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Cancer Genetics

Information About Ovarian Cancer

02/05/2001

Question:

With regard to your web page and your experience in many types of cancer, I would be interested in receiving answers and opinions to my following questions. I live in Greece and my 43-year-old mother has ovarian cancer, which has been detected on the 23th of December 2000. It has to be considered that her mother (my grandmother) died because of breast cancer. Our beginning symptoms were related to pressure in the pelvis and to abdominal swelling. After the diagnosis of the cancer we proceeded to the surgery (total abdominal hysterectomy with bilateral salping-oophorectomy). All the genitals (ovaries, fallopiantubes, uterus) and also the cyst, which contained the liquid that caused abdominal swelling, have been successfully removed in order to ensure that no cancer sign is left behind. Fortunately the surgeons and the doctors admitted that there is not any kind of metastasis in other organs. According to the biopsy results, the cancer has been staged to “STAGE I” (grade III), which means that it is limited only to the ovaries. The biopsy disclosed the followings: In a part of the right ovary was found a solid malignant tumor (grade III), whose cells cross the ovary and come out to the surface of that organ. Both of the saplings are not affected with malignity. It should be noticed that the other ovary was found at a beginning situation that could be developed to malignant tumors.To sum up the cancer was found only in the ovaries. After the surgery we started the chemotherapy (Paraplatin and Taxol drugs). I would be grateful if you could provide me with answers to the following questions: Is it able to appear in the future another kind of cancer in another organ? How do you find the treatment we follow (surgery and chemotherapy)? What else could we do in order to be absolutely sure that we will overcome the illness? Are there any newer, more efficient cancer drugs that we could also use? Do we know in advance the chances of the cancer to be spread eventually to other parts of the body? What are the survival chances and the minimum and maximum range of survival period? What else do you suggest to do in order to ensure the best results?

Answer:

While it is known that breast cancer is very common, striking 1 in 11 women in their lifetime, ovarian cancer is less common, affecting 1 in 100 women in their lifetime. The age of cancer onset is important, with breast or ovarian cancer normally occurring in the general population at 60-65 years on average.

In some families, clustering of breast and/or ovarian cancer can be due to chance. However, approximately 5-10% of all breast and ovarian cancer cases are hereditary; in other words they are a result of an inherited genetic change. Whenever there are close relatives in a family with ovarian cancer and breast cancer, such as your mother and grandmother, and especially if they are diagnosed under age 50, the chance for an inherited susceptibility to the cancer becomes more likely.

An individual who has hereditary breast-ovarian cancer is at increased risk for developing cancer. Women have an increased risk for the development of breast and ovarian cancers, and possibly colon cancer. The chance is increased that cancer can occur more than once, such as breast cancer in both breasts, or breast and ovarian cancer in the same individual. Males in families with hereditary breast-ovarian cancer syndrome may be at risk for associated cancers as well, such as male breast cancer and prostate cancer. Genetic counseling and testing, if appropriate, may help to determine if the cancers in your family are due to genetic susceptibility, and who may be at risk.

For more information about hereditary breast-ovarian cancer, you might want to review the factsheet, "Questions and Answers about Hereditary Breast-Ovarian Cancer", available on the Internet (see Weblinks below). It may be helpful to meet with a clinical geneticist or genetic counselor who could obtain more detailed information about your family history and your personal history. They would then be able to tell you how likely it is that your family history is hereditary and if so, what screening would be appropriate. If your family history does not appear to be hereditary, they could give you and your mother an accurate estimate of your lifetime risk for developing other cancers and discuss appropriate screening.

A contact for your family in your country (Greece) to possibly discuss these matters further would be Dr. Christos Bartsocas. Dr. Bartsocas is a clinical geneticist listed in the American Society of Human Genetics Membership Directory, and contact information can be found in the Weblinks below.

While your questions about the appropriate management of ovarian cancer is beyond the scope of this site, you may find some assistance from the CancerNet site (see Weblinks). You may obtain specific information about the treatment of different stages of ovarian cancer, including the most commonly used drugs. The physician portion of the information tends to be more specific than the lay portion.

Related Resources:

American Society of Human Genetics
CancerNet: PDQ --NCI's Comprehensive Cancer Database

For more information:

Go to the Cancer Genetics health topic, where you can:

Response by:

Kevin   Sweet, MS, CGC Kevin Sweet, MS, CGC
Cancer Genetic Counselor
College of Medicine
The Ohio State University

Judith A Westman, MD Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University