What You Need to Know About Ovarian Cancer | Access Health

ovarian cancer ranks fifth in cancer deaths among women accounting for more deaths than any other cancer of the female reproductive system the high mortality rate is mainly because ovarian cancer is often diagnosed at a late stage by which time the patient has a poor prognosis on today's show what you need to know about ovarian cancer your risks genetic testing and making informed decisions about your treatment options i'm ereka vetrini access health starts now [Music] ovarian cancer develops when cells in the ovaries or fallopian tubes begin to grow out of control although there is no consistently reliable screening test to detect ovarian cancer advances in awareness risk assessment and genetic testing are proving to be powerful tools for women and their doctors good morning and welcome to this special edition of access health here to give us a deeper understanding of ovarian cancer is dr. Michael J beer professor of ob/gyn at University of Alabama welcome doctor thank you a pleasure being here thank you for inviting me we're glad you're here we've heard the statistics we're all eager to have a better understanding how would you describe ovarian cancer there are two basic types of ovarian cancer epithelia ovarian cancers which was primarily what we're going to talk about today and germ cell cancers of the ovary the most common by far is the epithelial type ovarian cancer to put it in franc numbers 22,000 new diagnoses per year in United States add an extra zero if you want to talk about worldwide statistics resulting in about 14,000 deaths what are the symptoms that we should be looking for so it's important to acknowledge and I can't overemphasize this that there are symptoms if you ask ovarian cancer patients you ask ladies who have the tumor they will frequently say oh yeah I did not feel normal and I had a number of symptoms and those symptoms tend to be bloating what we call early satiety which means when they eat a meal to get filled early abdominal pain could even be some pressure on their bladder with increased urination and if you think about those symptoms they're relatively vague and nonspecific so is this why there is such a high mortality rate correct so if you think about it we can't these these symptoms are vague so we we can't screen every woman in the United States who has these these kinds of symptoms and to these symptoms are coming from the abdomen and that's because the tumors are raised spread so the tumor is spread out pelvis from the ovary into and around the intestines that are causing these symptoms so the symptoms present themselves at a later stage correct so then how is ovarian cancer actually diagnosed a small percentage of patients will actually pick be picked up by a pelvic exam and that's why we recommend an annual exam for ladies but that's pretty unusual these symptoms will go on for a while to a point where the primary care doctor or the gynecologist will repeat the pelvic exam or go straight to an ultrasound or CT scan which will demonstrate a mass in the pelvis or god forbid actually tumor throughout the abdomen now at the time that's done usually they get a blood test for ca-125 and ca-125 is a protein that's actually secreted by many ovarian cancers and the bigger the cancer the higher the ca-125 level if you put that all together and it's highly suspicious for ovarian cancer then the patient will either undergo a biopsy but more likely than not they'll go directly to surgery and at that point is the only time we know for sure correct tissue is the issue you have to have a pathology diagnosis for this tumor it's important to know that there is no early detection assay for this tumor and that is a huge problem in the field so doctor let's talk about the different stages of ovarian cancer can you walk us through them I will in and it's very important to recognize it's an incredibly important clinical feature of this tumor because depending on the stage that has a dramatic impact on survival so stage one is tumor that is confined to the ovary stage two the it has spreads from the ovary to the pelvis but just to the pelvis stage three it's spread throughout the entire abdomen in stage four it's gone beyond 75% of ovarian cancer is diagnosed in advanced stage four correct okay and so then doctor what are some of the risk factors that we should be aware of so first and foremost age is a risk factor the ovarian cancer is a disease of older women second of all family history and we now know through the terrific molecular biology work from a number of laboratories that these are patients who have inherited mutations in brca1 or 2 and potentially some other genes that dad has come out recently and then finally the risk factor is what I call total ovulatory cycles what this means is ladies who have had early menarchy late menopause not a lot of pregnancies no oral contraceptives they have had a lot of cycles and we know that total amount of cycles relate to ovarian cancer doctor such great information we're going to dive a little deeper in just a little bit but do you have any last thoughts or a message for any of the women out there they may have concerns sure I think I would first like to emphasize that if a woman feels her body's talking to her that something's changed that she's feeling these symptoms even they may be vague or nonspecific she should feel very comfortable going to her primary care doctor or kind of called just to get it worked up second of all god forbid they develop ovarian cancer we now know it is very important that they undergo genetic testing sequence sequence sequence and that's even for patients who don't have a family history and finally if ladies would like to have more information about this they ought to look at be Brock aware calm a great website with lots and lots of really important information information is power and listen to your body doctor thank you so much for all that great information you gave us today coming up how to assess your risk for ovarian cancer [Music] welcome back while the exact cause of ovarian cancer is not yet known research has shown that certain risk factors increase the likelihood a woman may get ovarian cancer and to help us understand these risk factors and more is paid Cottrell genetics program coordinator at sure Sheriff Peggy thank you so much for joining us today it's a pleasure to be here so before the break we were talking about general risk factors but as a genetic counselor what are some of the risk factors that we should be looking for so we want to take a close look at people's family history and in the family history we find clues that there could be something inherited causing cancer so we want to look very closely at the family tree and when we look at our relatives who may have had cancer we want to think not just about our mothers our sisters daughters and aunts but we also want to think about the paternal side and the men in the family as well and so we were particularly looking for cancer at young ages younger than what would normally be expected so young for breast cancer would be under 50 we're looking for rare cancers and so while breast and prostate cancer are common ovarian cancer or pancreatic cancer are more rare and male breast cancer is exceedingly rare and we're also looking to see if there are multiple family members who have been diagnosed with the same kind of cancer and so those are all things that raise our suspicion that there could be something inherited increasing risk so when we take a look at families one of the other things we're concerned about is ethnic background so in particular if people have Eastern European Jewish ancestry they may be more likely to carry mutation in BRCA 1 and 2 but that doesn't mean that we are only concerned about people with Jewish ancestry really all populations can carry mutations in these genes and so we want to look very closely at anyone who has this kind of pattern in their family family history is so important so as a genetic counselor having this family history what other indicators are you looking for so we want to take a look for genetic changes that could be causing something inherited and and two of the genes that were particularly interested in are brca1 and brca2 these are genes that everybody has they're the good guys they actually help our bodies to prevent cancer and what we look for when we do a genetic test is to see if something is wrong a mistake or what we call a mutation that could be preventing the genes from doing their job correctly so potentially we're more likely to have ovarian or breast cancer if we have this BRCA right so people who have a mutation in brca1 or brca2 have a significantly higher chance to develop breast and ovarian cancer and we think that probably about 10 to 15 percent of people with ovarian cancer carry a mutation in one of these genes there are also other genes that we look for in addition to brca1 and 2 there is a syndrome called Lynch that causes a combination of colon uterine and ovarian cancer and so that's why it's really important when you're trying to figure out if this is something you need to pursue that you talk to your doctor or even better speak to a genetic counselor to try to figure out if this is something you need to consider so Peggy getting this information requires genetic testing correct yes and so when you meet with a genetic counselor he or she will facilitate the process of getting genetic testing done the testing is done on either a blood sample or a saliva sample and so we're not looking so much to see if you have brca1 or 2 or one of the other genes that we might be testing for what we're looking for is the mistake or a mutation something that's preventing it from doing its job correctly and so the genetic test takes a look at the DNA in your cells that we've gotten from your blood or saliva and gives us a picture of what you've started with and whether there's something there that's increasing the chance that you'll develop cancer so people who've never had cancer but have this strong family history should consider getting a genetic test we want them to get the testing done so that we can do things differently in terms of screening or other treatments but if people have actually been diagnosed with ovarian cancer with fallopian tube cancer or primary peritoneal cancer then the guidelines tell us that they need to get a genetic testing right at the beginning of their diagnosis to help guide their treatment so much good information we have to take a break but Peggy you're not going anywhere more on genetic testing when we return welcome back I'm here with genetic counselor Peggy Cottrell and before the break we were talking about how certain inherited mutations namely BRCA gene mutations can contribute to the development of ovarian cancer so Peggy my question is if you have already been diagnosed with ovarian cancer can BRCA testing be useful so that's a very good question in fact very often when women come into my office they start out by saying well I've already had cancer how is this test gonna do any good for me and it's really important we try if at all possible to test the person the family who's been diagnosed with cancer so we really want to test our woman with ovarian cancer and there are two reasons for this the first has to do with their own diagnosis and so with ovarian cancer patients we want to do two kinds of BRCA testing we first want to look at the germline and what that means is we want to know what did people inherit what were they born with and that's the test that we were talking about earlier where we look at blood or saliva and see if there's something inherited there the second kind of test that we may want to do looking for brca1 and 2 is tumor testing and so it's possible to do a genetic test on the tumor itself and cancer develops as genetic mistakes accumulate so there going to be a lot of genetic mutations in a tumor and by looking at the tumor to see if it has mistakes in brca1 or brca2 it helps the doctor to know whether they will benefit from a targeted therapy that could be offered to treat the cancer incredible and can I ask you is is BRCA if it's not present in the germline could it then just be present in the tumor absolutely so the germline testing to look for something in heritage is important piece of this but we want to make sure that women have both kinds of testing done now the other reason that we want someone who's been diagnosed with cancer to have the genetic tests done is we really want to know for the sake of the family and often the person with cancer is the best person to test because they're the one who's most likely to have that inherited mutation and so if someone who has ovarian cancer test positive then that gives us the opportunity to test their family members and we might think of their siblings their children their parents to see which side of the family the mutation has been inherited from I can see how this information can be incredibly overwhelming Tommy Peggy what role does a genetic counselor play in a care team so the genetic counselor is really there to facilitate the process of getting a genetic test done and so when I first meet with someone we would review the family tree and determine if a genetic test is necessary explain the pros and cons this is a test that has an informed consent and then get their blood drawn and have the testing sent in and then once the results are returned we take time to go over what those results are and depending on what we find it can help someone make a better informed decision about their treatment plan and what options are for the future so Peggy tell me about sure Sharon so sure Sharon is an organization that was founded eighteen years ago to provide support for young Jewish women with breast and ovarian cancer and so we have lots of programs that were able to offer to women so if people have questions or concerns about their cancer treatment their genetic testing or whether they even need genetic testing they can call us up and we're able to provide them information on the phone or send them information packets that have the information they need and we have a peer support network so we can if you are concerned about a particular part of your treatment and you want to talk to someone else who's been through that we can set up relationships between two callers with one being a support person and those are things that can give people a lot of comfort as they're going through this process I can't imagine how overwhelming this must be for a patient diagnosed with ovarian cancer so it's really very very difficult and we and we've certainly said a lot of things today so I want everyone to know that if they have questions or concerns first of all talk to your own doctor who knows you the best you can find a genetic counselor to speak to and certainly if you have other concerns you can be in touch with sure Sherratt or with other organizations that provide this kind of information Peggy I cannot thank you enough for all of your time today so much great information thank you so much for joining us thank you while it is true that medical science has not found a cure for ovarian cancer a brighter future is hopeful through innovations in genetic testing risk assessment and targeted treatment options if you've missed any part of the discussion today as always you can find the links on our website access health TV and you can also visit be BR Co where com we'll see you next time [Music] [Applause] [Music] [Music] you

Channel: Access Health

Views: 5,731

Keywords: access health, lifetime television, nutrition, health, medical, fitness, Ereka Vetrini, AH0057 105447 1080P, ovarian cancer

Id: b_RcXQFP0MI

Length: 17min 53sec (1073 seconds)

Published: Wed Sep 18 2019