In a recent New York Times op-ed, actress Angelina Jolie opened up about her decision to undergo a bilateral salpingo-oophorectomy, a procedure to remove her ovaries and fallopian tubes, in order to reduce her risk for developing ovarian cancer. After losing her mother, aunt and grandmother to cancer, Jolie discovered she carries a mutation in her BRCA gene, which puts her at much higher risk for developing certain diseases, including breast and ovarian cancer. Previously, Jolie underwent double mastectomy surgery as a preventive measure against breast cancer, which brought widespread awareness for hereditary cancers and an increase in preventive surgeries.
Ovarian cancer is a disease in which malignant or cancerous cells are found in the ovaries, the two almond-shaped organs located on each side of the uterus that store eggs and produce female hormones. In women ages 35-74, ovarian cancer is the fifth-leading cause of cancer-related deaths, according to the National Ovarian Cancer Coalition.
Risk factors include family history, age, being a smoker, never being pregnant and certain medical conditions, such as polycystic ovarian syndrome. An annual Pap test does not screen for ovarian cancer.
The symptoms often are described as vague and can be difficult to link to ovarian cancer, which can lead to late detection. If any of these symptoms persist, see your doctor:
- Pelvic pain
- Abdominal pain
- Back pain
- Trouble eating, or feeling full early
- Frequent urination
- Upset stomach
- Pain during sex
- Menstrual changes
- Unexplained fatigue
Women with a family history of ovarian cancer can have a blood test for the early onset breast cancer gene, called BRCA1. If the BRCA test is positive, there is up to an 85 percent chance that you will develop breast and/or ovarian cancer.
If the test results are positive and the patient does not plan to have children, she can consider having her ovaries removed, as Angelina Jolie did. This can decrease the risk of developing ovarian cancer by 95 percent.
OB-GYN Dr. Jennifer Ashton emphasizes that surgery is not the only option for women who test positive for BRCA gene mutations, so patients should discuss the risks, benefits and options with their physician. Removing the ovaries will result in immediate surgical menopause, although symptoms can be managed through various treatments, including hormonal and non-hormonal therapies.
Taking oral contraceptives also can help reduce the risk for ovarian cancer in women with a family history of the disease by as much as 60 percent.
If cancerous cells are found, surgery to remove the tumor is usually the first treatment option and often is followed by chemotherapy.