BRCA Positive: Managing Your Ovarian Cancer Risk with Preventative Surgery and Chemoprevention

Medically reviewed by Steve Kim, MD on February 16, 2016Written by Jasmine Nelles on February 16, 2016

If you’ve tested positive for the BRCA gene, you’re likely wondering what it means for your health. BRCA1 and BRCA2 are the genes responsible for tumor suppression. When these genes are mutated, it causes uncontrolled growth of abnormal cells. This growth leads to tumors. The mutated genes can be found in both women and men, so you can inherit them from your mother or your father.

Keep reading to learn more about BRCA genes and how you can reduce your risk of developing ovarian cancer.

Testing Positive

It’s normal to have anxiety from a positive test result, as you now have an elevated risk for developing ovarian cancer. If you’ve tested positive for the BRCA-1 gene, you have a 25 to 65 percent chance of developing ovarian cancer. If you’ve tested positive for the BRCA-2 gene, you have a 10 to 20 percent chance. These are significant numbers, given that only 1 in 75 women get ovarian cancer.

Advances in modern medicine have improved the prevention of ovarian cancer. The two leading options are preventative surgery and chemoprevention medications. Preventative surgery is the most popular and most successful option. Chemoprevention methods are less invasive and radical, but may not be as successful.

Preventative Surgery

The preventative surgery for ovarian cancer is called an oophorectomy (or risk-reducing oophorectomy). During this surgery, both ovaries are removed. Both fallopian tubes may be removed as well, in a procedure called salpingectomy. The uterus and cervix are left intact. After this surgery, the chance of getting ovarian cancer drops significantly. But there’s no complete guarantee. If the cancer cells have migrated before the removal, the cancer can appear elsewhere in the body.

An oophorectomy can be performed through a laparoscope. This is a thin, lighted scope that requires only small incisions in the abdomen. The recovery time for this type of surgery is much shorter than a complete hysterectomy, which requires a large surgical opening. The ovaries and fallopian tubes are removed and sent off to a lab for further testing.

As with any surgery, there’s a risk of potential side effects. For women who haven’t gone through menopause, menstruation will stop and menopause will likely begin. Hot flashes and other symptoms associated with menopause are also likely. The procedure also increases your risk of heart disease. You may want to consider Hormone therapy to help reduce these symptoms.

It’s important to remember that an oophorectomy will only reduce your chances of ovarian cancer. It will not reduce your risks of other caners associated with the BRCA gene.

Chemoprevention Medications

Chemoprevention is a concept with conflicting views in the medical community. The types of drugs being researched are NSAIDs (nonsteroidal anti-inflammatory drugs), oral contraceptives, and Fenretinide.

NSAIDs are over-the-counter painkillers such as ibuprofen, aspirin, and acetaminophen. Studies have shown that aspirin and other NSAIDs can reduce the risk of invasive ovarian cancer. However, further research must be done to verify these findings.

Combined oral contraceptives have demonstrated promising results in preventing ovarian cancer. Studies show that women who have previously or are currently using oral contraceptives have significantly decreased risk of ovarian cancer, specifically in BRCA carriers. However, taking birth control increases your risk for blood clots, which can lead to a heart attack or stroke.

The investigational drug Fenretinide is a version of vitamin A, known as a retinoid. It’s been shown to have potential anti-tumor properties on ovarian cancers, by inhibiting growth of ovarian cancer cell lines. The use of retinoids can increase skin sensitivity, leading to rashes, dryness, and sun sensitivity. Some women also experienced gastrointestinal symptoms.

Overview

Preventative measures, such as surgery and chemoprevention, can help you manage your chance of getting ovarian cancer. Talk to your doctor about your options because what’s right for one person may not be the best choice for you.

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