutations might actually have better survival rates after treatment than
noncarriers.
If you have a strong family history of
ovariar cancer ( i.e., two or more first-or second-degree relatives have had
it), consider seeinga genetic counsellor for a BRCA blood test. You can also
ask her about a separate genetic condition called Lynch syndrome, which has
been linked to ovarian cancer, If you test positive for either, find a
gynaecological oncologist that you feel comfortable with and study all of your
options before making any prophylactic decisions.
One bright note for high-risk women: You
don’t need to rush into motherhood. Even if you have the surgery early,
scientific advances have made it possible to freeze eggs, remove the ovaries
and fallopian tubes, and implant fertilized eggs into the uterus. Yep-you don’t
necessarily need your ovaries to be pregnant or deliver a baby.
Reducing your intake of animal fat may help drop your risk
for ovarian cancer
Remove the tubes but leave the ovaries,
preserving fertility, “ says Micheal Seiden, M.D., Ph.D., president and CEO of
the Fox Chase Cancer Center in Philadelphia.
In the meantime, there are things you can
do to slash your risk, starting right now.
After your ovarian function. Though experts aren’t totally sure why, giving birth and
breastfeeding at least one baby are known risk reducers, possibly because they
both suppress ovarian activity. But you don’t have to become a mom : Being on
the Pill yields the same result. Taking oral contraceptives for just five years
can cut your ovarian cancer risk for the next 10 years by roughly 30 percent.
Snack on Brussels sprouts, cabbage, and
cauliflower. These foods are full of a
phytochemical called sulforaphane, which can help reduce the risk for cancer,
And new research from the National Institute of Health indicates that limiting
intake of fat-especially animal fat may also help drop your chances of
developing the disease.
Maintain a healthy weight. Women with a higher body mass index (BMI) may be at increased risk
for ovarian cancer.
Climb into the stirrups once a year. “ There’s no evidence that pelvic exams will catch ovarian cancer
early, but it’s a great time to discuss any new symptoms with your doctor,”
says Lu. Be on the lookout for the most common signs-particularly if they seem
to appear out of nowhere and never be embarrassed to speak up about down-there
discomforts. “Most of the time, it won’t be ovarian cancer,” says Goff, “but if
you have symptoms that persist or get worse after two to three weeks, it’s
worth a trip to the gynecologist to investigate.”
Another Ovarian Intruder
For reasons that
aren’t quite clear, women in their child-bearing years are particularly at risk
for a form of ovarian cancer called germ cell carcinoma, which grows in the
egg-making cells of the ovary rather than on the surface of the ovary itself.
The tumors, which make up about 5 percent of all ovarian cancer cases, are
usually limited to one ovary and are easier to spot by an ob-gyn during a
pelvic exam or ultrasound (exterior symptoms can include abdominal swelling).
“While surgery and chemo are needed, this type of cancer is very curable,” says
Barbara Goff, M.D. : The vast majority of diagnosed patients can keep their
uterus and other ovary, preserving their fertility.”
