Cancer is a disease in which certain cells in the body grow out of control and spread to other parts of the body. While many forms of cancer can be detected at an early stage, ovarian cancer often goes unnoticed until it reaches an advanced stage, making treatment more difficult. However, understanding the genetic risk factors associated with ovarian cancer may lead to earlier diagnosis and improved treatment outcomes.
Are genetics the only culprit?
Genetic mutations that can lead to ovarian cancer account for only 15-20% of cases. Some of the other risk factors include:
- Hormonal: excessive exposure to estrogen.
- Lifestyle factors: A sedentary lifestyle and obesity increase the risk of ovarian cancer
- Random Chance: So genetics is not the only thing to blame.
Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med. February 2017; 14 (1): 9-32. doi: 10.20892/j.issn.2095-3941.2016.0084. PMID: 28443200; PMCID: PMC5365187.
How to find out about genetic risk?
When considering the genetic risk of ovarian cancer, we need to look at our family tree to determine if any of our close blood relatives (sisters, mothers, grandmothers) or first or second cousins have been diagnosed with this cancer . If you find a patient there, you are at a higher risk of contracting the disease compared to the general population.
What if I have a family history?
The best approach is to see a gynecologic oncologist. There are certain guidelines for testing in such circumstances. Not everyone needs to be tested for genetic risk. Often, such testing is combined with pre- and post-test genetic counseling and should be provided by a geneticist. Such testing is not limited to ovarian cancer, but can also be done for breast, pancreatic, and prostate cancer.
Couples of reproductive age may face concerns about passing on such genes to the next generation. In such circumstances, preimplantation genetic testing is recommended.
What are my options if the genetic screening test is positive?
Again, the best option is to make an appointment with a gynecologic oncologist. Modalities available for such people:
- Non-surgical risk reduction: Use of ovulation-suppressing oral contraceptives and levonorgestrel IUDs has been shown to reduce the risk of ovarian cancer in average-risk women.
- Reduction of surgical risk: Involves the removal of both the fallopian tubes (salpingectomy) and the ovaries (ovariectomy). The timing of the operation, early or delayed removal, depends on the results of the genetic analysis.
Do children also need genetic testing?
According to NCCN guidelines, genetic testing is not required for children under the age of 18, as the results will not affect the treatment of such young patients.
Reference: NCCN Guidelines Version 3.2024 Ovarian Cancer
Is there a screening test for ovarian cancer?
Unlike cervical cancer, there is no effective screening test for early detection of ovarian cancer; therefore, for women at intermediate and low risk, screening is not recommended. But in the case of high-risk women, CA125 transvaginal ultrasound along with physical examination can be done every six months. However, knowing the symptoms, risk factors, and appropriate genetic testing can provide a small advantage against this cancer.
Should this knowledge increase my anxiety?
No, a recent study in Britain dispelled the idea that spreading cancer knowledge increases anxiety. Such information is recognized to reassure the public. It’s important to empower people with the knowledge to take care of their health and be good advocates for themselves.
Contributed by Dr. Satinder Kaur, Director, Max Super Gynecology Cancer Hospital, Vaishali.
Source: https://research.reading.ac.uk/research-blog/2023/02/03/meeting-the-psychological-needs-of-cancer-survivors
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