Overview of Prevention

Prevention Purposes of this summary

Ovarian Cancer Prevention

Significance of ovarian cancer Ovarian cancer prevention

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Overview of Prevention

Prevention

Doctors cannot always explain why one person gets cancer and another does not. However, scientists have studied general patterns of cancer in the population to learn what things around us and what things we do in our lives may increase our chance of developing cancer.

Anything that increases a person’s chance of developing a disease is called a risk factor; anything that decreases a person’s chance of developing a disease is called a protective factor. Some of the risk factors for cancer can be avoided, but many cannot. For example, although you can choose to quit smoking, you cannot choose which genes you have inherited from your parents. Both smoking and inheriting specific genes could be considered risk factors for certain kinds of cancer, but only smoking can be avoided. Prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chance of developing cancer decreases.

Although many risk factors can be avoided, it is important to keep in mind that avoiding risk factors does not guarantee that you will not get cancer. Also, most people with a particular risk factor for cancer do not actually get the disease. Some people are more sensitive than others are to factors that can cause cancer. Talk to your doctor about methods of preventing cancer that might be effective for you.

The purposes of this summary on ovarian cancer prevention are to:

• Give information on ovarian cancer and how often it occurs.
• Describe ovarian cancer prevention methods.
• Give current facts about which people or groups of people would most likely be helped by following ovarian cancer prevention methods.

You can talk to your doctor or health care professional about cancer prevention methods and whether they would be likely to help you.

Ovarian Cancer Prevention

The ovary is a female reproductive organ located in the pelvis. Its function is to produce female hormones and to store eggs that, if fertilized by sperm, can develop into a baby. Women have two ovaries, one on each side of the uterus.

Tumors found in the ovaries may be noncancerous tissue growths (cysts) or cancerous growths that may spread to other parts of the body.

In the United States, more women die of ovarian cancer each year than of cervical and endometrial cancers combined. Survival rates have not greatly improved, and screening has not been proven to decrease the death rate.

Ovarian cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided. Avoiding risk factors when possible and increasing protective factors may help prevent ovarian cancer.

Genetic Factors: Women who have inherited certain altered (mutated) genes have a much higher risk of developing ovarian cancer. These mutations may be found in BRCA1 , BRCA2 , or hereditary nonpolyposis colon cancer (HNPCC) genes. For more information on groups that are at high risk for ovarian cancer due to inherited genetic factors, see the PDQ summary on the Genetics of Breast and Ovarian Cancer.

Age: The risk of developing ovarian cancer increases as a woman gets older.

Obesity: Having excess body fat as measured by body mass index, including during the teen years, increases the risk of ovarian cancer. Diet and nutrition during the teen years may play a role in prevention.

Oral Contraceptives: Studies show that the use of oral contraceptives reduces the risk of developing ovarian cancer. The longer you use oral contraceptives, the lower your risk might be. The decrease in risk may last up to 25 years after the use of oral contraceptives has ended. This lower risk is seen both in women who have given birth and in women who have not. Oral contraceptives may also protect against ovarian cancer in women who are at higher risk because they have inherited an altered version of BRCA1 and BRCA2 genes.

Harms from taking oral contraceptives include:

• A higher risk of blood clots that can block blood vessels, especially in smokers.
• A slightly higher short-term risk of breast cancer that decreases over time when use is stopped.

Childbearing and Breast-feeding: Women who have had at least one child are less likely to develop ovarian cancer than women who have never had children. Studies have also shown that women who breast -feed are less likely to develop ovarian cancer.

Tubal Ligation or Hysterectomy: Studies have shown that women who have undergone tubal ligation (sterilization) or hysterectomy are at decreased risk of developing ovarian cancer.

Family History of Ovarian Cancer: A woman who has a first-degree relative (mother or sister) or a cluster of 2 or more relatives with ovarian cancer has a higher than average risk of developing ovarian cancer.

Prophylactic Oophorectomy: Sometimes women with a very strong family history of ovarian cancer decide to have prophylactic oophorectomy (removal of both ovaries) and salpingectomy (removal of the fallopian tubes). This greatly reduces the risk of ovarian cancer in women who have inherited an altered version of BRCA1 and BRCA2 genes or hereditary nonpolyposis colon cancer (HNPCC) genes. With prophylactic removal of the ovaries, there is still a small chance that ovarian cancer may develop in nearby abdominal and pelvic tissue. It is important to have a cancer risk assessment and counseling before making this decision.

Possible harms from prophylactic oophorectomy include:

• Loss of fertility, hot flashes, decrease in sexual interest, vaginal dryness, frequent urination, bone loss, and increased risk of heart disease.
• Risks from surgery, including bleeding, infection, damage to nearby organs, reactions to medications used, and the possibility of death.

Hormone Replacement Therapy/Hormone Therapy: Hormone replacement therapy, also called hormone therapy, is associated with an increased risk of ovarian cancer in postmenopausal women. The risk increases with the length of use, and may be different for estrogen -only therapy (ERT) and estrogen- progestin replacement therapy (EPRT).

Some studies show an increased risk of ovarian cancer in women who have used fertility drugs, especially in those who do not become pregnant. Other risk factors that have been suggested for ovarian cancer are the use of talcum powder in the area between the vagina and the anus, or eating a high fat or high lactose diet. The exact relationship remains unclear.

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Changes to This Summary (04/23/2007)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

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About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ². PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a certain drug or nutrient can prevent cancer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During prevention clinical trials, information is collected about the effects of a new prevention method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ⁵. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Glossary Terms

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

The opening of the rectum to the outside of the body.

A mass of blood that forms when blood platelets, proteins, and cells stick together. When a blood clot is attached to the wall of a blood vessel, it is called a thrombus. When it moves through the bloodstream and blocks the flow of blood in another part of the body, it is called an embolus.

A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

BMI. A measure that relates body weight to height. BMI is sometimes used to measure total body fat and whether a person is a healthy weight. Excess body fat is linked to an increased risk of some diseases including heart disease and some cancers. Also called BMI.

A gene on chromosome 17 that normally helps to suppress cell growth. A person who inherits a mutated (changed) BRCA1 gene has a higher risk of getting breast, ovarian, or prostate cancer.

A gene on chromosome 13 that normally helps to suppress cell growth. A person who inherits a mutated (changed) BRCA2 gene has a higher risk of getting breast, ovarian, or prostate cancer.

Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck. Cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the “neck”) of the uterus.

The process by which a professional counselor helps a person cope with mental or emotional distress, and understand and solve personal problems.

A sac or capsule in the body. It may be filled with fluid or other material.

The things a person eats and drinks.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

Having to do with the endometrium (the layer of tissue that lines the uterus).

A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.

A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

A record of a person's current and past illnesses, and those of his or her parents, brothers, sisters, children, and other family members. A family history shows the pattern of certain diseases in a family, and helps to determine risk factors for those and other diseases.

The ability to produce children.

The parents, brothers, sisters, or children of an individual.

The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

Inherited; having to do with information that is passed from parents to offspring through genes in sperm and egg cells.

HNPCC. An inherited disorder in which affected individuals have a higher-than-normal chance of developing colorectal cancer and certain other types of cancer, often before the age of 50. Also called HNPCC and Lynch syndrome.

One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

HRT. Hormones (estrogen, progesterone, or both) given to women after menopause to replace the hormones no longer produced by the ovaries. Also called HRT and menopausal hormone therapy.

A sudden, temporary onset of body warmth, flushing, and sweating (often associated with menopause).

Surgery to remove the uterus and, sometimes, the cervix. When the uterus and the cervix are removed, it is called a total hysterectomy. When only the uterus is removed, it is called a partial hysterectomy.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

Transmitted through genes that have been passed from parents to their offspring (children).

A type of sugar found in milk and milk products.

A legal drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition.

To change the genetic material of a cell. The changes (mutations) can be harmful, beneficial, or have no effect.

Any change in the DNA of a cell. Mutations may be caused by mistakes during cell division, or they may be caused by exposure to DNA-damaging agents in the environment. Mutations can be harmful, beneficial, or have no effect. If they occur in cells that make eggs or sperm, they can be inherited; if mutations occur in other types of cells, they are not inherited. Certain mutations may lead to cancer or other diseases.

The taking in and use of food and other nourishing material by the body. Nutrition is a 3-part process. First, food or drink is consumed. Second, the body breaks down the food or drink into nutrients. Third, the nutrients travel through the bloodstream to different parts of the body where they are used as "fuel" and for many other purposes. To give the body proper nutrition, a person has to eat and drink enough of the foods that contain key nutrients.

A pill used to prevent pregnancy. It contains hormones that block the release of eggs from the ovaries. Most oral contraceptives include estrogen and progestin. Also called birth control pill.

A part of the body that performs a specific function. For example, the heart is an organ.

Having to do with the ovaries, the female reproductive glands in which the ova (eggs) are formed. The ovaries are located in the pelvis, one on each side of the uterus.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

The lower part of the abdomen, located between the hip bones.

Having to do with the time after menopause. Menopause (“change of life”) is the time in a woman's life when menstrual periods stop permanently.

Any natural or laboratory-made substance that has some or all of the biologic effects of progesterone, a female hormone.

In medicine, something that prevents or protects.

Surgery intended to reduce the risk of ovarian cancer by removing the ovaries before disease develops.

Something that may decrease the chance of getting a certain disease. Some examples of protective factors for cancer are getting regular physical activity, staying at a healthy weight, and having a healthy diet.

The organs involved in producing offspring. In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). In men, it includes the prostate, the testes, and the penis.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (breast), colonoscopy (colon), Pap smear (cervix), and PSA blood level and digital rectal exam (prostate). Screening can also include checking for a person’s risk of developing an inherited disease by doing a genetic test.

The male reproductive cell, formed in the testicle. A sperm unites with an egg to form an embryo.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

A group or layer of cells that work together to perform a specific function.

An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

Having to do with the vagina (the birth canal).