Does the pill protect?

“Association between contemporary hormonal contraception and ovarian cancer… “

https://www.bmj.com/content/362/bmj.k3609

“Previous research has shown a reduced risk of ovarian cancer in users of combined oral contraceptives, an effect that persists for many years after stopping use.

Changes have occurred in formulations of combined oral contraceptives (notably reductions in oestrogen dose and the introduction of newer progestogens).

It is important for users of contemporary combined oral contraceptives to know whether they are likely to experience the same pattern of ovarian cancer benefit as users in the older studies.

The Danish Sex Hormone Register Study follows a national cohort of women aged 15-79 years. It was established to investigate the relation between hormone use and the risk of cancer or cardiovascular disease.

We calculated age standardised incidence rates of ovarian cancers per 100 000 person years, using the age distribution of the cohort as standard.

Conclusions

Based on results from our prospective study, contemporary combined hormonal contraceptives are still associated with a reduced risk of ovarian cancer in women of reproductive age, with patterns similar to those seen with older combined oral products”.

This is shocking!

World Ovarian Coalition

 

This information comes from: -

                 https://www.eurekalert.org/pub_releases/2018-10/wocc-doo101518.php

"The World Ovarian Cancer Coalition Every Woman Study is the largest ever review of the experiences of women with ovarian cancer and includes contributions from the clinical community. It presents a bleak picture of the challenges faced by women with ovarian cancer, and those who care for them.

Nine in ten of the women in the Every Woman Study experienced symptoms prior to diagnosis and of these, eight in ten consulted a doctor - though less than half within a month and one in ten waited six months.

Across the world, diagnosis took an estimated average of 31 weeks from a woman experiencing symptoms to her diagnosis; for one in ten women diagnosis came more than a year after visiting a doctor.

A survey participant in Australia said "Governments need to do more regarding GPs [family doctors] and their lack of diagnosis and interest in women with ovarian cancer. After diagnosis I Googled and all my symptoms were mentioned. GPs were not interested enough and made me feel like a hypochondriac. This went on for months!"

There are examples of best practice in prevention, diagnosis and treatment of ovarian cancer across the world, but no one country does well in all three areas. This means there are opportunities right now to transform survival in ovarian cancer, simply by learning from what others do well".

https://worldovariancancercoalition.org/wp-content/uploads/2018/10/THE-EVERY-WOMAN-STUDY-WOMENS-SURVEY-2018-FULL-RESULTS.pdf

Choose your mother carefully

“Familial risks of ovarian cancer….”

This information comes from:-

       https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205000

“Ovarian cancer risk increases with aging and peaks between the ages of 50 and 80 years. In the general Swedish population, the lifetime risk of ovarian cancer is 1%. 

Family history is a strong risk factor for ovarian cancer, and the relative risk is estimated to be 2.0 to 4.0 for those that have a first-degree relative affected by the disease

In this study, we use the recent national Swedish Family-Cancer Database, which included 16.1 million individuals, to estimate the familial risks of ovarian cancer by age at diagnosis, affected relative (mother or sisters) and histology.

In families of only mother, only sisters or both mother and sisters diagnosed with ovarian cancer, cancer risks for ovary were 2.40, 2.59 and 10.40, respectively; and were higher for cases diagnosed before the age of 50 years.

Histology in familial ovarian cancer is not specific, and if genes or polygenes contribute to familial clustering they may not define histology.”

Why does 75% of ovarian cancer start in the Fallopian tube?

This information comes from:-

https://today.uic.edu/crosstalk-between-fallopian-tube-ovary-may-drive-the-spread-of-ovarian-cancer-

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https://www.cancer.gov/news-events/cancer-currents-blog/2017/ovarian-cancer-fallopian-tube-origins

"Over the last several years we have come to learn that ovarian cancer cells, specifically high-grade serous ovarian cancer cells, originate in the fallopian tube and migrate to the ovary where they become established as ovarian cancer. 

We don’t know yet what the fallopian tube signals to the ovary, but we know that it causes the ovary to release norepinephrine, which signals cancer cells to migrate.

-

There is a window of several years between the development of abnormal cells, or lesions, in the fallopian tubes and the start of ovarian cancer

Most of the genetic alterations seen in ovarian tumors in these patients were present in serous tubal intraepithelial carcinomas (STICs) that had formed years earlier in their fallopian tubes

Clinical trials could be done to determine whether removing the fallopian tubes, and not the ovaries, in women who are at high risk for cancer is sufficient to reduce their risk of the disease" 

All about PARP

"Poly (ADP-ribose) Polymerase Inhibitors(PARPi) in the Management of Ovarian Cancer" 

This information comes from

https://www.ptcommunity.com/journal/article/full/2018/9/549/poly-adp-ribose-polymerase-inhibitors-management-ovarian-cancer-drug

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https://www.eurekalert.org/pub_releases/2018-09/waeh-dpw092618.php

"Familial and hereditary factors have been identified in the development of some cases of ovarian cancer, with approximately 10% to 15% of ovarian cancer cases associated with inherited mutations of the BRCA1 and BRCA2 genes.

Upon recurrence of disease, the goal of treatment is no longer curative, but instead becomes palliative, aimed at improving disease-related symptoms, prolonging survival, and trying to improve quality of life.

For patients harbouring a BRCA1/2 mutation, medications targeting PARP enzymes may be an effective therapeutic option. PARP is a family of enzymes that mediate DNA repair... PARP inhibition in the setting of BRCA1/2 mutations can cause tumour cells to lose 2 important DNA repair mechanisms leading to DNA damage and cell death.

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PARPi is administered as maintenance therapy (with) some patients deriving durable benefit for more than 3 years

Australian scientists (using the Melbourne tissue bank) have revealed a better way  to identify which patients should respond to powerful ovarian cancer drugs called PARP inhibitors (PARPi), resolving an important question in ovarian cancer care about why some patients respond to these drugs, while others do not.

  

The study: -
                              https://www.nature.com/articles/s41467-018-05564-z

was led by Professor Clare Scott, Dr Olga Kondrashova, Dr Matthew Wakefield and Dr Monique Topp from the Walter and Eliza Hall Institute; in collaboration with Associate Professor Alexander Dobrovic from the Olivia Newton-John Cancer Research Institute and LaTrobe University School of Medicine".

(L-R) DR OLGA KONDRASHOVA AND PROFESSOR CLARE SCOTT