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Shedding Light on Ovarian Cancer: Understanding, Awareness, and Hope

May 8 is World Ovarian Cancer Awareness Day! Today, we come together to shed light on one of the most formidable health concerns affecting women globally. Ovarian cancer is often referred to as the "silent killer" because its symptoms are subtle and easily mistaken for other less serious conditions. We can make a difference in the fight against this disease with knowledge, early detection, prevention, advancements in treatment options, and precision medicine. 

Understanding Ovarian Cancer

Ovarian cancer is a term used to encompass cancers that develop in the ovaries, fallopian tubes, and peritoneum. Women have a lifetime ovarian cancer risk of approximately 1.1%. While it is generally diagnosed over the age of 50, ovarian cancer can affect women of all ages. Unfortunately, diagnosis often occurs at an advanced stage, highlighting the critical importance of recognizing symptoms and understanding risk factors.

Symptoms may include:

Risk factors may include:

  • Persistent bloating
  • Pelvic or abdominal pain or pressure
  • Difficulty eating or feeling full quickly
  • Changes in bowel habits
  • Frequent urination
  • Unexplained weight changes
  • Age
  • Pathogenic or likely pathogenic variants (sometimes called mutations) in genes associated with ovarian cancer risk
  • Personal history of related cancers (eg, breast, endometrial, colon, pancreatic)
  • Family history of ovarian and/or related cancers
  • Reproductive/hormonal factors (eg, nulliparity)

Symptoms and risk factors are not necessarily specific to ovarian cancer and should be discussed with a healthcare professional to determine if further evaluation is needed.

Awareness

Awareness serves as a catalyst for informed decision-making, proactive engagement, and the cultivation of a compassionate community for those navigating this complex disease. Ovarian cancer differs from other types of cancer in that routine screening is not effective in diagnosis of early-stage disease. This underscores the importance of symptom awareness and identification of high-risk individuals who are most likely to benefit from risk-reducing interventions.

For women with germline (present from birth) pathogenic or likely pathogenic variants in certain genes, such as BRCA1, BRCA2, BRIP1, EPCAM, MLH1, MSH2, MSH6, PALB2, RAD51C, and RAD51D, the most impactful intervention is proactive removal of the ovaries and fallopian tubes. Some indications for genetic testing include family history of early onset cancer, individuals diagnosed with two or more separate cancers (including bilateral cancer), multiple affected individuals (particularly if more than one generation is affected), and certain tumor types (eg, male breast cancer, ovarian cancer, pancreatic cancer, and aggressive forms of prostate cancer). Those who have one of these genetic alterations, other significant risk factors such as a concerning personal or family history of cancer, or questions about genetic testing should consult their physician or a genetic counselor.

Hope

There’s a renewed sense of hope around the early detection and treatment of ovarian cancer fueled by advancements in testing strategies, groundbreaking therapies, and research. 

  • Germline genetic testing has become more widely available, allowing us to identify individuals born with an increased risk of cancer who should consider risk-reducing options.
  • Tumor testing, including DNA sequencing, can uncover specific genetic vulnerabilities of an individual's cancer, allowing for the development of personalized treatment strategies and determination of eligibility for clinical trials.
  • PARP inhibitors (a class of drugs that inhibit the PARP enzyme, preventing cancer cells from repairing damaged DNA and ultimately leading to their demise) are an example of a significant development in ovarian cancer therapy, offering renewed optimism in a subset of patients.
  • Liquid biopsy, a noninvasive method for detecting tumor-derived DNA fragments circulating in the blood, holds promise for early detection and treatment monitoring.

The emergence of these transformative technologies and a shift toward more personalized care renew the hope for better outcomes for individuals affected by ovarian cancer.

As we commemorate World Ovarian Cancer Awareness Day, let's honor the strength and resilience of women facing ovarian cancer and renew our commitment to this worthy cause. By empowering individuals to take charge of their health, we can make strides towards prevention, early detection, and ultimately, a cure for ovarian cancer.


Resources:
References:

Centers for Disease Control and Prevention. Basic Information About Ovarian Cancer. Published June 14, 2023. Accessed April 3, 2024. https://www.cdc.gov/cancer/ovarian/basic_info/index.htm

ChatGPT. Version 3.5. OpenAI; 2023. Accessed April 3, 2024. https://openai.com/

Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA. 2004;291(22):2705-2712. doi:10.1001/jama.291.22.2705

Johansen EL, Thusgaard CF, Thomassen M, Boonen SE, Jochumsen KM. Germline pathogenic variants associated with ovarian cancer: A historical overview. Gynecol Oncol Rep. 2022;44:101105. Published 2022 Nov 8. doi:10.1016/j.gore.2022.101105

Liberto JM, Chen SY, Shih IM, Wang TH, Wang TL, Pisanic TR 2nd. Current and Emerging Methods for Ovarian Cancer Screening and Diagnostics: A Comprehensive Review. Cancers (Basel). 2022;14(12):2885. Published 2022 Jun 11. doi:10.3390/cancers14122885

National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (Version 3.2024)  www.nccn.org Accessed April 3, 2024.

National Comprehensive Cancer Network. Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer (Version 1.2024)  www.nccn.org Accessed April 3, 2024.

National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Cancer State Facts: Ovarian Cancer. Published April 15, 2022. Accessed April 3, 2024. https://seer.cancer.gov/statfacts/

USC researchers develop blood test for early-stage ovarian cancer. News release. Keck School of Medicine of USC. October 11, 2023. Accessed April 3, 2024. https://keck.usc.edu/news/usc-researchers-develop-blood-test-for-early-stage-ovarian-cancer/

Authors

Jennifer Martz
Diana Tully, MS, CGC