Joining FORCES is the FORCE newsletter with news, views and supportive information for individuals concerned about hereditary breast and ovarian cancer.
by Lisa Held and Margaret Snow, MD
A study conducted in Israel and published in the January 2008 issue of the Journal of Clinical Oncology showed that ovarian cancer patients with a BRCA1/2 mutation had higher five-year survival rates than women without a BRCA mutation. BRCA carriers diagnosed with ovarian cancer at stage III or IV were much more likely to live beyond five years than women without mutations. Researchers don’t know if this is due to traits in the actual ovarian cancer tumors and/or a better response to chemotherapy.
The study was conducted between 1994 and 1999 and the women were followed for survival until 2003. All 605 participants were Ashkenazi Jewish and all were tested for BRCA mutations. Among these women, 213 (35.2 percent), carried a BRCA1 or BRCA2 mutation. This high percentage of carriers emphasizes the importance of genetic counseling and testing for any Jewish women with ovarian cancer.
Women with a BRCA mutation diagnosed at stage III or IV had a 28 percent reduced risk of dying than women with similar stage cancer and no mutation. There was no significant difference in survival rates among women diagnosed at stages I to II; however, being a BRCA carrier increased median survival by 16 months.
This is not the first study to conclude that ovarian cancer patients with BRCA1/2 mutations have improved survival rates compared to those without the mutations, but it is the largest and the first to follow women prospectively for over 6 years. Researchers acknowledged several other studies with similar results.
Because of research methods, in some cases the application of these results is limited. For instance, the findings of this study may not apply to women who have BRCA mutations other than the three most commonly found in people of Jewish descent. Combined with previous research, this study shows an extremely promising trend.
Although the study did not examine why women with mutations survive longer, the researchers speculated that hereditary tumors may be biologically different and/ or may be more sensitive to chemotherapy typically given for ovarian cancer.
Whatever the reason, survival rate differences for BRCA carriers is an important discovery with real implications. These results suggest that it may be beneficial to treat BRCA and non-BRCA tumors differently. Because BRCA carriers with ovarian cancer survive longer, they may be at high risk for breast cancer, emphasizing the importance for these women to consider their options for managing breast cancer risks.
Dr. Margaret Snow is a previvor and a Physical Medicine and Rehabilitation physician who enjoys golfing and photographing birds. She serves as FORCE’s West Michigan Outreach Coordinator.
Angela Chetrit, Galit Hirsh-Yechezkel, Yehuda Ben-David, Flora Lubin, Eitan Friedman, and Siegal Sadetzki. Effect of BRCA1/2 Mutations on Long-Term Survival of Patients with Invasive Ovarian Cancer: The National Israeli Study of Ovarian Cancer. Journal of Clinical Oncology, 2008; Vol . 26: pages 20-25.
The following websites offer resources and support for women with ovarian cancer:
The National Ovarian Cancer Coalition is a national nonprofit organization providing education, support and awareness for ovarian cancer.
The Ovarian Cancer National Alliance is a nonprofit organization that provides education, awareness and advocacy for ovarian cancer.
Sponsored by the Gynecologic Cancer Foundation, The Women’s Cancer Network has excellent overviews on all aspects of ovarian cancer, including symptoms, risks, treatments, and resources for finding a gynecologic oncologist.