There are opportunities to prevent ovarian cancer, particularly for people who have inherited a genetic mutation related to the disease.

In the context of cancer, “prevention” refers to actions taken that may decrease the likelihood of developing cancer. Preventing ovarian cancer begins with being aware of factors that might increase your risk, and knowing how you can protect yourself.

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Everyone who is born with ovaries has some risk of developing ovarian cancer. This disease impacts 1 in 75 Canadian females, and some are at greater risk than others due to age, ethnicity, family history of certain cancers, reproductive history, and the presence of specific genetic mutations.

Risk reduction for ovarian cancer can be broadly categorized as surgical and non-surgical: 

For expert advice, talk to your doctor.

Family History

At this time, about 25% of ovarian cancers are known to be hereditary, which means that they “run in the family”. This number may increase as scientists discover more genetic mutations. If you have a family history of ovarian, breast, prostate, pancreatic, endometrial, or colorectal cancer on either side of your family, there is a possibility of a genetic mutation being passed from generation to generation. Some genetic mutations are more common in certain ethnic communities, including people with the following backgrounds: French Canadian, Ashkenazi Jewish, Icelandic, Dutch, and Eastern European.

Genetic Mutations

Genes carry the instructions cells need to grow and function. A genetic mutation occurs when a gene is altered and stops working as it should. Certain genetic mutations, such as BRCA gene mutations, increase a person’s risk of ovarian cancer and other diseases.

There are two categories of genetic mutations: germline (inherited) and somatic:

A genetic mutation that is inherited from a biological parent is called a germline mutation and can be found in all the body’s cells. Germline mutations can be passed down from both the biological mother and biological father, so it is important to review the medical history on both sides of your family. Germline mutations can put you at risk for more than one type of cancer. For example, a BRCA mutation increases your risk for several cancers, including but not limited to ovarian, breast, prostate, and pancreatic cancer.

A genetic mutation that develops during one’s lifetime is called a somatic mutation and is found only in the cells of the tumour. Therefore, somatic mutations are not passed down through families. These types of mutations may be the result of a mistake that happens when a cell is dividing, or from certain environmental exposures (for example, smoking or UV rays).

The two main hereditary syndromes associated with ovarian cancer are Hereditary Breast and Ovarian Cancer Syndrome (HBOC) and Lynch Syndrome. 

You may have a genetic mutation that increases your risk of ovarian cancer, even if no one in your biological family has had ovarian cancer or other related cancers. This may be because you have a small family with few female biological relatives, or the mutation may be passed down through your biological father, biological grandfather, and so on. Some of your relatives may also have a genetic mutation, even if they have not developed cancer. To know for sure, be sure to talk to your doctor about getting a genetic test.

To find a genetics clinic near you, visit https://www.cagc-accg.ca/

Genetic testing

The only way to know for sure if you have a genetic mutation is to get a genetic test. A genetic test provides valuable information to people with ovarian cancer, as knowing of a genetic mutation can help them make decisions about which treatment options are best for them. Genetic tests can also help the biological relatives of a person with ovarian cancer learn more about their risk for certain cancers and how to take action to reduce their risk, if appropriate.

Germline genetic testing is done using a blood or saliva sample. This test looks for a mutation that you inherited from a biological parent. The genes that are tested for will vary across provinces and territories.

There are many possible results of a genetic test, and it is important to understand and be prepared for the possibilities.

Most people with ovarian cancer will test negative for a related genetic mutation. This is because most ovarian cancers are not related to an inherited genetic mutation that we know about at this time. Remember, this may change as more people get genetic testing and scientists learn more. For this reason, you are encouraged to contact the clinic that performed your genetic test every few years to request to have your sample retested.

If your doctor tells you that you are not eligible for genetic testing, there are options available to you. For example, there are private companies that do genetic testing. You would have to pay for these tests. There is also a major research project being conducted out of Women’s College Research Institute in Toronto, Ontario called The Screen Project. The Screen Project is enrolling any Canadian over age 18 for BRCA 1 and BRCA 2 genetic testing.

Recommendations based on genetic testing results

If you test positive for a genetic mutation that increases your risk of ovarian cancer, it is very important to talk to your doctor about how to reduce your risk. One way to significantly reduce your risk of ovarian cancer is to have a surgery called a risk-reducing salpingo-oophorectomy (RRSO). During this surgery, both fallopian tubes and ovaries are removed in order to reduce a person’s risk of ovarian cancer.