Ovarian Cancer Prevention
||Can Ovarian Cancer Be Prevented?
All women have one or more risk factors for ovarian cancer at some stage in their life. The risks include:
Women who take contraceptive pills for 5 years or more have a 50 percent less chance of developing ovarian cancer than women who do not. However, birth control pills do have some possible side effects which may need to be taken into consideration such as headaches, acne, nausea, hair loss and depression. Yet for many women the possible disadvantages far outweigh the disadvantages.
Women who have rare familial ovarian cancer syndromes, which may account for between 1 and 10 percent of all ovarian cancers, have a 50 percent lifetime risk of developing the disease. If several members of women over several generations develop ovarian cancer, then this usually represents a familial syndrome. Genetic tests can help determine if a woman has a familial syndrome. Familial ovarian cancers tend to occur in younger women before the age of 50 and they also tend to be advanced serous epithelial cancers. As a result doctors often advice those with a familial syndrome to have their ovaries removed (prophylactic oophorectomy) before the age of 35. This will mean the woman loses her fertility and will enter premature menopause. According to the National Institutes of Health Consensus Statement (1994), women who undergo prophylactic oophorectomy are advised to take estrogen replacement therapy (ERT). This will reduce her osteoporosis risk factors and chances of coronary heart disease (CHD), as well as help with menopause symptoms such as hot flashes and menopause depression.
Women with more a more common type of family history of ovary cancer - that is, those with one or more relatives with the disease but no documented familial syndrome - are not usually recommended prophylactic surgery. Although oophorectomy, hysterectomy and tubal ligation (tubectomy or having your 'tubes tied') may reduce the chances of developing the disease, experts agree these operations should only be carried out for valid medical reasons. Ovarian cancer prevention is not considered a valid reason. If you are recommended a hysterectomy for other reasons, and you have a strong history of breast or ovarian cancer in the family you may also consider having the ovaries and fallopian tubes removed at the same time (bilateral salpingo-oophorectomy). If surgery is not possible then women in this risk category should discuss other screening methods with their doctor such as regular pelvic examinations and periodic CA 125 blood tests. They should also consider taking the birth control pill.
If there is a history of breast or ovarian cancer in your family it is worth talking to a genetic counselor about genetic testing. Women who test positive for the BRCA1 or BRCA2 gene mutations have a higher risk of developing both breast and ovarian cancer. Research shows that these women can reduce their risk of ovarian cancer by taking the birth control pill, but the pill may also increase their risk of breast cancer. It still is not clear if tubal ligation has a positive effect on risk reduction in women with BRCA mutations, but a prophylactic salpingo-oophorectomy surgery does protect them from both ovarian and fallopian tube cancer. This type of surgery is only however recommended to very-high risk women and only after they have finished having children. It cancer occurs after this, it because it was likely already to be present but just too small to spot. Additionally women with BRCA mutations are also more vulnerable to primary peritoneal carcinoma (PPC), a cancer which can still develop after the ovaries are removed. Overall however, women with BRCA mutations who have their ovaries removed reduce their risk of ovarian cancer by 85 to 95 percent and breast cancer risk factors by 50 to 60 percent.
Women with a strong family history of ovary cancer should consider registering with a registry such as the Gilda Radner Familial Ovarian Cancer Registry (www.ovarian-cancer.com). Taking part in a registry allows you access to new developments in genetic testing and screening recommendations.
There is still no effective screening for ovarian cancer; a Pap test used for cervical cancer is not useful in this instance. Some experts insist that an annual pelvic examination is one of the best methods. Cancer clinical trials are continually trying to discover better methods of discovering ovarian cancer in its early and most curable stages (see ovarian cancer staging). To date the most promising screening method involves a blood test to check for CA 125 tumor markers which are found in high quantities in women with ovarian cancer. A transvaginal ultrasound (TVU), where a probe is inserted into the vagina to allow a doctor to view the ovaries may also be used. Unfortunately neither technique has proven useful in detecting the disease in the general population. According to the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial which followed over 78,000 women from 1993 onwards, simultaneous CA 125 and TVU screening did not reduce the overall ovarian cancer mortality of American women. Researchers speculate that it may be because TVU's can only pick up tumors large enough for advanced stages of the disease. As for tumor markers, even if a lower threshold of CA 125 levels were picked up, it could lead to an over-diagnosis of benign tumors. It may also lead to too many false-positive test results causing unnecessary anxiety to a lot of women.
Like all cancers (see guide to cancers in women), the best defense against ovary cancer is to find it early. This is why women should become very familiar with their own body and recognize when something is not 'quite right'. Talk to your doctor or nurse and explain any symptoms you are having. Pay particular attention to any unusual pelvic pain, feeling of fullness even after a light meal and abdominal bloating (see symptoms of ovarian cancer).
Staying active can help to reduce your overall cancer risk factors. The World Cancer Research Fund recommends 30 minutes of exercise a day, for 5 days a week. Exercise also has the additional benefit of reducing the chance of diabetes, high blood pressure, osteoporosis and heart disease in women. Maintaining a healthy body weight and eating a balanced diet are also recommended. Include lots of cancer diet foods such as fruit and vegetables in your daily eating plan. For further information see: Cancer Prevention.
|Related Articles on Ovary Cancer
For more facts, see the following:
• Ovarian cancer treatment: Chemotherapy and Surgery
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