Ovarian cancer has often been called the "silent killer." Although experts are making progress in identifying ovarian cancer symptoms, early warning signs can be vague—like abdominal and pelvic pain, bloating, urinary frequency, feeling full quickly while eating, fatigue, upset stomach—and hard to differentiate from our body's usual quirks. Plus, in many cases, by the time we have identifiable symptoms, the cancer may have progressed to a later, harder-to-treat stage. That's why it's important to know the ovarian cancer risk factors that may affect you. Read on to reduce as many risk factors as you can, then keep a watchful eye on the symptoms above if you have risk factors outside of your control.
Genetics: Lynch Syndrome
Another known genetic link to ovarian cancer is an inherited syndrome called hereditary nonpolyposis colorectal cancer (HNPCC or Lynch Syndrome). While HNPCC poses the greatest risk of colorectal cancer, women with HNPCC have about a 12 percent lifetime risk of developing ovarian and a 40-60 percent change of developing uterine cancer.
Age
A woman’s risk of developing ovarian cancer increases with age. Women of all ages have a risk of ovarian cancer, but women over 50 are more likely to develop it. Sixty-eight percent (68%) of women with ovarian cancer are older than 55, and 32% are younger than 55.
Family history
Women with a first-degree relative (mother, daughter, or sister) with ovarian cancer have about a three times higher risk of developing the disease. This risk increases when two or more first-degree relatives have been diagnosed with ovarian cancer. If you are concerned ovarian cancer may run in your family, it is important to get an accurate family history, including breast cancers in the family. Both breast cancer and ovarian cancers can run together in families so it’s important to tell your doctor about what you discover. By understanding your family history, you and your doctor can take steps to reduce your risk and be proactive about your health (see below).
Family history
Eight out of 10 ovarian cancer cases are 'sporadic'. This means they are one-offs, and close female relatives face no significant increase in their risk of developing the disease themselves. This is important to remember, as it can be worrying if a close family member is affected by ovarian cancer. In most cases women can be reassured. The remaining two in ten cases are believed to be caused by an inherited ‘faulty’ gene, which is often the BRCA1 or BRCA2 gene, also called a ‘mutation’. Women who inherit a ‘faulty’ copy of the BRCA1 or BRCA2 gene (BReast CAncer 1 and 2) have a much higher risk of developing breast and/or ovarian cancer than the general population.
If there are two or more cases of ovarian cancer, and/or breast cancer on either your mother or father’s side of the family, you should speak to your GP who will offer you more information about your level of risk and may refer you to a genetic counsellor to help you decide whether or not to undergo genetic testing to see if you carry the inherited faulty gene BRCA1 or BRCA2. Women will be supported to understand this risk and offered advice on risk reducing options. There are some other genes which have also been linked to ovarian cancer such as RAD51C and RAD51D and those linked to Lynch Syndrome (also known as hereditary non polyposis colorectal cancer, HNPCC). The HNPCC gene can be responsible for clusters of small bowel, ovarian, endometrial, stomach, liver, kidney, bladder or brain cancers.
Hormone Replacement Therapy
Doctors may prescribe hormone replacement therapy to alleviate symptoms associated with menopause (hot flashes, night sweats, sleeplessness, vaginal dryness) that occur as the body adjusts to decreased levels of estrogen. Hormone replacement therapy usually involves treatment with either estrogen alone (for women who have had a hysterectomy) or a combination of estrogen with progesterone or progestin (for women who have not had a hysterectomy).
Women who use menopausal hormone therapy are at an increased risk for ovarian cancer. Recent studies indicate that using a combination of estrogen and progestin for five or more years significantly increases the risk of ovarian cancer in women who have not had a hysterectomy. Ten or more years of estrogen use increases the risk of ovarian cancer in women who have had a hysterectomy.
Prevention
Different factors cause different types of cancer. Researchers continue to look into what factors cause this type of cancer. Although there is no proven way to completely prevent this disease, you may be able to lower your risk. Talk with your doctor for more information about your personal risk of cancer. Research has shown that certain factors may reduce a woman's risk of developing ovarian cancer:
+ Taking birth control pills. Women who took oral contraceptives for three or more years are 30% to 50% less likely to develop ovarian cancer.
+ Breastfeeding
+ Pregnancy
Women who have had a hysterectomy or a tubal ligation may have a lower risk of developing ovarian cancer. A hysterectomy is the removal of the uterus and, sometimes, the cervix. Tubal ligation is having the fallopian tubes tied surgically to prevent pregnancy. A salpingectomy, which is the removal of the fallopian tubes, is also sometimes recommended for women with a risk of ovarian cancer.
For women with mutations in the BRCA1 or BRCA2 mutation, which cause 5% to 10% of all breast cancer and 15% of all ovarian cancer. Having the ovaries and fallopian tubes removed after childbearing is sometimes done to prevent breast and ovarian cancer. This can help with risk reduction ranging from a 70% to 96% reduction in ovarian cancer, and a 40% to 70% reduction in breast cancer. It is very important for women considering this surgery to talk with their doctor and a genetic counselor to fully understand the risks and side effects of this surgery compared with the risk of developing ovarian cancer.
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