General Question

livelaughlove21's avatar

Family history of ovarian cancer - precautions?

Asked by livelaughlove21 (15623points) March 11th, 2014

*Sorry this is so long!

My biological father left when I was six and I haven’t seen him since, so I never knew anything about that side of my family. My mother’s side seems to have quite a few medical ailments, but never two of the same thing – my grandmother had breast cancer at the age of 70 and survived, my aunt died of cervical cancer, my great aunt died of a brain tumor, another great aunt had stomach cancer and is currently undergoing treatments, and many of the older women have problems like chronic pain and arthritis.

My biggest fear is breast cancer. I have always had sore breasts, but my anxiety goes up every time I have any sort of sensation there. Every few months, as some of you know, I have a “I’m dying of cancer” episode before I force myself to chill out (usually by going to the doctor and leaving feeling stupid that I ever went). I’m told that, since my grandmother’s breast cancer was post-menopausal, it’s not considered to be genetic. I also know most breast cancer patients have no family history, but it’s a risk factor nonetheless. I always wondered whether any women on my biological father’s side had breast cancer or died from it.

My husband and I told my mother recently that we plan on trying to conceive our first child in the next year or so. She decided to call my father’s sister and ask about their family medical history. No breast cancer, yay! However, strokes and heart disease seem to be a trend on that side and my paternal great-grandmother and aunt both died of ovarian cancer. Hopefully our kids will take from my husband’s side when it comes to medical issues. They’re all incredibly healthy and live long lives.

Now, I know what I can do to avoid problems like high blood pressure and heart disease (diet and exercise) and, if it’s unavoidable, there are medications that can be effective. However, I started to think about the ovarian cancer and realized that, unlike breast cancer, I know next to nothing about it. I looked it up and found out that only 15% of cases are diagnosed in early stages and late stage ovarian cancer has a 25% survival rate. No bueno. I also discovered that there are really no tests that can be done routinely to catch ovarian cancer early enough to treat it easily, and pap smears don’t test for that.

I’ve heard of people with strong family histories of breast cancer having their breasts removed in order to avoid the nearly inevitable diagnosis. Do people do this with their ovaries as well? Is my family history with this cancer even strong enough to consider such a thing? What precautions can I take to avoid a late stage diagnosis in the future? If I did have my ovaries removed, what effects would that have on my body? Would I need hormone replacement?

I’m not suggesting having my ovaries removed anytime soon. This is just something I’m wondering about and I’d like to see if anyone here had some input. Of course I’ll talk to my OBGYN about it, but this isn’t pressing enough to call for a visit and I won’t see him again for a few months.

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29 Answers

Coloma's avatar

Kiddo….you MUST get a handle on your health anxieties, or, you are going to MAKE yourself sick!
Talk to your doctor about your fears and don’t borrow trouble when none exists!
You are in your early 20’s and the odds of any serious illness befalling you at this time of life are very minimal.
STRESS IS THE #1 killer, and at the rate you’re going you will be dead by 40 if you don’t get a grip on your hypochondria!

livelaughlove21's avatar

@Coloma I tried pretty hard to make sure I didn’t come off as freaking out about this, because I’m not. It’s not stressing me out, but that doesn’t mean I shouldn’t think about it and know what to look for. I know that it’s very unlikely I’ll develop ovarian cancer right now. I’m asking about the future and what I should be doing from now until then.

janbb's avatar

Yes, I have a cousin who had a prophylactic hysterectomy because her Mom died of ovarian cancer. But that was well after her childbearing years.

livelaughlove21's avatar

@janbb But that was well after her childbearing years.

Of course. Just to be clear, I never meant to suggest my undergoing this surgery anytime soon.

KNOWITALL's avatar

Are there tests that can be done at any point to clear you from that particular worry right now?

livelaughlove21's avatar

@KNOWITALL It doesn’t appear so. They said sometimes a lump is felt during a gynecological exam, but usually not until late stages. A tumor can also be seen on an ultrasound or CT scan, but those aren’t exactly routine tests. There’s a blood level (some type of antigen I think) that is usually elevated in ovarian cancer patients, but research does not show that any particular test makes a difference in survival rates in the long run.

And again, there’s no worrying going on right now. I wouldn’t do a test for ovarian cancer at my age with no symptoms even if there was one out there, unless told to do so by a doctor.

janbb's avatar

@livelaughlove21 I understood that.

skfinkel's avatar

If you have been following all the talk in the paper about mammograms, you can see that much (or some) of what we were told was breast cancer was tiny little things that would not harm us—but the damage from the results of all testing and worry and even unnecessary treatments was worse. Your anxiety about all this I would also put in the category of side effects of a damaging campaign of breast cancer “education.” Eating a good diet (ie avoid bad fats and sugars) and no smoking will probably be the best thing you can do for yourself. Nursing a baby for a good long time has also been shown to correlate with lower cancer rates. But the high anxiety you have about this is something to confront and deal with. Don’t waste your time on worrying about breast cancer.

Juels's avatar

You mentioned that you’re planning to start having children soon. Studies indicate that pregnancy and breastfeeding may reduce your risk of breast cancer. There is still controversy on the subject, but why not err on the side of caution?

I find the best way to control my anxiety is to do something about it. Go for regular check-ups (pap smears, mammograms), eat well, exercise, and don’t smoke.

livelaughlove21's avatar

UPDATE: So, my mother just told me that my great grandmother was diagnosed in her early 80s and my aunt was diagnosed in her early 70s (yes, my dad is much much older than my mother – he’s closer to my grandmother’s age than my mom’s). Psht, at that age, you gotta die of something, right?

janbb's avatar

@livelaughlove21 Yup – don’t worry about it.

OpryLeigh's avatar

Firstly, my doctor told me the same thing about the breast cancer history in my family. My grandmother had it after going through the menopause and my doctor told me, because of this, I have the chance of getting as someone who had no immediate family history of the disease. I’m pleased to hear this from another doctor (ie: through you)

My great (maternal) grandmother survived ovarian cancer in her late 70s/early 80s. I have often wondered (although it doesn’t concern me as much as it seems it does you) if I am any more likely to get it because of this. This doesn’t answer your question, sorry, but I am interested to read what others think.

GloPro's avatar

About 8 years ago I dated a man that was battling testicular cancer. Every single man in his family had died of testicular cancer before the age of 50. His father, brother, uncle… And his cousin while he was battling it himself. His mother is the strongest person I have ever met.
He had one testicle and 40 lymph nodes along his torso removed, went through radiation and chemo, had a port for administering meds, the works. He never lost hope. He researched cancer and diet and began juicing to combat the growth of cancer cells. He is the only man in his family to beat testicular cancer and has been in remission for 7 years.
He just turned 40 this year.
We parted ways right as he found out he was in remission. About a year later he got married. I spoke to him once while his wife was pregnant, and he shared his fear of having a son with me. I could not imagine how he felt inside. But in the end he voiced that life is for the living. Some are blessed with wonderful lives that end early. Some have shitty lives and die of old age. Whatever your timeline has in store for you, you should live for the sake of living. Sure, modify your diet and exercise to stay ahead of the game, but worry does nothing.
Jay had a son. He’s 6 now, and it’s pretty much a sure bet that at some point he will face testicular cancer. But Jay beat it, it is possible, and now he has an amazing son. I think it’s worth the risks and consequences.

JLeslie's avatar

I think you should get the BRCA test. That genetic mutation is associated with both breast cancer and ovarian cancer. The only reason in my opinion (non medical opinion) to get your breasts or ovaries removed prophylacticly is if you are positive for one of those genes. Even then I would not do it until age 40 or later. That’s my opinion mind you, don’t take it like a doctor recommending it to you. Right now you are too young to obsess about it, even though of course there are women who get these cancers younger than age 40.

BRCA used to be quite expensive and not covered by insurance all too often. The price might have come down because one, possibly their patent is expired; or two, laws are beginning to change regarding the right for a company to own a gene sequence. I don’t know where the testing stands now. If the price is still high it should hopefully come down soon regarding the patent, and you could get the test then. You will still be reasonaly young.

Ovarian cancer typically is discovered late because women dismiss the symptoms and even doctors do, and there has been little effort to get the word out about ovarian cancer. Things like back pain, cramping, bloating, and some others can easily be mistaken for other illnesses.

My opinion is have babies young. I say this to everyone, even people not worried about cancer. Once you know you want children, feel secure in your marriage, and reasonably secure financially, go for it. Having the ability to have children taken away is not fun to deal with. Anyone can have fertility trouble.

As far as cervical cancer in your family, don’t worry about that just get your yearly pap.

I remember that you try to eat healthy and exercise, so you already probably have that working in your favor compared to your relatives. If any of them smoked they increased their cancer chances by a lot.

livelaughlove21's avatar

@JLeslie My opinion is have babies young.

What do you consider young?

non_omnis_moriar's avatar

Ask your doctor for DNA testing. If you carry the genes for ovarian cancer, breast cancer talk about options.

gailcalled's avatar

Dr. Joel Furhman sums up the current common sense anti-cancer way of eating. Add exercise and stop worrying. (This way of eating permits no animal protein of any kind, no dairy, no sugar, no coffee and limited amounts of fats and oil. It includes complex carbs.)

“Eating large quantities of high-nutrient foods is the secret to optimal health, disease prevention and maintaining a healthy slim waistline. The health equation describes a way of eating that is truly a longevity diet, yet it effortlessly has you achieve an ideal weight and it is an anti-cancer and anti-heart disease diet-style.

A typical anti-cancer diet should contain at least 4 fresh fruits daily, at least one large raw green salad, as well as a two other cooked (steamed) vegetables, such as broccoli, carrots and peas, squash or other colorful vegetables. A huge pot of soup laden with vegetables, herbs and beans can be made once a week and conveniently taken for lunch. Raw nuts and seeds are another important, but often overlooked, group of foods with documented health benefits contributing to longevity.” Source

Another very similar approach

non_omnis_moriar's avatar

23andme competed with doctor’s charging for only BRCA test and provided a lot of data about inherited problems but FDA stopped it from testing for medical.

I have Jewish ancestry plus breast cancer on two sides of my family but I do not carry the genes. You have pay now for just the BRCA but it’s worth it.

livelaughlove21's avatar

@gailcalled This way of eating permits no animal protein of any kind, no dairy, no sugar, no coffee and limited amounts of fats and oil.

This is going to sound awful, but I’d almost rather get cancer one day than give up meat, dairy, and coffee.

gailcalled's avatar

Your choice. How much fun is the constant obsessive worrying?

JLeslie's avatar

@livelaughlove21 As young as you feel comfortable. I obviously cannot decide anything like that for you. For me, I got married at 25 and tried at 27. I became pregnant first try and then miscarried and there is the beginning of my infertility story. Cancer treatments can leave women in fertile. An accident can leave you with no uteris. Any host of things can go wrong that affects fertility. Still, the vast majority of women are fertile and have no trouble, and most people don’t have major health issues until much later in life. So, you have to weigh the odds and decide.

Like I said, if you know you want children then I feel sooner better than later, but if you are unsure or feel not ready for children then certainly don’t do it now. I just would not postpone kids for a significant amount of time for a career. That’s me personally, everyone has to make their own decision for their own life. I have no idea how you look at it regarding being ready, career, finances, etc. I’m not assuming anything about you or your situation.

I would say definitely before age 35. 35 is when fertility typically starts to decrease in all women, although it varies. It also is when genetic problems start to increase in numbers width being aware of. If your mom went through menopause young that might be something to consider.

I don’t remember how old you are? Aren’t you still in your 20’s?

livelaughlove21's avatar

@gailcalled It’s not nearly as constant as people here seem to think it is.

@JLeslie I’m 24. I plan on being done having kids (we’d like two) by 30. We’ll see.

JLeslie's avatar

@livelaughlove21 if I remember correctly you are just getting above water financially again after your husband having reduced hours at work and you were out of a work for a while. I might be confusing you with someone else. The little I know about you from fluther I feel like it will all fall into place. You’ll pay off the debt you have looming, start saving, get a nice nest egg and a year or so under your belt at your job, and then maybe start trying for a baby. That would fit with your two by age 30 scenerio. Or, it might stretch to early 30’s, but that is still young for your last child.

livelaughlove21's avatar

@JLeslie I don’t believe you’re thinking of someone else, but we’re firmly above water financially. We had a brief moment of feeling overwhelmed toward the end of my last semester of school, but we were never truly as broke as we felt. If we went under $2000 in the bank, I’d start to consider us broke and worry. Silly if you think of how most college students live. But we’re fine now. Down to only one credit card balance and three months until my first student loan payment. We could support a baby now but like you said, I’d like to get some time under my belt at work. I figure if we start trying toward the end of the year, I’ll have been there for a year by the time we get pregnant (if it happens quickly). So just shy of two years once I have to take leave, assuming there’s no bed rest in my future.

Buttonstc's avatar

I’m certainly not trying to add to your worries, but have you and your husband been tested for HPV? This is something proactive you can do rather than needless worrying.

The correlation between HPV and many types of cancers (especially gynecological cancers) is very high.

You might also consider getting the HPV vaccination. Talk to your MD about it.
The World Health Organization (WHO),[10] as well as public health officials in Australia, Canada, Europe, and the United States recommend vaccination of young women against HPV to prevent cervical cancer, and to reduce the number of treatments for cervical cancer precursors.[11]

Worldwide, HPV is the most common sexually transmitted infection in adults.[3] For example, more than 80% of American women will have contracted at least one strain of HPV by age fifty.[12][13][14][15]

80% is a pretty high number. Hopefully you’re in the 20%. Wouldn’t it be nice to know that?

JLeslie's avatar

@Buttonstc Men don’t get tested for HPV. They can be tested on their anus and tongue, but it is almost never done except for HIV positive men usually. The OP could have been exposed to HPV and come up negative in the test, because the test takes cells from the cervix and if it is latent it will come up negative. It doesn’t mean she won’t have a bad pap smear or be positive for HPV a year later. Basically, all women have to assume they have been exposed to HPV and get regular pap smears. I’m waiting for doctors to test our anus and mouth also, I wish they did.

livelaughlove21's avatar

@Buttonstc I got the vaccine as a teenager.

JLeslie's avatar

@livelaughlove21 You still need to get pap smears. I’m sure you know that. The vaccine covers some of the worst of the HPV strains known to cause cancer but there are bunches and bunches of HPV strains.

livelaughlove21's avatar

@JLeslie Of course. I get them every year, like clockwork. I’ve never had an abnormal pap.

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