Facts

• Ovarian cancer is not one single disease, in fact there are many known ‘subtypes’ of ovarian cancer. This allows for individualized subtype-specific treatment protocols and possibly future opportunities for early detection.
• High grade serous cancers are the most deadly form of ovarian cancer and account for up to 70 per cent of cases.
• Clear Cell Carcinoma and Endometrioid are the second and third most common forms of ovarian cancer.
• The majority of high grade serous ovarian cancers have now been found to originate in the fallopian tube, not the ovary.
• By removing the fallopian tubes during gynecological surgeries such as hysterectomies and tubal ligation (a simple change in surgical practice) this could reduce ovarian cancer related deaths by 30 per cent.
• Women diagnosed with high grade serous ovarian cancer can undergo genetic counseling and testing for a specific genetic mutation (BRCA 1 & 2).
• The BRCA gene mutation is linked to high grade serous pelvic cancers and breast cancer.
• One in five women with a high grade serous pelvic carcinoma will be found to have a genetic mutation in BRCA.
• Identifying women who have a genetic BRCA mutation and subsequently testing related family members could proactively help reduce ovarian cancer deaths by 20 per cent.
• Hysterectomy is the second most common surgery for Canadian women, after Caesarean section.
• Approximately 20 per cent of women in B.C. have undergone a hysterectomy.
• The most common reasons for a hysterectomy are: Uterine fibroids (35%); menstrual disorders (19%); genital prolapse (15%); gynecological cancers (15%); and Endometriosis (8%).¹

Frequently Asked Questions

About Ovarian Cancer

Q: How many women are diagnosed with ovarian cancer in BC each year?
A: Approximately 310 women in BC are diagnosed with ovarian cancer in B.C. each year.

Q: What are the survival rates for women diagnosed with ovarian cancer?
A: Most cases of high grade serous ovarian cancer are diagnosed at a late stage—3 or 4—when the disease has already progressed, in these cases the 5 year survival rates are 15 per cent. For those diagnosed early in stage 1 or 2, the five year survival rate is much higher at approx. 90 per cent.

Q: How many women die from ovarian cancer each year in B.C.?
A: Approximately 220 women will die from ovarian cancer each year B.C..

Q. What is a high grade serous cancer?
A: High-grade serous carcinomas are distinct neoplasms with different pathogenesis, behavior, and response to treatment than low grade tumours. They are aggressive tumours that usually grow quickly and spread widely before diagnosis. Although these tumours typically respond well to initial treatment with surgery and chemotherapy, the goal of cure is illusive.

Q: What are the signs and symptoms of ovarian cancer?
A: Symptoms of ovarian cancer are often vague, you should see your physician if some of the following symptoms persist or progress for 2 to 3 weeks: abdominal discomfort, pressure or pain, abdominal swelling, change in bowel habits, feeling full after a light meal, indigestion, gas, upset stomach, fatigue, more frequent or urgent urination, abnormal vaginal bleeding.

Q: Isn’t ovarian cancer one disease?
A: Ovarian cancer is now known to have a number of subtypes, which originate in different areas, develop in different ways, and respond differently to treatment. Some of the commonly known ovarian cancer subtypes are: high-grade serous cancer, clear cell carcinoma, and endometrioid cancer.

Q: I have endometriosis; does this mean I will one day develop ovarian cancer?
A: Recently it was discovered that endometriosis is linked to two types of ovarian cancer, but this does not mean that every person with endometriosis will develop ovarian cancer.

Prevention: Removing the Fallopian Tubes

Q: Aside from surgical removal of my fallopian tubes, are there other ways to reduce the risk of developing ovarian cancer?
A: Currently, there is no known screening test for ovarian cancer. It’s known that use of the oral contraceptive, pregnancy and breastfeeding all lower the risk of ovarian cancer.

Q: I have a scheduled hysterectomy in the coming months, should I talk to my physician to ensure they remove my fallopian tubes at the same time?
A: Absolutely! We have distributed an educational DVD which addresses the connection of the fallopian tube to “ovarian” cancer to every Gynecologist in BC. Your gynecologist will be the best person to talk to about your coming surgery.

Q: I have already had a hysterectomy, is it likely that I still have my fallopian tubes?
A: If your ovaries were left in place at the time of your hysterectomy, it is most likely that you still have your fallopian tubes. Removing the fallopian tubes is a new change in surgical practice. To be sure, you can check with the surgeon who performed your surgery.

Q: Should I have my fallopian tubes removed now if I’ve already had a hysterectomy or tubal ligation?
A: The OvCaRe program recommends that any person who still has their fallopian tubes remain vigilant about their general health, but would not suggest undergoing a surgical procedure to remove the fallopian tubes without an indication of ovarian cancer.

Q: Will all gynecologists in BC receive an educational DVD?
A: Yes! DVD’s were sent to gynecologists throughout BC in early September 2010, and it is now available to view online at www.ovcare.ca.

Genetic Mutations in Ovarian Cancer

Q: I was recently diagnosed with ovarian cancer, should I be tested for the BRCA gene mutation?
A: There are several types of ovarian cancer and we are recommending that all patients diagnosed with high grade serous ovarian cancer be referred for genetic counseling through the Hereditary Cancer Program at the BC Cancer Agency. You have to be referred by your physician.

Q: My mother had ovarian cancer, should I have testing for the BRCA 1 and 2 gene mutations?
A: That depends on a complete understanding of your entire family history. Your physician can consult the BC Cancer Agency’s Hereditary Cancer Program for specific referral criteria.

Q: How do I access genetic testing for ovarian cancer?
A: You must be referred by a physician.

Q: I’ve had genetic testing for the BRCA gene mutation and it was positive, should I have a hysterectomy and remove my fallopian tubes?
A: It is important that every BRCA mutation carrier have a through understanding of her risks and options for prevention. You will likely be referred to a Gynecologic Oncologist at the BC Cancer Agency for a complete individualized discussion.

Q: What is ARID1A?
A: Recently, researchers with BC’s OvCaRe program have discovered a genetic mutation in the gene ARID1A and have proven that this genetic mutation is connected to 46 per cent of clear cell carcinoma cancers and 30 per cent of endometrioid cancers.