Ovarian cancer is the fifth most common cause of cancer deaths in women, with more than 22,000 diagnoses and around 14,000 deaths each year in the U.S. alone.
A small percentage of ovarian cancers are hereditary, driven by inherited mutations in genes such as BRCA1 and BRCA2. Most ovarian cancers are “sporadic,” however, meaning they are driven by mutations caused by unknown environmental or behavioral factors or by random mutations.
More than half of all ovarian cancers are serous carcinomas. Clear-cell carcinoma, mucinous carcinoma and endometrioid carcinoma each make up 6 to 10 percent of ovarian cancers. High-grade serous cancers, known as HGSCs, are the most common and most lethal type of ovarian cancer.
If found and treated early, ovarian cancer is often survivable. Unfortunately, many patients are diagnosed with late-stage disease because the symptoms can be easily missed, mistaken for something else or dismissed. Our scientists are working to develop biomarkers, molecules that indicate the presence of cancer, to aid in early detection of this disease.
Surgery and chemotherapy are the most common treatments for ovarian cancer. Radiation may also be used, along with targeted therapies and hormone therapies. Fred Hutch researchers continue to refine these treatments and develop new targeted therapies and immunotherapies for the disease.
Ovarian cancer research at Fred Hutch encompasses a range of studies. We study risk factors and early detection and are identifying new genetic drivers of this cancer. Our work ranges from
the development of new therapies to the use of data from genetic and protein analysis to discern which patients will respond to treatment.
Since most ovarian cancers are found at an advanced stage, much of our work on ovarian cancer is in the realm of early detection. For example, our researchers created an effective symptom-screening tool to expedite ovarian cancer diagnoses.
Oncologists use blood levels of the proteins CA125 and HE4 as biomarkers to detect the presence of ovarian cancer. Drawing on patient data from blood and tissue repositories, Our researchers are seeking out new biomarkers that can improve ovarian cancer detection. We are also studying how to improve the use of imaging to pick up the presence of ovarian tumors.
Obesity has been linked to a higher risk of specific types of ovarian cancer — but not HGSCs, which are the most common and lethal type. Women who have used oral contraceptives have a lower risk of ovarian cancer. Women’s risk also diminishes with their number of full-term pregnancies.
Our epidemiologists continue to explore other factors, including hormonal factors, that influence a woman’s risk of ovarian cancer and how that risk could be lowered. For example, they are investigating whether night-shift work is associated with ovarian cancer, as it is with breast cancer. They are also exploring whether lifestyle factors and medications may help reduce risk of the disease. And they are working to address the poorer cancer care that certain groups — such as the elderly, the economically disadvantaged and communities of color — often receive.
Many ovarian cancers are driven by inherited mutations in the BRCA1 or BRCA2 genes. Our researchers continue to look for new genetic drivers of this disease. They are also studying the ways the body’s immune system responds to ovarian cancer cells and the signaling pathways the cancer cells use.
Not all patients respond to ovarian cancer chemotherapies. Our investigators are using genetic and protein analysis — known as proteogenomics — to predict which patients will respond to these toxic treatments. This new approach may also help to identify new biological targets that can be used against the cancer.
Our researchers are also exploring the potential of immunotherapies, which harness the immune system, to treat ovarian cancer.
Clinical research is an essential part of the scientific process that leads to new treatments and better care. Clinical trials can also be a way for patients to get early access to new cutting-edge therapies. Our clinical research teams are running clinical studies on various kinds of ovarian cancer.
Some families, like Susan Glick’s, seem to be disproportionately affected by cancer. When her mother was diagnosed with stage 4 ovarian cancer while Susan was still in college, Susan became her caregiver. This early experience with cancer — and the multiple cancer diagnoses in her family — helped Susan make prevention and treatment decisions for herself in the years that followed.