Genetic Testing and Ovarian Cancer
- Mutations to the BRCA genes may increase a woman’s risk for ovarian cancer.
- These genetic changes may also make some treatments, like PARP inhibitors, more effective.
- Genetic testing is recommended for everyone with ovarian cancer.
How Genes Affect Ovarian Cancer Risk
"There are certain cancer-causing genes that can be passed down from generation to generation," Dr. Haslem says. As researchers learn more about the genes that are associated with different types of cancer, they become more adept at determining who might be most at risk. They’re also developing more fine-tuned and effective methods of diagnosing and treating cancers.
If genetic testing indicates that you do have genes associated with a higher risk of ovarian cancer, your doctor may recommend preventive surgery. "If you were tested and you had that gene, then somebody might talk to you about prophylactic surgery to remove the ovaries and fallopian tubes," says Dr. Haslem. Prophylactic surgery minimizes the risk of developing cancer in the future for those with a genetic predisposition.
Your doctor may also use tests to determine whether ovarian cancer has already developed.
Genetics and Ovarian Cancer Treatment
Genetic changes can also affect how you respond to different cancer therapies. "Certain chemotherapies and targeted therapies are much more effective in those types of cases," says Dr. Haslem. Recently developed medications like PARP inhibitors, which target the DNA of cancer cells, work much better in patients with BRCA mutations and HRD. Genetic testing is important to determine the best treatment path.
Originally prescribed after a cancer has come back in women with BRCA mutations, PARP inhibitors can now be offered after initial surgery and chemotherapy, and continued for months, or even years, as long as the side effects are tolerated. The option to offer these drugs to women even after their first course of a different treatment increases the number of patients who can benefit.
However, the American Society of Clinical Oncology (ASCO) guidelines recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
While the number of ovarian cancer patients undergoing genetic testing has increased, it is still not done for every patient. "I think part of the reason that genetic testing is not done as routinely as maybe it should be is that it's still relatively new," says Dr. Haslem. "It wasn't that long ago that we developed the means and methods to do it."
Still, genetic testing is becoming more commonplace as the technology develops and tests become cheaper and faster. According to Dr. Haslem, "It used to cost thousands and thousands of dollars and took weeks and weeks to get the results back. Now, technology has advanced to the point where we can get those results back at a fairly cheap cost. The turnaround time is measured on the order of days, rather than weeks and months."
If you have a family history of ovarian or breast cancer, talk to your doctor about genetic testing. Also discuss these tests if you’ve recently been diagnosed with ovarian cancer yourself. Knowing your genetic profile could lead your doctor to a treatment that’s more likely to work against your cancer.
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