How to reduce your risk of ovarian cancer

Ovarian cancer is difficult to detect early because it does not present with symptoms right away, and later stage symptoms can be easily confused with less serious conditions. Because it is so difficult to identify, ovarian cancer has become one of the leading causes of cancer death among women.

While it’s not possible to prevent ovarian cancer, there are ways to reduce the risks for the disease, especially among those most vulnerable. Risk factors for ovarian cancer include:

• A family history of ovarian, breast or colorectal cancers.
• Nulliparity, or never having been pregnant, and never having breastfed. Pregnancy and breastfeeding interrupt the monthly cycle and reduce the body’s exposure to reproductive hormones.
• Age. Half of ovarian cancers occur in women over the age of 60.

“It’s good to be aware of your family history. We have an opportunity to decrease the risk of ovarian cancer among patients who have genetic risk factors,” said Dr. Jessica Parker Metter, a gynecological oncologist at IU Health and assistant professor at the IU School of Medicine. “If you have two or more close relatives, such as immediate family members, with a history of ovarian, breast or uterine cancers, it’s worth getting evaluated to see if you might have a genetic syndrome that can increase your risk of cancer.”

Genetic testing for ovarian cancer

Genetic testing can help at-risk individuals better understand their likelihood for developing ovarian cancer. It’s best to start by testing the person in the family who had ovarian cancer to help triage which other family members should be tested next. For instance, if the woman diagnosed with ovarian cancer tests positive for a specific genetic marker, her immediate family should also get tested. If anyone in this group of relatives tests positive, then their families should get tested, etc. This process is called cascade screening. If screening is not available, you can schedule a conversation with a genetic counselor to help you evaluate risk.

Genetic testing can also help people who’ve already had ovarian cancer. Patients with specific genetic mutations may be able to find medications to prevent a recurrence of disease.

“We think ovarian cancer recurs in greater than 70% of women, so it’s important to know are there some personalized treatment options available to those patients,” Dr. Parker Metter said.

How to reduce the risk of ovarian cancer

There are no reliable screening methods or concrete ways to prevent ovarian cancer, but there are steps high-risk individuals can take to lower their chance of developing disease.

A healthy lifestyle is a first step toward preventing many types of cancer. Quitting tobacco, reducing alcohol intake, increasing exercise and eating healthy foods help cut down on inflammation in the body, which is associated with developing cancer.

Oral contraceptive pills have been shown to decrease the risk of ovarian cancer among high-risk patients because they limit monthly hormone exposure during the menstrual cycle. The longer the pills are used, the greater the decrease in cancer risk, up to 30 or 50%.

Bilateral salpingo-oophorectomy (BSO) surgery is an option for older, high-risk patients to remove the ovaries and fallopian tubes to reduce the risk of developing ovarian cancer. While older women may elect to have their ovaries removed to prevent cancer, oral contraceptive pills remain a great alternative to BSO surgery for younger women with a genetic risk for ovarian cancer who want to keep their fertility options intact.

Dr. Parker Metter is leading a research study (NRG-CC008) on whether it’s more effective to simply remove the fallopian tubes in younger patients with high risk factors, such as the BRCA-1 gene, and avoid removing the ovaries to allow patients to continue hormone production longer. The question is important because removing the hormone-producing ovaries prior to the age of 50 increases women’s risk of early death from a variety of causes.

“We’re trying to determine the differences in both quality of life and outcomes for removing the fallopian tubes but not the ovaries,” Dr. Parker Metter said. “We think that ovarian cancer originates in the fallopian tubes, and if we take out the tubes, we may be able to decrease that risk as well. This theory is still under investigation.”

Advocate for yourself to reduce your chance of getting ovarian cancer

Without any helpful screening resources, it may seem daunting to have an increased risk for ovarian cancer. Instead, focus on reducing the modifiable risk factors for disease, research your family history of cancer, ask your doctor about genetic testing if you have a family history and be vigilant about monitoring potential symptoms of ovarian cancer.

While many of the symptoms of ovarian cancer can look and feel like mild concerns, it is important to listen to your body and address any lingering or worsening issues, such as:

• Bloating that worsens
• Belly pain that worsens
• Changes in bowel or bladder habits
• Nausea or vomiting

It’s also important to maintain regular gynecological exams. Not only do these exams provide pap smears to check for cervical cancers and other issues, but the provider will also examine the vulva and vagina to check for skin cancers and feel the ovaries for any abnormalities. These evaluations are important, even for older women who may no longer need pap smears.

Being aware of your family history, living a healthy lifestyle and discussing risk factors with your physician can help at-risk patients reduce the risk of ovarian cancer. As researchers learn more about the disease and what lowers someone’s risk for developing it, eventually more options will exist for preventing and screening for ovarian cancer.