Ovarian cancer may be the eighth-most common cancer among women, but barely 46 percent live longer than five years after their diagnosis, according to the National Cancer Institute.
That's because the symptoms--bloating, pelvic or abdominal pain, back pain, and indigestion--can be confused with less serious conditions. And there's no general screening test for ovarian cancer; the CA-125 test, which looks for a protein that's elevated when you have ovarian cancer, is only recommended if you're at risk.
This year, the American Cancer Society estimates that there will be 22,280 new cases of ovarian cancer; of those, only 15 percent will be diagnosed in the early stages. So we talked to Paul DiSilvestro, M.D., head of research with the Program in Women's Oncology at Women & Infants Hospital in Providence, RI. Dr. DiSilvestro, who's also a professor of obstetrics and gynecology at the Warren Alpert Medical School of Brown University, was part of a research team that recently discovered more genetic mutations linked to ovarian cancer. Here's what you need to know if you suspect this cancer runs in your family.
1. Ovarian cancer is actually three diseases. Cancerous cells in your ovaries is what most of us think when we hear "ovarian cancer." But you can get cancer in your fallopian tubes or in your peritoneal lining, the tissues that coat the organs in your abdomen (like the intestines and spleen). Both those two kinds of cancer are rare, says Dr. DiSilvestro.
2. There are at least 11 genetic mutations that have been linked to ovarian cancer at this time. The most well-known and researched are the BRCA1 and 2 mutations, which also up your risk in breast, pancreatic, and colon cancers. Another one is the PALB2 mutation, which can increase your chances of breast cancer too.
3. These mutations can drastically increase your risk. Most women have a 2 percent chance of getting ovarian cancer by age 70, according to the American Cancer Society. If you carry the BRCA1 gene that risk increases to 35 to 70 percent; if you carry the BRCA2 gene you have between a 10 and 30 percent higher risk. What does that mean? For every 100 women with the BRCA2 gene, between 10 and 30 will get ovarian cancer--and potentially get it at a younger age than average (which is between 55 and 64 years old, according to the National Cancer Institute).
4. No group of folks is immune from being a carrier. While some ethnic groups seem to have a higher risk for being carriers of the BRCA1 and 2 mutations, no group of people is free of the mutations that have been linked to ovarian cancer. "It’s potentially out there for everybody," Dr. DiSilvestro explains.
5. Look for patterns. There are certain clues that can help you figure out if ovarian cancer runs in your family: if a couple of close family members had breast cancer, especially if they were diagnosed before they were 50 years old; if a direct relative--even a cousin--has had ovarian cancer; or if several family members have had colon cancer. Whatever the pattern is, bring it up to your general practitioner--or better, your gynecologist, Dr. DiSilvestro suggests.
6. Don't discount other types of illnesses far back in your family tree. Maybe everyone thinks your grandmother died of stomach cancer, but she could have had ovarian cancer. Or colon cancer. Diagnoses weren't that accurate as recently as 30 years ago.
7. Your father can pass down ovarian cancer. "It’s not just your Mom—these genetic mutations are carried down by both sets of parents," notes Dr. DiSilvestro. "So ask about your dad’s side too."
8. Your mother can pass down the genes that are linked to ovarian cancer, even if she was never diagnosed. It's not uncommon for mutations to skip a generation.
9. If you have a strong family history, get genetic testing. But do it with a counselor, who can walk you through the findings so you better understand what they mean and what to do next. A lot of variables come into play--your age, the relative lifetime risks, whether you have children--and you want someone to guide you through your options. Also, a NEGATIVE result for a mutation may not necessarily mean you're not a carrier--unless you know for sure a direct relative with ovarian cancer didn't have that mutation, either, Dr. DiSilvestro explains.
10. Birth control pills can reduce your risk Oral contraceptives can minimize your risk of developing ovarian cancer--and the longer you take them, the lower your risk. The benefits continue even after you've stopped! One study found the same perks for women getting the Depo-Provera injection.
11. Make some lifestyle changes. Eating healthier foods and watching your weight are always good ideas; there is some evidence that obesity can increase the chances of developing ovarian cancer.