Gynecologic cancer | Ovarian Cancer | Risk


 How do I know if I'm at risk for ovarian cancer?

 The exact cause of ovarian cancer is unknown. There are thought to be some factors that may put a women at risk. Ovarian cancer is either referred to as "sporadic cancer", in other words cancer that occurs without a determined genetic link, or "hereditary cancer", where a familial or inherited link exists. Research is showing that women who begin menstruating at an early age may be at higher risk, and also, those who have never been pregnant. There is also thought to be hormone-related risks (elevated levels of gonadotropins) which is why the use of the birth control pill is thought to reduce a woman's risk of ovarian cancer.*

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 How concerned should I be about ovarian cancer if I have a family member with the disease? Is there a genetic link?

 It is thought that the genetic risk is transmitted through BOTH parents. Two genes that exist in every cell of every person, the BRCA1 and the BRCA2 genes, normally suppress tumour growth. In the case of ovarian and breast cancers that are hereditary, a woman inherits a mutation of one of these genes. The risk increases with a higher number of relatives that have had the disease, and how closely related they are. For example, the risk is higher if it's sisters or mothers that have had ovarian cancer vs. aunts and grandmothers. Often women are offered 'genetic counselling' to determine estimated risk based on family history. It's a bit like drawing up a family tree. 'Genetic testing' involves taking a blood test which searches for any gene mutations.*

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 Cyndee, Pennsylvania, USA: We have a strong history of ovarian, breast and colon cancer in our family. My mother was diagnosed at age 42. I also was diagnosed at age 42. My 22 year-old daughter is extremely concerned. She spoke with my gynecological oncologist and discussed gene testing and having a prophylactic hysterectomy/oophorectomy after she has her children. We were told that she should begin to be monitored ten years before the age that I was diagnosed at. So when she is 32, she should begin to be watched and have an annual transvaginal ultrasound test.

 Kathy L., New Jersey, USA: My sister was diagnosed with ovarian cancer. To our knowledge, no one in the family has had ovarian, breast or colon cancer, so it was quite a surprise. I went to my gynecologist for advice, and he put me on birth control pills. He said that there is a correlation between ovarian cancer and uninterrupted ovulation - in other words, breastfeeding, pregnancy, or being on birth control pills, which all temporarily stop ovulation, reduce the risk.

I have a gynecologic exam and a Pap smear every six months and an ultrasound annually. During my last visit, I had a transvaginal ultrasound. My doctor said this was more reliable because it examines the ovaries more closely.

Try not to worry, but do speak to your doctor. Most ovarian cancer is not hereditary.

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 Gina, Pennsylvania, USA: My paternal grandmother and aunt each died of breast cancer, and I wondered for a long time if there was a link between ovarian and breast cancer that had made me more susceptible. About six years after my initial diagnosis, research came out that revealed some mutated genes contain the potential for types of both ovarian and breast cancer. (Years later, by the way, my maternal grandmother died quite quickly from ovarian cancer, although it was discovered in a very late stage and she was already 87 years old. She had never had any other significant health problems in her life.)

Personally, my bigger concern is the environmental link to ovarian cancer. Industrialized nations have a much greater rate of ovarian cancer than non-industrialized nations, and I grew up in an area very close to a lot of industry.

* Source: "Ovarian Cancer and You" Supplemental to Current Oncology Journal, vol 5, supp 2. Nov 98.

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