Improving early detection and treatment of ovarian cancer is an important area of focus for the Basser Center for BRCA. While ovarian cancer is less common than other women's cancers, affecting about 1 in 70 women in this country, a lack of early detection or prevention strategies is a major cause of poor outcomes for patients, especially for those at high-risk (such as BRCA mutation carriers). About 20-25% of women diagnosed with ovarian cancer have an inherited mutation in a cancer risk gene. Because ovarian cancer is difficult to detect early in medical exams, it is important to be aware of your family history of the disease on both your mother’s and father’s sides of the family. All women with ovarian cancer should be offered genetic testing.
We sat down with Ronny Drapkin, MD, PhD, director of Penn’s Ovarian Cancer Research Center and director of Gynecologic Cancer Research at the Basser Center to discuss the current guidelines for ovarian cancer screening and the latest updates in ovarian cancer research.
Are there symptoms of ovarian cancer?
One of the challenges of detecting ovarian cancer is that there are no typical symptoms. Bloating, constipation, and changes in bowel habits are often a sign of a gastrointestinal issue; however, if these symptoms persist, they can be symptoms of ovarian cancer. Dr. Drapkin says that knowing your body and understanding how you usually feel is crucial. Only you can know when you aren’t feeling quite right. He also recommends getting tested to see if you carry a BRCA gene mutation. This information could help identify those at risk in your family and potentially help you get ahead of a cancer diagnosis.
Ovarian cancer research on the horizon
There is a lot of exciting research happening within the Basser Center – particularly within ovarian cancer research. Dr. Drapkin, a pioneer in ovarian cancer research, and his team are working to better understand ovarian cancer tumor development, progression, and response to therapy in order to improve early detection and treatment options for women with ovarian cancer.
Research conducted by Dr. Drapkin has shown that many ovarian cancers actually begin in the fallopian tubes. Building upon this paradigm shifting discovery, Dr. Drapkin and his team are contributing to several international studies of BRCA mutation carriers (particularly BRCA1 mutation carriers) that are investigating the removal of only the fallopian tubes in risk-reducing surgery, leaving the ovaries behind. This technique could help prevent putting women into surgical menopause, which can produce long-term health risks and symptoms that impact quality of life. They are exploring if removing the fallopian tubes alone can give women the same degree of risk-reduction as when both the fallopian tubes and the ovaries are removed. This could mean that a better prevention strategy can be offered to women.
Another investigation that Dr. Drapkin and his team are involved in focuses on intercepting cancerous cells by applying the latest data in molecular approaches to learn what potential markers can be used for early detection. They are working to see if new therapeutics can be developed to give young women who carry a BRCA mutation but have not been diagnosed with ovarian cancer an option to eradicate any cancerous cells early on before the cells develop. This finding could lead to preventing cancerous cells from occurring, or at least delaying their development considerably.
Current guidelines for screening for ovarian cancer
At this time, there are no early detection screening protocols for ovarian cancer. Currently available methods for ovarian cancer screening often fail to detect ovarian cancer at an early stage. Although there are two FDA-approved blood biomarkers for ovarian cancer, they do not have the sensitivity and specificity to deploy to the general population for screening. They are most effective for monitoring patients who are already known to have ovarian cancer. However, Dr. Drapkin is optimistic for the near future. He says, “While we are not there yet, we are on our way to develop better tools to look into the uterus, fallopian tubes, and ovaries for future screening.”
Can you have children after an ovarian cancer diagnosis?
Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy. A gynecological oncologist would typically go in and remove as much of the tumor as possible, removing the uterus, fallopian tubes, ovaries as well. Most women will likely not be able to conceive after surgery. Women who know they carry a BRCA gene mutation can act proactively and speak with a genetics provider on all reproductive considerations and create a plan that works best for them.
To learn more about ovarian cancer risk, symptoms and treatment options explore our resources on BRCA in women, managing cancer risk and treating BRCA-related cancers like ovarian cancer. If you are interested in participating in any open clinical trials and research studies involving ovarian cancer, visit our website.