Ovarian cancer is the most fatal of all reproductive cancers that women face. Fewer than half of the women diagnosed with ovarian cancer will survive more than five years after their diagnosis, leading to over 152,000 deaths each and every year. Cancer research programs are constantly trying to find new screening tools, treatment options, and extending the lifespan of those affected by the disease. Researchers hope to one day eradicate the disease completely, but as of current, the best hope is to continue researching the disease, how it develops, spreads, and dies. New studies point to positive implications for patients at risk of dying from ovarian cancer.
Possible Advantage of High Blood Pressure
Research by epidemiologists at Roswell Park Cancer Institute suggests that some women with ovarian cancer may benefit from high blood pressure, as published in Cancer Causes & Control. This research shows that hypertension, diabetes, heart disease, and the use of medications to treat these conditions may act as a benefit towards the survival of ovarian cancer patients.
The data was pooled from 15 studies that were all part of an international team of research collaborators led by Albina Minlikeeva and Kirsten Moysich, as part of the Ovarian Cancer Association Consortium. The researchers examined the links between patients that were diagnosed with a specific type of ovarian cancer, invasive epithelial ovarian cancer, and their history of hypertension, diabetes, heart disease, and the medications that the ovarian cancer patients took to treat those conditions (Krizner, 2017).
Kirsten Moysich, a Distinguished Professor of Oncology in the departments of Cancer Prevention and Control and Immunology at the Buffalo, NY cancer center said, "We found that history of diabetes was associated with increased mortality. Surprisingly, among patients diagnosed with endometrioid ovarian cancer, history of hypertension was inversely associated with risk of progression."
Moysich added, "We also found that the use of certain medications such as oral anti-diabetic medications and insulin was associated with increased risk of dying, and use of diuretics with better survival.”
The researchers found that no significant mortality associations were made for hypertension or heart disease, although patients with a history of diabetes were associated with 112% higher risk of mortality across over 7,600 cases. The research actually found that the 26% of women pooled who had epithelial ovarian cancer along with hypertension experienced a 46% lower risk of their cancer progressing (Krizner, 2017).
Moysich said, “This is a coincidental and unintended consequence of hypertension and its treatment, but it’s a silver lining to a serious but largely manageable medical condition that has reached epidemic prevalence in the U.S. and many other countries worldwide."
The study is the first of its kind to emphasis the role of comorbidities in relation to confirmed previous findings that linked a history of diabetes to increased death among ovarian cancer patients and ovarian cancer survival by histological subtype. It may be possible that beta blockers and other prescribed antihypertensive medications may influence the growth of ovarian tumors. However, the team also noted that further study is needed to gain a better understanding of these processes and interactions because of an overall risk of mortality for ovarian cancer patients who had ever taken beta blockers (Krizner, 2017).
Minlikeeva, a postdoctoral research affiliate with Roswell Park's Department of Cancer Prevention and Control, said, “Our results suggest that it is important to investigate factors that explain the difference in cancer outcomes among women with different types of ovarian cancer. Most studies only consider clinical characteristics at diagnosis, such as stage and histology in relation to ovarian cancer prognosis.”
Minlikeeva added, “Our findings emphasize the importance of understanding the full clinical profile for women with ovarian cancer in order to predict ovarian cancer outcomes.”
Endometrioid carcinoma accounts for over 20% of all epithelial ovarian cancers each year. An estimated 14,200 women die every year in the U.S. from ovarian cancer with over 22,300 total new cases of the disease each year (Krizner, 2017).
Minlikeeva said, “The results of our study draw our attention to the necessity of further research investigating the role of antihypertensive medications in relation to prognosis of ovarian cancer patients. Both preclinical and epidemiologic studies may clarify mechanisms for these observations and provide insight regarding treatment."
Minlikeeva added, "Our results also suggest that integration of the full clinical profile for ovarian cancer patients may be essential in understanding the factors related to their overall morbidity and mortality.”
Additional Benefit of Preemptive Surgery and Hormone Replacement Therapy
New research by the Queen Mary University London indicates that preemptive surgery to remove a woman's fallopian tubes and ovaries, in combination with hormone replacement therapy, may be a benefit for women at risk for or with ovarian cancer (Scutti, 2016).
The researchers studied women who were 40 or older who had a lifetime risk level of mortality of 4 percent or greater. The combination of the preemptive surgery along with the hormone replacement therapy would provide a population-spanning average of 43 extra days of life expectancy.
Dr. Ranjit Manchanda, lead author of the study said that even though it only seems like a few extra days, "This is an average across the population. It's pretty high in health statistics." Each individual woman's life span would vary, but it could end up being considerably longer.
We know that ovarian cancer is the most fatal of the reproductive cancers in women, responsible for more than 152,000 deaths each year. Although it can affect women of all ages, it seems to be highest among older women and women with a family history of ovarian cancer.
Those women considered to be at the highest risk include those who have an immediate family member (mother, sister, or child) who carry the risk genes, including the BRCA1 and BRCA2 mutations. The BRCA1 and BRCA2 mutations account for over 15 percent of all ovarian cancers, according to the National Cancer Institute.
The preemptive surgery that calls for the removal of both the fallopian tubes and the ovaries (also called a salpingo-oophorectomy) might benefit women differently at different risk levels. The operation is considered by researchers and medical professionals to be the best known option for high risk women who are attempting to prevent the disease from occurring (Scutti, 2016).
According to the Society of Gynecologic Oncologists, three separate studies revealed that women who are carriers of the BRCA1 and BRCA2 mutations who choose to undergo preemptive surgery may reduce their risk for acquiring ovarian cancer by 71 percent to 96 percent.
Even though the surgery may be life-saving and is generally safe, there are a few possible complications. The ovaries secrete the hormones estrogen and progesterone and possess a woman's reproductive eggs. When younger women undergo this surgery, they may be thrust into menopause early. The chance for developing heart disease, osteoporosis, and sexual dysfunction may increase after the surgery (Scutti, 2016).
In the U.K., due to the risk of complications, the procedure is only available to women who have at least a 10 percent lifetime risk of developing ovarian cancer. This standard is based on a mathematical model used by Manchanda to compare preemptive surgery with not surgery for higher-risk women who were 40 years old or older, but not yet menopausal (Scutti, 2016).
Krizner, T. (2017, June 06). Ovarian cancer: Possible advantage of high blood pressure. [Web]. Managed Healthcare Executive. Retrieved from: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/ovarian-cancer-possible-advantage-high-blood-pressure
Scutti, S. (2016, June 27). Women would benefit from preemptive ovarian cancer operation. [Web]. CNN. Retrieved from: http://www.cnn.com/2016/06/27/health/ovarian-cancer-prevention-extends-life/index.html