Webinar: What Women Need to Know about Ovarian Cancer

This is a very common question and one with no good answers. The best way to boost the immune system is with a medication called Neupogen (assuming the low dose chemo is weekly) or Neulasta (if the chemo is every 3 weeks) but this isn’t something you can do on your own and would require a prescription. I think the question you raise is referring to vitamins, certain foods, or complimentary medicine ways to boost the immune system. I’m not aware of anything non-prescription therapy that can overcome the immunosupressive activity of chemotherapy.

The United States Preventative Services Task Force (USPSTF) does not recommend screening (ultrasound and CA125) for average risk women. As such, these tests are not recommended for the general population of women (ovarian cancer risk 1.4% in lifetime). This is because in average risk women, these tests have not yet been shown to detect ovarian cancer at early stages. However, in those women at high risk of ovarian cancer development (BRCA, family history of ovarian cancer), the National Comprehensive Cancer Network (NCCN) recommends every 6 month ultrasound and CA125 until a woman is ready for risk reducing surgery to remove her ovaries and tubes.

Thank you for sharing your experience with ovarian cancer. This question comes up daily. Durable remissions have been observed in women with recurrent ovarian cancer. This doesn’t mean the cancer is gone forever (cured) but it means we can’t see the cancer with any of our tests, which is the next best thing. If long-term remission is not achieved, the cancer can still be treated. Clinical trials increase the treatment options.

Studies have shown that cancer cells respond differently to chemotherapy when they are grown in 2D (in a petri dish as is what happens with ChemoFx) v. 3D (as a structured tumor as is what happens in an Avatar). Some chemotherapies that are not active against cells grown in a dish are active against cells grown as a tumor, and vice versa. It is thought that 3D tumors grown respond more like the tumors in the human body. The Avatar study will help better understand this. Although ChemoFx is commercially available, the American Society of Clinical Oncology has reviewed the data and experts have come to the conclusion that these tests should not be used in general clinical practice and further investigation is needed in a clinical trial setting. I have not used this test in my practice.

Recommend evaluation by your care provider.

For this question, I would refer you to the http://www.NCCN.org guidelines for a comprehensive list of treatment options. Mayo Clinic is a member of NCCN.

Recommend discussing personal and family history with genetics professional to assess risk for Lynch syndrome

There are other genes, aside from BRCA1 and BRCA2, that may have been associated with your ovarian cancer. Would recommend revisiting with a genetic counselor to discuss whether additional genetic testing is warranted. If you have one of the less common genes that has been implicated in ovarian cancer, your sister’s risk could be elevated above the general population risk.

You should not have to do any type of screening or preventative measures if you do not have the mutation identified for your mother.

Many types of tumors develop mutations in genes over time. Most often these mutations or alterations in tumors are not inherited. Encourage you to discuss results with your oncologist.