Webinar: What Women Need to Know about Ovarian Cancer

Tue, May 12, 2015
12:00pm to 1:00pm ET

Description

Mayo Clinic gynecologic cancer specialists Jamie N. Bakkum-Gamez, M.D. and John Weroha, M.D., Ph.D. discuss the signs and symptoms women should be aware of for detection of ovarian cancer, understanding treatment options, and the importance of new clinical trials. Mayo Clinic medical geneticist Myra J. Wick, M.D., Ph.D. discusses the importance of family history and genetic counseling in preventing ovarian cancer. A live question and answer session followed the presentation. You can still ask questions using the chat box to the right. Speakers include: - Jamie N. Bakkum-Gamez, M.D. - John Weroha, M.D., Ph.D. - Myra J. Wick, M.D., Ph.D. Would you like to: Request An Appointment Learn More About Ovarian Cancer

Location

Online

@bluhmcd

I have stage 4 and have my first recurrence. I’m doing low dose carbo/taxol treatments and am unable to be some treatments because my wbc count and anc are too low. What can I do to boost my immune system?

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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.

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@elainefowler

Would you recommend an annual ultrasound and a CA125 test? My doctor used to prescribe this but now says it’s not necessary?

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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.

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@karenh

Stage
3C recurrent at 44 yrs old. Was in remission for a little over a year. Genetic testing was all negative. Are there any new studies showing cure in these types of scenarios? I’m being told at this point there won’t be cure.

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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.

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@theodoreanthony

What is the difference between the Avatar trial vs the ChemoFx testing? I am familiar with Chemofx. Aren’t they already testing live cells up against approved recurrent therapies? What your thoughts?

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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.

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@momatat

breast cancer survivor- BRCA1/2 negative. having pain in abdomin, urgency, back pain would CA 125 clarify

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Recommend evaluation by your care provider.

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@gill

I live in UK and have Ovarian Cancer Stage3. Our survival rates are some of the poorest in Europe. Firstly what chemotherapy or drugs would you use on a second recurrence. Avastin is only used for first recurrence here. Are there any other drugs beside chemotherapy that you try to keep the disease stable between treatments.

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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.

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@beachtennis

If you are negative BRCA1/2, should we ask to have Lynch testing?

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

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@peggycampbell327

I am a stage 2c survivor; negative on both braca1 + 2 test. Am I correctly understanding that my sister remains at a 1.4% risk range? Or is her risk higher?

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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.

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@lynnkw

Mother passed from ovarian cancer at 51 y.o. She was BRCA1 positive. Both my sister and I are negative for this gene mutation. Is there any reason for us to do any type of regular screening/preventative measures? are there any environmental or other factors that could ‘turn on’ this gene?

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

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@sepdvm

Recent Foundation One testing of a metastatic squamous cell carcinoma of the lung lobe showed BRCA1 and BRCA2 as VUS (varients of unknown significance), present but unknown as to their effects on the SCC. Is this evidence that I carry both gene alterations and should consider preventative treatment for Ovarian cancer?

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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.

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@danmhaye

My sister had surgery at Mayo last week. It was too large and involved to remove and the oncologist is recommending traditional chemo which she is scheduled for at Mayo. Is she a candidate for the ovatar trial?

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Alex, thank you very much for the reply.

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@above

Please share your latest research on best preventing ovarian cancer from recurring (non hereditary, stage 3B after major hysterectomy))

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Dear Alex
Thank you for your reply. Are the clinical trials open to non-americans? Im Danish and might be willing to travel:-)
Best rgs
A

Sendt fra min iPhone
derfor lidt kort 🙂
bedste hilsner Anne

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I have been experiencing severe pelvic/abdominal pain. My u/s and ct showed I have a small mass on my left ovary and one on my uterus (a small cyst in my liver) and my alpha feta protein test was abnormal, CA125 was normal. My doctor says there is nothing to worry about, I see my gyny on the 2nd June. My question is: can a doctor tell by my test results that the mass is benign? I am a 58 yr old female. I took HRT for 7 years stopped 1 year ago. The pain is increasing in severity now extending into my back and the groin area, I have had to stop work and am taking painkillers Tramadol 24/7. Thank you for you help.

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@dugan

I have stage 4 recurring ovarian cancer. I have been treated with Chemo four 4 1/2 years after surgery. Was given 2/3 months and started treatment of HEXALEN. Is there any other treatment that you would suggest.

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There are many potential therapies for recurrent ovarian cancer and the pros/cons should be discussed with your local oncologist. It is difficult to give advice about what treatments to do now or next without having more information about your medical history, tolerability of prior chemo, life goals, physical condition, etc. The best way to answer this question is through a face-to-face consult or electronic consult if your physician is part of the Mayo Clinic Network.

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@mfell

I have stage 3 recurrent clear cell ovarian cancer. You mentioned carboplatin and taxol are the standard chemo treatments for ovarian cancer. Would you say they would be the same for clear cell? Thank you.

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Yes, we currently do not distinguish between the different subtypes of ovarian cancer and use the same general platinum-taxane doublet therapy (for instance cisplatin or carboplatin plus paclitaxel or Taxotere) for all subtypes.

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