Ovarian Cancer Survivors
Up to 14% of ovarian cancer is due to a hereditary change such as a BRCA mutation. Because such a significant portion of ovarian cancer is hereditary, an appointment with an expert such as a geneticist or a genetic counselor is often recommended after an ovarian cancer diagnosis. Learning that ovarian cancer is hereditary may change follow-up recommendations. Further, if a cancer survivor is the first person to have a genetic test in a family, his/her test result may help identify the cause of hereditary cancer in this family. This information can help other family members make decisions about genetic counseling and testing.
Ovarian cancer survivors with a BRCA mutation or hereditary cancer have a higher likelihood than women with sporadic cancer of developing breast cancer. Options for risk management of breast cancer in ovarian cancer survivors are similar to option for cancer previvors who have never been diagnosed.
Ovarian cancer survivors who have hereditary cancer are at higher risk for breast cancer than women with sporadic ovarian cancer. The exact risk for breast cancer after ovarian cancer is unknown, but may depend on a number of factors.
Ovarian cancer survivors with an hereditary cancer have options for managing their risks for a breast cancer. The most appropriate options differ between women and depend on many considerations. In general there are 3 categories of risk management options which are discussed in more detail in their respective sections.
- chemoprevention for breast cancer
- surveillance for breast cancer
- Prophylactic (risk-reducing) mastectomy
It is important to remember that none of the risk-management options will eliminate all cancer risk. Some risk always remains, even with the surgical options.
Risk management decisions are highly personal. If you are at high risk for breast cancer, you need a clear sense of your own personal risk and an understanding of the potential benefits, risks, and side effects of each risk management option. Genetic experts can help ovarian cancer survivors who have a BRCA mutation, a family history of cancer, or other indicators of hereditary cancer determine their risk for breast cancer and develop a risk management plan. Continue to keep in touch with a genetics expert for updates on current knowledge
Studies have shown that ovarian cancer survivors with BRCA 1 mutations generally have a better survival rate than women with sporadic ovarian cancer. There is some speculation that this may be due to a higher sensitivity of BRCA 1-associated ovarian cancers to the chemotherapy drugs called platinums which are typically used for ovarian cancer treatment.
As new research continues, treatments that specifically target hereditary cancers may become available. Some studies have suggested that BRCA-associated cancers may respond more favorably to certain chemotherapies. A new class of medications called "PARP Inhibitors" may specifically kill hereditary cancer cells caused by a BRCA mutation and spare healthy cells. A preliminary study on breast cancer cells in mice has been encouraging, killing cells that model the BRCA breast cancer cells and eliminating tumors. Research using PARP inhibitors for BRCA-associated cancer in women with metastatic breast cancer has begun in the United Kingdom. The research is still in Phase I (preliminary) trials and the availability of these drugs for cancer patients is years away. If proven effective for breast cancer, it is believed that the drug would also be effective for other types of BRCA-related cancers such as ovarian cancer and primary peritoneal cancer.
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