Kathryn (Moderator) - 11:00 AM:
Our chat on ovarian cancer is now open. You can send questions at any time during this chat.
Elena Moore (NorthShore) - 11:02 AM:
Hello! I am happy to answer any questions regarding ovarian cancer that anyone may have.
Negar (Glencoe, IL) - 11:02 AM:
What are signs and symptoms of ovarian cancer?
How are women typically diagnosed?
Elena Moore
Thanks for the excellent question.
Some of the typical signs and symptoms of ovarian cancer are abdominal or pelvic pain and bloating as well as changes in bowel or bladder habits.
Most women are diagnosed after seeing their physician with such symptoms.
Gilda (Pleasant Prairie, WI) - 11:04 AM:
Where can I get genetic testing for ovarian cancer? Do I need to go through a PCP or OB-GYN?
Elena Moore
Either your PCP or an OB/GYN can order the test. We also have an excellent Medical Genetics division that we refer many patients to. We recommend that you do have the genetic testing though a physician's office as they can best help you to interpret the results and also give you some couseling about possible results even before ordering it.
Sara (Skokie, IL) - 11:08 AM:
Can some of the HPV viruses cause ovarian cancer?
Elena Moore
No, thankfully HPV is not associated with ovarian cancer. It is, however, associated with cervical, vulvar and vaginal cancers.
Susan (Libertyville, IL) - 11:12 AM:
I was an IVF patient for 5+ years and am concerned if my risk is higher from having stimulated my ovaries for such an extended time. Could IBS-type symptoms be indicative of ovarian cancer?
Elena Moore
IVF has been shown to slightly increase the risk of ovarian cancer. IBS-type symptoms can be seen as symptoms of ovarian cancer. If you have any concerns about this I would recommend seeing your gynecologist.
Jenna (Chicago, IL) - 11:16 AM:
Can polycystic ovary syndrome (PCOS) eventually turn into ovarian cancer?
Elena Moore
No, we do not think that polycystic ovarian cancer is a precursor for ovarian cancer.
Kathryn (Glenview, IL) - 11:19 AM:
Are there any significant advances on the horizon for early detection of ovarian cancer?
Elena Moore
Early detection of ovarian cancer has been one of the toughest issues in our field. Recent data looking at an algorithm combining pelvic ultrasound and CA 125 (a tumor marker that can be elevated in ovarian cancer) over time has shown promise but this is still not recommended in the general population.
Griselda (Chicago, IL) - 11:25 AM:
My brother passed away at the age of 34 from colon cancer, three months later my sister was diagnosed with kidney cancer, which she had removed and is now cancer free. Since ovarian cancer may go undiagnosed, is there any preventative testing or steps I might consider since I have a family history of cancer?
Elena Moore
I am so sorry to hear about your siblings' cancers. How tough. May I ask if your brother ever underwent any genetic testing?
Griselda (Chicago, IL) - 11:27 AM:
No.
Elena Moore
In general, ovarian cancer is not associated with kidney cancer. There is a genetic syndrome known as Lynch Syndrome which places patients at risk of colon, uterine and ovarian cancers. I would recommend meeting with a genetic counselor to discuss whether testing for Lynch Syndrome would be appropriate for you given the very young age of diagnosis in your brother. If you were to test positive for Lynch Syndrome, we would recommend removal of the uterus, fallopian tubes and ovaries preventatively around age 40. The number for our Medical Genetics division at NorthShore is 847-570-1029. They are excellent.
Susan (Vernon Hills, IL) - 11:34 AM:
What are your thoughts on ovarian cancer and the connection with Lynch Syndrome?
Elena Moore
Lynch Syndrome appears to increase lifetime ovarian cancer risk to anywhere from 3-20% depending on which exact mutation is present. The lifetime risk of the general population is 1.4%, just to put this into perspecitve.
Liz (WI) - 11:35 AM:
My sister was told recently she has a large ovarian tumor. It has a mix of solid and cystic components on ultrasound. What might she expect going forward? Are there odds on what is malignant vs benign? What can she do in terms of finding a surgeon?
Elena Moore
Sorry to hear that she is dealing with this. I know it can be very stressful. May I ask how old your sister is? This impacts the risk of the mass being malignant.
I would definitely recommend she be operated on by a Gynecologic Oncologist given how you are describing the mass. If she is close to us here at NorthShore I would be more than happy to see her in consultation and operate on her.
Rachel (Chicago, IL) - 11:39 AM:
I've heard some of the symptoms for ovarian cancer (or even endometriosis) are similar to those of gastrointestinal disorders. How can you tell the difference? Are there ways women can be vigilant of our health so that we don't miss the signs of ovarian cancer and catch it too late?
Elena Moore
What you are saying is very true. It is difficult for patients to tell the difference based on symptoms alone and even difficult for doctors to in many cases. The best thing to do is to bring any new symptoms of that sort to your doctor so that they can do an exam and do appropriate testing. This may include blood work or imaging as needed.
Sam (Skokie, IL) - 11:49 AM:
How effective is the Olaparib as a maintenance therapy for a BRCA1 positive patient? What other maintenance option might be considered beside the Parb Inhibitors ?
Elena Moore
Olaparib appears to improve progression free survival (PFS) from 5.5 months to over 19 months in patients with BRCA mutation. Avastin (an anti-angiogentic therapy) has also been studied extensively but confers a much more modest improvement in PFS on the order of 3 months. Taxol has also ben evaluated as a maintenance therapy and does not appear to improve outcome and has quite a bit of long term toxicity.
Ginny (Zion, IL) - 11:53 AM:
I have two sisters that have recently been diagnosed with ovarian cancer. One was 53 and the other 55 years old at time of diagnosis. They both have BRCA1 VUS and Lynch Syndrome. I am 57 and uncertain about prophylactic surgery vs waiting for genetic testing results. What options might I have?
Elena Moore
Genetic testing should not take too long (usually a few weeks) so I would consider getting these results before making your decision because if you do not harbor those mutations you yourself may not be at increased risk.
Kathryn (Glenview, IL) - 11:54 AM:
My mother had ovarian cancer and my sister had uterine cancer. Both were diagnosed in late stages, as is common. Why is it so difficult to detect these cancers in early stages? Is any work being done within the immune system to make cells stronger before it turns into cancer - like a preventative immunotherapy? My sister tested negative for the BRCA mutation, but got uterine instead, so genetic testing would not have helped her.
Elena Moore
I'm so sorry to hear about your family members. Ovarian cancer is difficult to detect most likely because there is not a long pre-cancerous phase like there is in cervical cancer, for example. So once the cancer develops it develops relatively quickly within a shorter interval than any routine screening could be recommended.
Most uterine cancers are thankfully detected early because women have abnormal bleeding, however, this is not universally the case and certain types of uterine cancer have a higher likelihood of spread.
I am not aware of any immunotherapy being looked at preventatively if you are referring to the many immunotherapy drugs that are now being tested and found to be effective in many cancers. This is because they do have significant toxicity and therefore using them prevenatively would probably carry more risk than benefit. That being said, other more holistic approaches to boosting immune health like increasing antioxidant intake, etc certainly has been advocated
Jan (IL) - 12:00 PM:
I had massive adhesions on my right side due to an emergency surgical repair done when I was 14, when a large ovarian cyst ruptured. I worry those adhesions ( abnormal cells) could turn into ovarian cancer. Is this possible? Thank you!
Elena Moore
No, thankfully adhesions themselves should not put you at any increased risk of ovarian cancer.
Kathryn (Moderator) - 12:03 PM:
This will be the end of our chat - thank you very much for your questions!
For more information on ovarian cancer, or to schedule an appointment with a specialist like Dr. Moore (or if you have a referral), please contact our Gynecologic Oncology team at 847.570.2639 or visit the NorthShore Kellogg Cancer Center.
Elena Moore - 12:04 PM:
Thanks everyone for participating!