7 Causes of Ovarian Cancer Doctors Want You to Know About

Knowing your risk factors could help you spot symptoms you may otherwise have ignored.

By Jane Bianchi, Prevention

First, some good news: ovarian cancer is actually not all that common, with just 22,240 women diagnosed each year, according to the American Cancer Society. A woman's risk of developing ovarian cancer at some point in her life is about 1 in 78 (compared to 1 in 8 for breast cancer).

Now, the bad news. Though there are fewer cases of ovarian cancer overall compared to other cancers, ovarian is among the most fatal. It's the fifth leading cause of cancer death among women, and it accounts for more deaths than any other gynecologic cancer.

Why's it so deadly? The problem is that women often don't experience ovarian cancer symptoms until the disease has progressed—and the later cancer is caught, the harder it is to treat. If and when women do experience symptoms, those symptoms are usually mild and include bloating, abdominal swelling, and frequent urination. It's easy to chalk up these symptoms to weight gain, PMS, stress, a stomachache, a urinary tract infection, or irritable bowel syndrome. "So typically when we diagnose, in almost two-thirds of patients, the ovarian cancer has already spread beyond the pelvis," says Ali Mahdavi , MD, a gynecologic oncologist and the Medical Director, Specialty Care Ascension Medical Group, OB/GYN Clinic at Ascension Columbia St. Mary's Hospital in Milwaukee, Wisconsin.

We don't yet fully understand exactly what causes ovarian cancer, it's so important to know the most common ovarian cancer risk factors. If any of these apply to you, be extra vigilant about listening to your body and report any concerning changes—no matter how subtle—to either your primary care physician or ob/gyn.



1

Having an inherited genetic mutation


There are several genetic mutations that you can inherit from your parents at birth that increase your risk of ovarian cancer, such as BRCA1, BRCA2, and Lynch syndrome. For example, roughly 1 percent of women in the general population will develop ovarian cancer in their lifetime. By contrast, women with a BRCA1 mutation have a 44 percent chance, the odds of those with a BRCA2 mutation are 17 percent, and women with Lynch syndrome have a 6 to 8 percent chance. These mutations can increase your risks for other types of cancers, too. For instance, BRCA1 is also linked to breast cancer; BRCA2 is also linked to melanoma (skin cancer) as well as breast, pancreatic, and prostate cancers; and Lynch Syndrome is also linked to colon and endometrial cancers. If any of those cancers run in your family—especially if first-degree relatives have them (a parent, sibling, or child) and/or were diagnosed at young ages—ask your primary care physician or ob/gyn about seeing a genetic counselor, who can help you figure out whether genetic testing is right for you. There are pros and cons to genetic testing, but one major benefit is that if you find out you have a genetic mutation, especially in young adulthood, it gives you an opportunity to take proactive measures to help reduce your risk of developing cancer in the future.




2

Family history of ovarian cancer

Even if you don't have an inherited genetic mutation, if you have two or more close relatives with ovarian cancer, then you're at increased risk of developing the disease.



3

Getting older

Age is one of the most common risk factors for many cancers and half of all ovarian cancers are diagnosed in women age 63 or older. In short, the longer you live, the more your cells divide, and the greater the chance that you'll develop a "mistake" or genetic mutation. And these can gradually accumulate. "When we're younger, our body is a little bit more likely to repair those mistakes or mutations and overcome them," says June Hou, MD, a gynecologic oncologist and Assistant Professor of Obstetrics & Gynecology at Columbia University Irving Medical Center.



4

Being overweight

The explanation for this risk factor comes down to hormones. "What the fatty tissue does—it produces estrogen. We know that excessive production of estrogen, especially in older women after the age of menopause, puts them at risk for ovarian cancer and cancer of the uterus," says Dr. Mahdavi. "In addition to that, fatty tissue produces some molecules that are destructive to DNA and the gene. Those are called oxidative agents." This is one risk factor that is within your control because it is, of course, possible to maintain a healthy weight through eating more nutritious foods and exercising regularly.



5

Taking estrogen hormone replacement therapy

Using this kind of therapy after menopause is linked with an increased risk for ovarian cancer. The risk is highest for those taking estrogen by itself (no progesterone) for at least five or 10 years, according to the American Cancer Society.



6

Ovulating a lot

The more you ovulate, the greater your risk for ovarian cancer. "During ovulation, the epithelium or the skin, the capsule of the ovary, breaks and releases an egg and then the break heals itself—it's like a tear. That healing process takes cells to divide and regenerate," says Dr. Hou. And the more your ovarian cells divide, the more likely you'll experience genetic mutations that may accumulate over time and cause ovarian cancer. Pregnancy, breast-feeding, and taking oral birth control all prevent ovulation, so they all give your ovaries a rest. On the other hand, infertility, choosing to never have children, starting your period at a very young age, or going through menopause at a late age all mean you have ovulated more.



7

Having endometriosis

There is a small increased risk of ovarian cancer if you have endometriosis, a condition in which the endometrium (tissue) grows outside the uterus instead of lining the inside of the uterus and tends to cause painful periods.


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