Ovarian Cancer: Risk Factors, Prevention and Early Detection

Posted by Brigham and Women's Hospital August 25, 2015

Among women with symptomatic ovarian cancer, BWH researchers determined that the fallopian tube was a starting point in 50 percent of cases.

Angelina Jolie Pitt’s decision to have her ovaries and fallopian tubes removed highlighted concerns about an uncommon but lethal disease – ovarian cancer. About one in every 70 women will get ovarian cancer in their lifetime, versus one in nine women who will develop breast cancer. Although ovarian cancer is less common, the odds of survival for women with the disease are much lower than for those with breast cancer. Of the 22,000 women who develop ovarian cancer each year, nearly two-thirds die from the disease.

Lower survival rates are partly due to the fact that ovarian cancer often is diagnosed much later than other cancers. Currently, there are no screening tests for early detection of ovarian cancer, and symptoms are non-specific and vague. Symptoms may include bloating, abnormal bleeding, or other abdominal symptoms. However, ongoing research at Brigham and Women’s Hospital (BWH) is shedding light on who is at risk for developing ovarian cancer and what steps can be taken to reduce that risk.

Ovarian Cancer Risk Factors

Women who are born with BRCA 1 and BRCA 2 gene mutations have a much greater risk of developing both breast and ovarian cancer in their lifetime. In women with these mutations, the risk for developing breast cancer may be as high as 80 percent and as high as 40 percent for ovarian cancer. As a result, if a woman is known to have a BRCA mutation, it is recommended that she consult her physician and genetic counselor about the advantages and disadvantages of having her ovaries and fallopian tubes removed by age 40, when the risk begins to accelerate. Removal of the ovaries and fallopian tubes will reduce the risk of developing ovarian cancer by about 90 percent.

Beyond genes, other factors may reduce the risk of ovarian cancer. These include having multiple births, the use of oral contraceptives, and breastfeeding. Women who have undergone tubal ligation also have a lower risk of developing ovarian cancer.

Link between Ovarian Cancer and the Fallopian Tubes

The recommendation to remove the fallopian tubes as well as ovaries in BRCA-positive women is based on research done at BWH. In 2005, a team of pathologists led by Dr. Christopher Crum, Division Chief of Women’s and Perinatal Pathology, developed a method called the SEE-FIM protocol for evaluating the end of the fallopian tube to detect the origin of ovarian cancer. Using the SEE-FIM protocol, BWH researchers evaluated the fallopian tubes of women who had BRCA mutations. They found that five to 10 percent of these women had a very early cancer in the fallopian tubes. Among women with symptomatic ovarian cancer, BWH researchers determined that the fallopian tube was a starting point in 50 percent of cases.

In this video, Dr. Crum discusses additional steps that can be taken to reduce ovarian cancer risk and research to develop diagnostic tests that can further identify ovarian cancer risk or detect early signs of the disease.

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- Jamie R.

Shape the Future of Medicine: Cast Your Vote

Posted by Brigham and Women's Hospital August 13, 2015

Two compelling competitions to advance medical innovation the BRIght Futures Prize and Stepping Strong Innovator Awards – are currently under way at Brigham and Women’s Hospital (BWH), and you can help determine the winner.

BRIght Futures Prize

The BRIght Futures Prize supports BWH investigators as they work to answer provocative questions or solve vexing problems in medicine. This year’s BRIght Futures Prize finalists – Christopher Fanta, MD, from the Division of Pulmonary and Critical Care Medicine in the BWH Lung Center; Wilfred Ngwa, PhD, from the Department of Radiation Oncology; and William Savage MD, PhD, from the Department of Pathology  are pursuing forward-thinking and inventive research to improve patient care. Each of the three finalists hopes to receive the $100,000 BRIght Futures Prize, which will be awarded at Discover Brigham on Oct. 7, 2015. Discover Brigham, highlights the cutting-edge biomedical investigations of more than 3,000 researchers at Brigham and Women’s Hospital (BWH).

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Brigham and Women’s Hospital Jumps to #6 on U.S. News Honor Roll

Posted by Brigham and Women's Hospital August 6, 2015

For the twenty-third year in a row, Brigham and Women’s Hospital (BWH) has been named to U.S. News & World Report’s Honor Roll of America’s Best Hospitals, moving up three spots to number six. The Honor Roll highlights just 15 hospitals, out of nearly 5,000 nationwide, for their breadth and depth of clinical excellence.  

In today’s post, we’ve gathered a collection of videos highlighting life-giving breakthroughs in our top-ranked clinical specialties.

#2 Gynecology

Christopher P. Crum, MD, Division Chief of Women’s and Perinatal Pathology, discusses ovarian cancer risk and techniques for detecting ovarian cancer at earlier stages of the disease.

The Department of Obstetrics and Gynecology supports women through all the stages of their lives, offering specialized evaluation and treatment for complex women’s health conditions, including gynecologic cancers.

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Making Leaps and Bounds in Stem Cell Transplants

Posted by Brigham and Women's Hospital July 23, 2015

The average age of transplant recipients in the Stem Cell Transplantation Program today has increased to 55 to 60 years of age.

A stem cell transplant is a lifesaving treatment option that provides healthy stem cells for patients with blood cancers and other diseases. In the Stem Cell Transplantation Program at Dana-Farber/Brigham and Women’s Cancer Center, one of the largest such programs in the world, specialists perform more than 550 transplants each year. The Program has grown substantially over the past few decades.

“A lot has changed since we started our program in 1972,” explains Dr. Joseph Antin, Chief and Program Director for the Stem Cell Transplantation Program. “Advances in technology and our increasing understanding of the underlying biology of the diseases that we treat are enabling us to provide this therapy in cases that we never dreamed possible when we began offering stem cell transplantation more than 40 years ago.”

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Speeding up Treatment Decisions for Blood Cancer Patients

Posted by Brigham and Women's Hospital June 4, 2015

Genetic mutations associated with certain blood cancers can be detected by testing blood or bone marrow samples.

For patients with aggressive types of leukemia and other blood cancers, quickly identifying and starting the right treatment can make all the difference. In a major advance in the care of these patients, physicians at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) have begun using the Rapid Heme Panel, a high-tech genetic test that provides, within a week, an unprecedented amount of critical information to aid the choice of treatment.

In this video, Dr. Jon Aster, Director of Hematopathology at Brigham and Women’s Hospital (BWH) and one of the developers of the Rapid Heme Panel, explains how the test uses blood or bone marrow samples to search for alterations in genes that are frequently associated with leukemias and myeloproliferative disorders – detecting key mutations that determine prognosis and the specific drugs the cancer is most likely to respond to. The Rapid Heme Panel testing is performed at the Center for Advanced Molecular Diagnostics at BWH.

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Understanding Skull Base Surgery for Meningiomas

Posted by Brigham and Women's Hospital May 26, 2015

Pre-operative MRI of a meningioma

In observation of Brain Tumor Awareness Month, this post was written by Dr. Tracy Ansay and physician assistant Stanley Mui of the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Ansay provides pre- and post-surgical patient care at our practice in South Weymouth. She also performs surgery at South Shore Hospital in South Weymouth, as well as our main hospital campus in Boston.

Meningiomas are one of the most common brain tumors within the general population. Meningiomas make up about 14 to 19 percent of all brain tumors. They are more common among women and occur with increasing frequency as people get older. Meningiomas are found in about three percent of people over the age of sixty.

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More Precise Diagnosis Leads to More Precise Treatment for Patients with Brain Tumors

Posted by Brigham and Women's Hospital May 21, 2015

Members of the brain tumor diagnostic board

The information used in diagnosing a brain tumor takes many forms. At Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), a patient’s brain tumor tissue undergoes a broad range of diagnostic tests: not only standard pathology exams in which tumor cells are viewed under a microscope, but also next-generation scans looking for mutated genes and misassembled chromosomes, as well as whole-genome searches for extra or missing copies of genes.

Such extensive testing helps pinpoint the exact type and characteristics of a particular tumor. The more specific the diagnosis, the more precise the therapy can be.

But test results are only as valuable as the ability of pathologists and physicians to interpret them. As the diagnosis of brain tumors becomes more complex, DF/BWCC pathologists and cytogeneticists (specialists who focus on chromosome structure) routinely consult one another, compare notes, and present physicians with a unified report on their diagnostic findings.

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Advancing the Treatment of Malignant Gliomas

Posted by Brigham and Women's Hospital May 14, 2015

Gliomas can arise anywhere in the brain.

Malignant gliomas are a set of tumors that can arise anywhere in the brain. Tumor cells divide to create a mass, as well as infiltrate into normal brain tissue. The current standard of treatment for malignant gliomas is surgery to remove as much of the tumor as possible, often followed by chemotherapy and radiation. There are, however, many new treatment approaches being evaluated for malignant gliomas.

In the following video, Dr. E. Antonio Chiocca, Chair of the Department of Neurosurgery and Co-Director of the Institute for the Neurosciences at Brigham and Women’s Hospital, describes a promising new approach called oncolytic virotherapy. This involves the use of common viruses to treat malignant gliomas. Studies of the herpes simplex virus type 1 have shown that the virus invades tumor cells and destroys them, while also stimulating the immune system to create a vaccine-like effect against the tumor.

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New Immunotherapy Vaccines Show Promise in Treating Brain Tumors

Posted by Brigham and Women's Hospital May 7, 2015

Dr. David Reardon

Researchers in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center are now launching attacks on glioblastomas from a new angle – by turning the patient’s immune system against the cancer cells. Where targeted chemotherapy uses drugs to disable proteins that cancer cells need to grow, immunotherapy drugs stimulate the patient’s immune system to recognize and kill cancer cells.

Traditional drugs and even targeted chemotherapy agents have had little success in treating glioblastoma – a very aggressive type of brain tumor.

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Don’t Leave Women’s Health to Chance

Posted by Brigham and Women's Hospital April 30, 2015

Dr. Paula Johnson

The author of today’s post is Paula A. Johnson, MD, MPH, Executive Director of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School.

Did you know that, 20 years ago, women and minorities were not routinely included in federally funded clinical trials? That changed in 1993 when President Bill Clinton signed into law the historic NIH Revitalization Act, making inclusion of women in health research a national priority.

Today, we know that women are different from men down to the cellular and molecular level. We see these differences across all organ systems — from our hearts to our joints, lungs, and brains. The Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital is dedicated to exploring and discovering why these differences occur, and translating those differences into clinical care. However, roadblocks remain in research and clinical care. Here are just a few examples:

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