Alternative Names
cancer of the ovaries
Symptoms & Characteristics
The ovaries produce eggs as well as female hormones, which are important in female development and fertility. Much of the time, women with ovarian cancer have no symptoms or only mild symptoms until the cancer is in advanced stages. Some common symptoms may include:
- urinary problems (urgency and frequency)
- difficulty eating or feeling full quickly
- abnormal periods or vaginal bleeding
Ovarian cancer usually happens in women over age 50, but it can also occur in younger women. Ovarian cancer is hard to detect early, but the sooner it is found, the more effective the treatment.
Treatment
Ovarian cancer treatment is usually surgery followed by chemotherapy.
How Common Is It?
About 20,000 women are diagnosed with ovarian cancer each year in the United States.
Genetics & Inheritance
Most cases of ovarian cancer are not inherited and occur sporadically. Cancer is a multifactorial condition, which means it involves a combination of genetic, lifestyle and environmental factors.
- A high fat diet has been proposed to increase ovarian cancer risk, while taking birth control pills appear to decrease ovarian cancer risk.
Researchers believe that there are probably a number of genes that cause susceptibility to ovarian cancer. However, only about 5-10% of all ovarian cancers are familial and are caused by a hereditary cancer syndrome.
- A hereditary cancer syndrome is caused by an inherited gene mutation that increases the chance to develop one or more types of cancer. Families are more likely to have a hereditary cancer syndrome if there are multiple generations of affected family members with the same cancer (or associated cancers). People who are diagnosed at an unusually young age or have certain rare cancers are also more likely to have a hereditary cancer syndrome. Several different hereditary cancer syndromes have been identified. Click here for more information about Cancer Genetics.
Two of the more common hereditary cancer syndromes associated with ovarian cancer include hereditary breast and ovarian cancer syndrome and Lynch syndrome.
Hereditary breast and ovarian cancer syndrome: The two genes associated with hereditary breast and ovarian cancer syndrome are BRCA1 and BRCA2. Women who have a mutation in either of these genes, have an estimated 60%-80% lifetime risk to develop breast cancer and an estimated 20%-40% lifetime risk to develop ovarian cancer depending on if there is a family history of ovarian cancer, breast and ovarian cancer, or breast cancer alone. Males with a mutation in either of the BRCA1 or BRCA2 genes have a lower breast cancer risk, but it is still higher than the general population.
- The BRCA1 gene is located on chromosome 17 at the location q21. Males who have a BRCA1 mutation have a prostate cancer risk three times higher than the general population.
- Three specific mutations in the BRCA1 and BRCA2 genes are more common in people of Ashkenazi (eastern and central European) ancestry. These mutations are187delAG (BRCA1), 5385insC (BRCA1), and 6174delT (BRCA2). About 1 in 40 Ashkenazi Jewish people have one of these mutations.
- Specific mutations in the BRCA1 and BRCA2 genes have also found in the people of Icelandic, Norwegian, and Dutch ancestry. Particular genetic variations occur more frequently in all of these ethnic groups because they have a shared ancestry over many generations.
Lynch syndrome: Lynch syndrome is a hereditary cancer syndrome that confers an elevated risk to develop ovarian cancer along with other even higher risks to develop other types of cancers, like colon (80% risk), stomach (10%-20% risk) and uterine (20%-60% risk) cancers. Women with Lynch syndrome have an estimated 9%-12% lifetime risk to develop ovarian cancer.
- Lynch syndrome is caused by mutations in one of four genes: MLH1, MSH2, MSH6, or PMS2. The vast majority of Lynch syndrome families (about 90%) have a mutation in either the MLH1 or MSH2 gene.
- People with Lynch syndrome may also be at increased risk to develop cancers of the bile duct, kidney, ureter and renal pelvis, and pancreas.
People with other hereditary cancer syndromes, such as Peutz-Jeghers syndrome are also at increased risk to develop ovarian cancer.
Some researchers have proposed that genetic variations called SNPs may influence the risk to develop ovarian cancer in some people. Single nucleotide polymorphisms (or SNPs) are small variations in a single "letter" of DNA that can be found throughout our entire genetic make-up. Currently, much of this research still needs to replicated in order to clearly establish an association.
Other yet to be identified or adequately classified genes may also contribute to ovarian cancer.
A cancer genetic consultation with a trained genetic professional is important for a complete evaluation, accurate diagnosis, as well as discussion of the benefits and limitations of testing and recurrence risk.
Genetic Testing
Cancer predisposition testing for hereditary breast and ovarian cancer syndrome is available online (over the internet) as well as through an in person genetic consultation for people who are considered at risk. Go to the Tests tab to link to the best online providers, compare providers and read provider reviews.
- Whenever possible, genetic testing should be performed on the person in the family who is most likely to have a BRCA1 and BRCA2 mutation, and who is less likely to have developed sporadic (non-inherited) breast or ovarian cancer. If a mutation is found, genetic testing can then be offered to non-affected family members.
Clinical predisposition testing for other hereditary cancer syndromes associated with ovarian cancer may be available through an in person genetic consultation for people who are considered at risk.
The decision to have genetic testing is personal and should always be discussed with trained medical professional. Use our find a genetic professional directory to locate a trained genetic professional in your area.
Informational genetic testing for susceptibility to ovarian cancer is available online (over the internet) as part of a whole genome scan. Whole genome scanning involves analyzing thousands of SNPs at once related to a number of different health conditions.
- At this point, many genetic professionals do not consider this testing clinically useful or medically relevant, but for informational purposes only. Go to the Tests tab to link to the best providers, compare providers and read provider reviews.
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