September is Ovarian Cancer Awareness Month

ovarian cancer: is the fifth most common cancer in women.
It is a cancer that forms in tissues of the ovary.
There are three types: 1) those of the covering of the ovaries or the epithelial; 2) those of the ovaries themselves or germ cell (this type is seen most often in women under 40) and, 3) those of the connective tissue or sex-cord stroma.

Most ovarian cancers are either ovarian epithelial carcinomas (85-90%) or malignant germ cell tumors (5%)

Estimated New U.S. Cases and Deaths from Ovarian Cancer
New cases - 21, 880 Deaths - 13, 850 (World wide cases 230,000)

RISK FACTORS
*Age
*Family History of Ovarian Cancer
*Being of Eastern European (Ashkenazi) descent
*Having never given birth (or had difficulty doing so)
*Personal History of Breast, Uterine, Colorectal Cancer

*Personal History of Endometriosis
Modified from NCI




From CDC.gov
More white women than other ethnicities get this cancer (but Hispanic women come in at a close second) The average age of diagnosis is 63 and although most women get this over the age of 50 (90% of women are over the age of 40), women of any age can be diagnosed. In depth statistics are here

Symptoms

Early ovarian cancer may not cause obvious symptoms. But, as the cancer grows, symptoms may include:

• Pressure or pain in the abdomen, pelvis, back, or legs

• A swollen or bloated abdomen

• Nausea, indigestion, gas, constipation, or diarrhea

• Feeling very tired all the time


Less common symptoms include:

• Shortness of breath

• Feeling the need to urinate often

• Unusual vaginal bleeding (heavy periods, or bleeding after menopause)


Based upon the presenting symptoms and since they more often are not due to ovarian cancer, women who get diagnosed are often at advanced stages of their disease.


IN THE NEWS.... Two Gene Mutations Found That Mark Hardest-To-Treat Ovarian Cancer - Sept 9, 2010
Finding published in the journal Science and the New England Journal of Medicine (click here for full article)
The genes are for ovarian clear cell carcinoma (10 - 12% of all ovarian cancers) and is one of the most difficult to treat as well as most lethal. It is linked with endometriosis and is resistant to chemotherapy. Two teams of researchers published on this - one from Hopkins and one from the British Columbia Cancer Agency. Dr. Bert Vogelstein and colleagues at Johns Hopkins University in Baltimore named the two new genes as ARID1A and PPP2R1A. (Science abstract here )

Dr. David Huntsman from the British Columbia Cancer Agency published his groups study in New England Journal of Medicine and found that ARID1A was mutated not only in ovarian clear-cell carcinoma but also in a second type of ovarian tumor linked with endometriosis. He found that "Overall, 46 percent of patients with ovarian clear-cell carcinoma and 30 percent of those with endometrioid carcinoma had ... mutations in ARID1A," It was not found in other ovarian tumor types. The ARID1A gene is also a suspect in some cases of lung and breast cancer, Huntsman's team said.
These findings may identify new 'on-off switches' for these tumors, as well as mechanisms of action that aide in developing new medications to treat it.
MECHANISM OF ACTION - The ARID1A gene is involved in a process called chromatin remodeling, which helps squeeze DNA into cells and control when and how it gets "read" to perform a biological function. Mutations in it allow DNA to improperly 'read' and activated, per the Hopkins team.
"Taken together, these data suggest that ARID1A is a classic tumor-suppressor gene," Huntsman's team wrote. These genes, when not mutated, aid in blocking tumor formation -similar to other genes such as BRCA1 and p53.
Currently, since most women are diagnosed with widely spread disease, most (70%) die within five years.
SOURCES: link.reuters.com/nyg52p Science, September 8, 2010 and link.reuters.com/pyg52p

MORE INFO


*HERE NCI Site with information, clinical trials and more

*What You Need To Know About™ (Epithelial) Ovarian Cancer NCI created resource on ovarian cancer

*If you have a hysterectomy, should you get ovaries out to prevent disease? Controversy discussed at CNN report



* Here's a CDC Podcast on Gynecologic Cancers



New England Journal of Medicine, September 8, 2010.


FULL NEJM ARTICLE AVAILABLE AT ARID1A

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