Ovarian cancer accounts for just 3 percent of cancers in women, but it’s one of the most deadly, with the highest mortality rate of all reproductive cancers. The five-year survival rate for women diagnosed with late-stage ovarian cancer — which makes up about 75 percent of the diagnoses — is just 39 percent.
The reason why ovarian cancer is so deadly is it’s often not caught until it has already spread, said Dr. Gina Westhoff, a gynecologic oncologist at Legacy Medical Group in Salmon Creek.
“There’s no good screening for ovarian cancer, and there’s no clear symptoms,” Westhoff said.
So Westhoff has turned her focus to preventing the diagnoses, which can be done through genetic testing. About 15 to 25 percent of ovarian cancer cases can be tied to familial or genetic causes, she said.
“If we can identify a familial risk, that’s the best way to prevent it,” Westhoff said.
Ovarian cancer doesn’t typically present symptoms until it has reached late-stage, and even then, the symptoms are nonspecific and could be attributed to various other conditions. Symptoms include abdominal bloating, quickly feeling full when eating, discomfort in the pelvis area, changes in bowel habits and frequent need to urinate, according to the Mayo Clinic.
Ovarian cancer can be treated with surgery and chemotherapy, but those are more likely to be successful in the earlier stages.
The American Cancer Society estimates more than 22,000 women will be diagnosed with ovarian cancer this year, and the disease will claim the lives of an estimated 14,200 women. Even though ovarian cancer accounts for only 3 percent of cancers in women, it’s the fifth most deadly behind lung, breast, colon and rectum, and pancreas cancers, according to the American Cancer Society.
Those sobering statistics are why Westhoff encourages women to know their family history. She wants women to empower themselves by learning their history and using that information to determine whether they should undergo genetic testing.
Women who should consider testing are those with a known mutation or who have a family member with two or more breast cancers, a first-degree relative with breast cancer before age 45 or a family member with ovarian cancer, Westhoff said.
A variety of genes and gene mutations have been discovered to increase a woman’s risk of developing breast and reproductive cancers. The most well known of those are the BRCA1 and BRCA2 gene mutations.
Women with BRCA mutations typically have a 45 to 85 percent, or more, risk of developing breast cancer and a 15 to 46 percent risk of developing ovarian cancer, Westhoff said. That’s compared with a 12 percent risk of breast cancer and 1.7 percent risk of ovarian cancer in the general population.
“There are many more genes that increase the risk, either for both breast and ovarian or just one or the other,” Westhoff said.
That’s why she advocates for genetic testing panels, where blood samples are used to look for 27 to 30 different genes. Those panels cover the most common mutations but also more rare genes. A genetic counselor can determine the best testing panel based on each individual, Westhoff said.
Women who test positive for a gene mutation can opt for treatment or surveillance.
The standard treatment recommendation is surgery to remove the ovaries and fallopian tubes at age 35, or once the woman is done having children, Westhoff said. That will reduce a woman’s chances of developing ovarian cancer by 95 to 97 percent, she said.
“Not everyone chooses surgery. Some choose surveillance,” Westhoff said. “But you need the data in front of you to understand the risks and benefits of those options.”
“Knowledge is power,” she added. “Not only for them, but for their families.”
