Ovarian cancer: what are its causes and how to prevent it?


How to minimize the risk of developing ovarian cancer? On the occasion of World Ovarian Cancer Day, Medisite is interested in this complex cancer to detect which is often diagnosed at an advanced stage, in 75% of cases at stage 3 or 4. In order to promote its prevention and to further follow up those who may be affected, it is important to know the risk factors for this very deadly cancer. It is indeed an unrecognized cancer which represents about 5,000 cases each year, ten times less than breast cancer.

“The main risk factor is family history, that is to say mutations of the BRCA1 and BRCA2 genes”, assures Dr. Jean-Claude Darmon, gynecological and breast surgeon, specializing in oncology. Unlike other organs, this cancer does not give warning signs and develops quietly, thus most often escaping early diagnosis.

According to the specialist, “regular endovaginal ultrasounds and the dosage of tumor markers do not work well”. Faced with “this failure” of early detection of a cancer that is “poorly cured”, it is important to take a detailed look at the risk and protection factors. “We have reoriented our approach to do prevention. One of those that works best remains removal of the ovaries. To remove a woman’s ovaries as a preventive measure, she must have a high risk of ovarian cancer or the operation must have few consequences, as in postmenopausal women,” explains Dr. Darmon.

The surgeon explains that this is why “family history” is of primary interest the specialists. “If there has been breast or ovarian cancer in a family, we can search for these famous mutations which, if present, justify preventive removal of the ovaries from women”. Dr. Darmon specifies that the medical response will be different depending on the age of the patient. “In reality, depending on the age of the women at whom the diagnosis of predisposition to ovarian cancer is made, the issues are extremely different,” specifies the specialist. In effect, if the woman is postmenopausal, there are no harmful consequences to the removal of the ovaries. “After the menopause, it’s a very well accepted small intervention,” he explains.

On the other hand, “if the diagnosis is made on a young woman, who is still menstruating, the acceptability of the gesture is much lower because the consequences are major”. Provoking a surgical menopause is quite violent and you thus expose the young woman to premature aging with a drop in libido.

There exists a alternative for young women when the predisposition diagnosis is made by the discovery of a BRCA mutation and the latter have already had children. “It consists to remove the tubes completely”, specifies Dr. Darmon. This reduces the risk of ovarian cancer because according to the surgeon, research suggests that it is the end of the fallopian tubes that irritates the ovary and this is where the cancer would be born of the ovary. “Removing the fallopian tube, in particular the pavilion, would have a preventive effect on the subsequent development of ovarian cancer”.

Ovarian cancer: ovulation, risk factor

Ovarian activity length overexposure to ovarian cancer, birth control pill and pregnancy protect you

Dr Darmon

The specialist points out that “ovarian trauma” is one of the mechanisms evoked at the origin of ovarian cancer apart from genetic mutations. Thus, the more a woman will have ovulation during her life, the more the risk increases. Early first periods or late menopause are associated with an increased risk while pregnancy or breastfeeding are protective factors against ovarian cancer, such as oral contraception but not the IUD which does not prevent ovulation.

Tubal ligation also has a protective effect against ovarian cancer. “The pill, which prevents the woman from ovulating, reduces the number of traumasin the same way as pregnancy, in addition to reducing the risk of endometriosis, which is also a risk factor for ovarian cancer, protects against ovarian cancer. All the factors that will decrease the number of ovulations are protective factors. All the factors that will conversely increase the number of ovulations are therefore risk exposure factors”, assures the specialist.

For Dr. Darmon, “the ideal scheme would be that women protect their sexual activity with oral contraception until pregnancy. This choice has multiple benefits, in particular fertility protection”. Note that the pill taken for a long time can however be a risk factor for other pathologies, which makes the choice complex for women. Increasing age at first pregnancy would also contribute to the increased risk of cancer. “It’s complicated as a gynecologist to tell women that he should not wait to have children, opposes medical concepts and societal developments.

Ovarian cancer: “A peak risk factor around 75 years old”

The decrease in the number of pregnancies and the decline in the practice of breastfeeding contribute to the increased risk since both block ovulation. Only 25% of women breastfeed today and most often for two to three months, against sometimes up to a year in the past. Pregnancy is a protective factor to reduce the risk of ovarian cancer. “The more maternity we have, the more we are protected”, assures the specialist. According to the gynecological surgeon, “societal projects are increasingly deviating from what medicine could recommend”. “Regarding assisted reproduction procedureswe do not yet know if stimulating the ovaries a lot would be a risk factor or not”.

Ovarian cancer: age, physical inactivity and overweight increase the risks

For ovarian cancer, age is also a major risk factor. “Ovarian cancer is a cancer that affects mature women. The average of affected women between the ages of 65 and 70 with a peak frequency around 75 years old”, specifies Dr. Darmon. the menopause treatment is also a likely risk factor. The specialist also blames a sedentary lifestyle and being overweight. In thirty years, ovarian cancer cases increased by 25% approximately, environmental factors have therefore also been implicated. “We have an explosion of obesity among children, boys and girls. The increase in female obesity is dramatic. It is a risk factor for cancer in general and ovarian cancer in particular, an important comorbidity factor“, laments the surgeon.

On the other hand, it is difficult to identify particular foodswhich would be risk factors or conversely foods that would be protective against ovarian cancer. “We would like to say that eating organic food is enough, but other toxic sources (water and air pollution) remain predominant” according to Dr. Darmon. However, according to him “it is tragic to see that many foods that we eat are overprocessed”. The specialist indeed blames the role of pesticides in the rise in cancer rates as well as that of endocrine disruptors. “Smoking is also a major risk factor in cancer for the ovary as for the rest”.

Ovarian cancer: exposure to asbestos and X-rays involved

Other suspected environmental causes of increases in ovarian cancer include X-ray exposure. “People who have been exposed to radioactive fallout or atomic bombs have had a small increase in ovarian cancer.” The gynecological surgeon believes that there is also occupational risk factors. “Depending on where you live, asbestos is still a direct risk factor for those who have worked in asbestos and indirectly for those who live in places with asbestos or who work in habitats that have been asbestos. The risk can also be indirect for women contaminated by their spouses who have worked in asbestos-containing places”.

“Faced with the increase in cases which is multifactorial, we cannot say that the increase does not come from the toxic substances to which we are exposed, from societal changes in terms of pregnancy, breastfeeding, contraception, sedentary lifestyle and power supply. And these are factors on which we could have simple actions”, concludes Dr. Darmon.

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