This article was updated on September 15, 2020 to reflect new research and data.
September is ovarian cancer awareness month: Are you at risk?
- What is ovarian cancer, and what are its causes and risks?
- How knowing your risk can save your life.
- A glance at the signs and symptoms of ovarian cancer.
[3 MIN READ]
Angelina Jolie’s stellar acting career and humanitarian efforts have for decades been in the spotlight. In recent years, however, Jolie has gained intense public interest for openly sharing her personal experiences to raise awareness about ovarian cancer, the disease that claimed her mother’s life. Her story is particularly relevant as September marks Ovarian Cancer Awareness Month.
In 2015, Jolie announced in an opinion piece in The New York Times that she elected to undergo surgery to remove her ovaries and fallopian tubes because she carries a genetic mutation in the BRCA1 gene that increases her risk of ovarian cancer. This genetic mutation also raises Jolie’s risk of breast cancer, prompting her decision in 2013 to have a preventative double mastectomy.
Who’s at risk for ovarian cancer
The BRCA1 and BRCA2 genes are linked to about 3% of breast cancers and 10% of ovarian cancers, according to the Centers for Disease Control and Prevention (CDC). Women who have a family history of these cancers are more likely to carry either of the gene mutations. They also have a significantly higher risk of ovarian cancer.
Jolie, at age 40 when she made the decision, fit that profile. In addition to her mother, Jolie’s aunt and grandmother died of cancer.
In an ideal situation, a woman with a high risk of ovarian cancer would be able to have children before having her ovaries and fallopian tubes removed and before the onset of natural menopause.
In an ideal situation, a woman with a high risk of ovarian cancer would be able to have children, as Jolie did, before having her ovaries and fallopian tubes removed and before the onset of natural menopause. Experts do not recommend this procedure before age 35, largely because of early menopause, which increases the risk of conditions such as cardiovascular disease, osteoporosis, Type 2 diabetes and dementia.
Current guidelines recommend that women with BRCA mutations consider this surgery between 35 and 40 because having your fallopian tubes removed before menopause reduces the risk for ovarian cancer, and also lowers the risk for breast cancer in high-risk women.
Current guidelines recommend that women with BRCA mutations consider this surgery between 35 and 40 because having your fallopian tubes removed before menopause reduces the risk for ovarian cancer, and also lowers the risk for breast cancer in high-risk women. Since Angelina Jolie was in this age range, and it made sense for her situation, she took the actions she could to reduce further risk.
Assessing your risk and next steps
Does Angelina Jolie’s decision make sense for all women? Seeking genetic counseling is recommended if you are concerned about your risk. A thorough look at your family history and possibly a genetic blood test will help give you guidance for any decisions you make.
In addition to the BRCA1 and BRCA2 mutations, other genes are also involved in ovarian cancer, and genetic testing isn’t always perfect. However, a thorough evaluation can help.
In addition to the BRCA1 and BRCA2 mutations, other genes are also involved in ovarian cancer, and genetic testing isn’t always perfect. However, a thorough evaluation can help your genetic counselor look for the genetic mutation in other family members to determine who has a higher cancer risk and who doesn’t.
Is early detection possible?
Ovarian cancer is a stealthy disease, and it is found at an early stage in only about 20% of cases, according to the American Cancer Society. However, 94% of patients who were diagnosed early live more than five years after diagnosis. For women who are considered high risk, there are two potential screening tests for ovarian cancer:
- TVUS (transvaginal ultrasound) offers a view of the uterus, fallopian tubes and ovaries through an ultrasound wand placed inside the vagina. While it may reveal a mass in the ovary, further testing would be required to determine whether it is cancer or benign.
- CA-125 blood test measures the amount of this protein, which often is elevated in women with ovarian cancer. This test is not always reliable, however, because high levels of CA-125 also are associated with common conditions such as endometriosis and pelvic inflammatory disease. Additionally, women who have ovarian cancer do not always have higher levels of this protein.
Unlike with breast cancer, there are no routine screenings to detect ovarian cancer early in women who are not considered high risk. That’s why it’s important to schedule your annual women’s exams.
Unlike with breast cancer, there are no routine screenings to detect ovarian cancer early in women who are not considered high risk. That’s why it’s important to schedule your annual women’s exams, and see your doctor right away if you have symptoms such as:
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary problems such as the frequent urge to go
Keep the conversation going
Jolie said she made the decision to have her ovaries removed after consulting with her doctors and reviewing her choices. And she encouraged all high-risk women to do the same, saying, “Knowledge is power.”
The buzz Jolie started has increased awareness of ovarian cancer. Her openness gives people a reference point to start conversations around personalized medicine and the choices women can make. The next steps are about prevention.
Find a doctor
To learn more about ovarian cancer and BRCA1 and BRCA2 gene mutations, or to schedule a consultation with a doctor or genetic counselor, see our provider directory.
Are you or someone you love concerned about ovarian cancer? #TakeActionNotChances and share what you’ve learned, ask questions or celebrate healthy victories @providence.
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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