Ovarian Cancer

Description

Prevention

No lifestyle factors have proven to protect against ovarian cancer, although the following are some study results that suggest some lower or higher risk;

• One study reported that women who consume fish and vegetables had a lower risk for ovarian cancer. In support, another 2001 study suggested foods high in specific chemicals called alpha carotene (e.g. carrots) and lycopene (e.g. tomatoes) may be specifically protective.
• Exercise, which protects against many diseases and even some cancers, appears to have no effect on ovarian cancer. Nevertheless, a 2001 study found a higher risk for ovarian cancer in women who were obese, particularly when they were sedentary. Moderate exercise is a good idea and may offer some protection against breast cancer, in any case.
• Smokers should quit. Although evidence of an association with ovarian cancer is weak, it is always wise to stop smoking.

These and other studies on lifestyle factors are generally not considered to be evidence, although they can suggest directions for future research.

Limiting Ovulation

In general, factors or behaviors that limit stimulation of the ovaries or inhibit ovulation appear to be protective.

Pregnancy. The more times a woman has been pregnant the less likely she is to develop ovarian cancer. One study indicated that ovarian cancer was reduced by 40% with one pregnancy and by 14% with each subsequent pregnancy.

Breastfeeding. Breastfeeding, even for only one or two months, may also reduce the risk for ovarian cancer by as much as 40%. A longer duration of breastfeeding does not appear to increase its protective benefits.

Oral Contraceptives (OCs) and Progestin. Studies have suggested that routine use of birth control pills that contain the female hormones estrogen and progestin, even low-dose forms, reduces a woman's risk of ovarian cancer by about 50% when compared to women who have never taken oral contraceptives. The longer a woman takes oral contraceptives the greater the protection and the longer protection lasts after stopping OCs.

Click the icon to see an illustrated series detailing the birth control pill.

Birth control pills should not be taken by pregnant women or women with breast cancer. Other conditions that may preclude taking oral contraceptives include the following:

• Liver disease.
• Migraines.
• Coronary artery disease and any risk factors for heart disease or stroke (particularly smoking, obesity, high blood pressure, blood clotting disorders, or diabetes).

Tubal Ligation. Tubal ligation, a method of sterilization that ties off the fallopian tubes, has been associated with a decreased risk for ovarian cancer in some -- but not all -- studies. A 2001 study specifically reported a significantly lower risk in women who carried the BRCA1 mutation.

Click the icon to see an image of tubal ligation.

Removal of Ovaries (Oophorectomy)

Surgical removal of the ovaries, called oophorectomy, significantly reduces the risk for ovarian cancer. When it is used to specifically prevent ovarian cancer in high-risk women, the procedure is called a prophylactic oophorectomy. Prophylactic oophorectomy is approximately 95% protective against ovarian cancer.

Some experts now consider prophylactic oophorectomy in the following situations:

• Women who have two or more first-degree relatives afflicted with ovarian cancer (or who have a BRCA1 or BRCA2 mutation), and who are 35 years old or older and have completed their families.

Considerable controversy still exists, however for the following reasons:

• One study reported that oophorectomy might improve survival rates in women carrying the BRCA1 or BRCA2 genes by about half a year to over two years. However, the impact of this procedure on survival is still uncertain.
• Even after oophorectomy, women in high-risk groups for ovarian cancer still have a risk for the development of cancer in the peritoneum (the sac inside the abdomen that holds the intestines, uterus, and ovaries).
• The procedure causes early menopause in younger women.