Ovarian Cancer

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Genetic Testing and Ovarian Cancer

Dr. Beth Karlan UCLA Medical Center

Genetic testing for ovarian cancer can lead to life-saving actions and screening tests for early detection. And when it comes to ovarian cancer, which is curable in over 90 percent of cases when diagnosed early enough, genetic testing can be a valuable option.

Mutations of the BRCA gene, like BRCA1 or BRCA2, can place people at a heightened risk for breast cancer or ovarian cancer. But in the U.S., 90 percent of people who carry a BRCA gene mutation aren’t aware of it until someone in their family gets cancer.

These gene mutations are commonly passed down among family members. In fact, if one of your blood relatives is found to carry a BRCA gene mutation, there’s a 50-50 chance you could be carrying it, too. And because BRCA mutations aren’t found on the X or Y sex chromosome, you’re just as likely to inherit the risks of cancers associated with BRCA from your father as you are from your mother.

“Genetic testing can empower you with such important information,” says Dr. Beth Karlan, gynecologic oncologist at UCLA Medical Center.

If you do have a family history of breast or ovarian cancer, Dr. Karlan strongly recommends having a discussion with a genetic counselor or physician about whether genetic testing could be right for you.

And if you find out you have ovarian cancer, experts say genetic testing should be done at the time of diagnosis, not recurrence. Although current guidelines recommend genetic testing at the time of diagnosis for all women with ovarian cancer, regardless of age, the specific type of ovarian cancer that she has, or her family history, a recent study found that too few women are being tested for these cancer-related gene mutations.

Genetic testing after an ovarian cancer diagnosis can also help your oncologist determine whether certain treatments may be right for your specific cancer. This is especially true when it comes to the promising family of PARP inhibitor drugs (olaparib, niraparib, and rucaparib), which work by preventing cancer cells from repairing their own DNA after it’s been damaged during chemotherapy.

PARP inhibitors have been found to be effective and extend life for women at all stages of cancer treatment, and studies have found they are particularly effective in women with the BRCA gene, whose cancer cells are already in a state of disrepair. PARP inhibitors are often prescribed to women whose cancer is being maintained, or after it recurs. And the PARP inhibitor olaparib (known by its brand name, Lynparza) was recently approved to treat BRCA-mutated advanced ovarian cancer in the first-line setting, meaning before the woman’s initial round of chemotherapy. This earlier PARP inhibitor treatment could have promising effects on survival.

If you’re considering genetic testing for ovarian cancer risk rather than after a diagnosis, it’s important to ask your relatives whether breast or ovarian cancer runs in your family. A history of cancer can be indicative of hereditary BRCA mutations—although it’s also possible for someone to carry a BRCA mutation without a family history of cancer.

“It’s important when you’re deciding whether or not genetic testing would benefit you to try to find out what types of things run in your family,” Dr. Karlan says. “Because it can really help to save lives.”

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Dr. Beth Karlan is a gynecologic oncologist at UCLA Medical Center in Santa Monica, California. Read More

Ovarian Cancer: Screening and Risk

Ovarian cancer is notoriously hard to detect in the early stages when it’s most effectively treated. That’s why women should evaluate their risk factors for the disease and be vigilant about possible symptoms and warning signs.