Should I Get Ovarian Cancer Genetic Testing?

Why You Should Get Ovarian Cancer Genetic Testing

Cancer is sneaky. It is unpredictable. Ruthless. Merciless. In a way ridiculous. Cancer isn’t just one disease. It’s an umbrella term for several different kinds of diseases. Depending on where in the body it attacks such as breast and ovarian cancer, it has a different progression, a different speed,and a different fate. Each cancer is unique. Some are treatable in some people, while others are not treatable at all in other people. Each cancer has its own story. That sounds entirely horrifying, doesn’t it?

Ovarian cancer is, as the name states, cancer of the ovaries. The female reproductive system has two of them, one being on each side of the uterus. They are about the size of an almond, and their task is to produce eggs (ova—hence ovaries, hint, hint) as well as the hormones estrogen and progesterone. Like prostate cancer in men, both breast and ovarian cancer in women are sneaky—they go undetected until they have spread into other areas such as the fallopian tube, the pelvis,and the stomach. This is where it becomes tricky. At the point when it is spread so far, it is more difficult to treat and thus lethal. This is late-stage ovarian cancer. Early stage ovarian cancer, while still in the ovaries, is typically treated much more successfully with either chemotherapy and/or medication.

The risk of ovarian cancer is unknown as it currently unclear what causes it, although some factors that can increase the risk for it have been identified. Older age is one of the main factors and, while ovarian cancer can strike at any time, it is most common in women ages 50 to 60 years. Inherited gene mutations are the second-most common cause of ovarian cancer. Few ovarian cancers are caused by a BRCA gene mutation that is inherited from parents (hereditary cancer) and there are two different types. One is called breast cancer gene 1 (BRCA1) and the other is called, you could guess it, breast cancer gene 2 (BRCA 2). You’re probably wondering why ovarian cancer genes named after breast cancer. That is because these genes also increase the risk for breast cancer. Other factors such as family history of ovarian cancer (those who have two or more family members or second-degree relative who have had the disease) as well as long-term estrogen hormone replacement therapy are also said to increase the chances of ovarian cancer. Lastly, women whose periods started early in life and who were menopausal later in life are also at an increased risk. The National Ovarian Cancer Coalition adds a few more items to the list such as a triple negative breast cancer diagnosis at age 60 or younger, a history of colorectal or uterine cancer before the age of 50, a family history of breast cancer at age 45 or younger, to name a few.

So, wouldn’t it be nice if such an aggressive cancer that, once detected with certainty is deadly, could be nipped in the bud beforehand—especially for those who have an increased risk?

Well, it can be, thanks to genetic testing that looks for ovarian cancer risk genes.

It is a little-known fact It is a little-known fact that 1 in 4 women who have ovarian cancer have a hereditary mutation (have received it from family members) or a genetic mutation. This is a lot of women and BRCA genetic testing could have prevented hereditary ovarian cancer in the future. Let’s look at this from a much scarier perspective, shall we? An estimated quarter of a million people in the country have BRCA mutations while only 5% to 6% of them have been tested through specific BRCA genetic mutation testing. This means that people are either not getting tested enough or they are not aware enough. Or both! But let’s assume that people heavily assumed that ovarian cancer was an inherited cancer only and that could be behind the low percentage of tested individuals. But what if I told you that you don’t need a family history for you to have the mutation?

Given all this information, it is clear to see that everyone is at risk and women with ovarian cancer. So, the only way to eventually lower that risk is to test everyone and help them make lifestyle changes to keep the cancer risk at bay.

Genetic testing for ovarian cancer is done just like any other genetic testing. Following genetic counseling and a discussion about your lifestyle as well as family history of cancer, a blood sample is drawn. This sample is then processed so that your DNA is extracted from it, after which it will be analyzed to look for mutations in the BRCA genes. Positive test results may be both scary as well as devastating.From a positive perspective, however, knowing that one is at risk may bring about positive lifestyle changes that may actually lower the risks of actually having cancer or abolishing it completely. Negative test results are a relief. One knows that there is no risk and that their children and family members are also ok in that regard.

So, let’s get back to the initial question: “Should you get ovarian cancer genetic testing?” Before answering that, let’s look at your family history. Any family members that have had any type of cancer, not just ovarian or breast cancer? Then, yes, you should get ovarian cancer genetic testing. If you are lucky and don’t have any family members that have had cancer, don’t write genetic testing off yet. If you are older than 50 or 60, the answer is yes. If your period has started early, the answers are yes, again. If you have had long-term estrogen treatment, again yes. If any of the above is a no, there is still a chance you may be a carrier of the mutations, so that’s a general yes. If you know your genetic predispositions in terms of ovarian cancer, you could also know your predispositions to other cancers. Furthermore, knowing your risks means that you can inform family members of their risks, or the lack thereof.

However, I’m no certified genetic counselor. And genetic testing is deeply personal and complex. It is a decision you should make for yourself given the facts and figures. Perhaps a certified genetic counselor could best advise what you should do. It can be scary to find out you may be at risk. But knowing is half the battle.

Laura Day
 

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