There’s Hope on the Horizon for Ovarian Cancer
As of this year in the United States, it is estimated that there will be 1.7 million new cancer cases – of which 22,000 will be ovarian cancer diagnoses. Ovarian is the the 11th most common type of cancer among women and approximately 14,000 will pass away from the disease this year. However, there is hope on the horizon for ovarian cancer.
The incidence of the disease in the United States has fallen over the last two decades and similarly, mortality rates have declined as well. According to Angeles Alvarez Secord, an associate professor in the division of gynecologic oncology at Duke University Medical Center, understanding the biology of ovarian cancer tumors will help to continue to prevent and treat the disease – one day possibly even to cure it.
Risk factors are similar to those of other cancers
Some risk factors for ovarian cancer include having a personal and family history of the disease, having a genetic predisposition to the disease, as well as other factors including smoking, being overweight, and receiving hormone therapy after menopause.
However, factors that may decrease a woman’s risk of developing ovarian cancer include having given birth and using oral contraceptives throughout the course of one’s lifetime. Other research has shown that undergoing tubal ligation (getting one’s tubes tied) can greatly lower a woman’s risk of developing the disease, although researchers are not entirely certain as to why this is the case. “Some suspect the reason may be that tubal ligation cuts off the ovaries’ exposure to outside environmental factors that may increase the risk of ovarian cancer. Others think it could be related to the anatomical changes in the fallopian tubes that happen after a tubal ligation,” said Paul Haluska, an oncology specialist at Mayo Clinic in Rochester, Minnesota.
Not all cases of ovarian cancer are the same
“One of the things about ovarian cancer is that we have learned it doesn’t just fit under one umbrella, not one ovarian cancer is the same. We now know that there are several histologic subtypes,” said Alvarez Secord, who spoke at the 2018 National Ovarian Cancer Coalition on the importance of genetic testing. These different subtypes include endometrioid, clear cell, high-grade serous, low-grade serous mucinous, and a subgroup of other types of ovarian cancer that make up a small percentage of the disease.
Understanding the subtype is a great advantage for treatment
When high-grade and low-grade ovarian cancers are broken up, each has specific changes in their molecular biology that can impact treatment options. For instance, a woman with low-grade disease may have a NRAS, KRAS or BRAF mutation, while a woman with a high-grade disease may have TP53 or BRCA 1/BRCA 2 gene mutation or chromosomal instability. “The exciting part here is once you understand the underlying biology of the tumor, you can then target your therapies,” said Alvarez Secord.
Read on to learn about advancements in ovarian cancer diagnosis, management, and treatment.