There are many risk factors for ovarian cancer–heredity and a high-fat diet among them–but one stands out. A woman’s risk seems to correlate roughly with the number of times that she ovulates during her lifetime. Every time an egg is released, it ruptures the surface of one of the ovaries. Cells have to replicate to repair the damage–and the more they do, the greater the odds that a cancer-causing mutation will occur. Pregnancy, breast-feeding and oral contraceptives all interfere with ovulation–and all three diminish the risk of developing ovarian cancer. “Women on the pill for five years cut their risk by half,” says Dr. David Fishman, director of the Northwestern Ovarian Cancer Early Detection Program in Chicago. Fertility drugs increase the number of eggs released. Some studies suggest that those drugs may boost the risk, but the link is unproven.
The good news is that better tests and treatments are in the works. Researchers at the Cleveland Clinic are developing a blood test that could someday provide an effective screening tool. In one preliminary study it was 90 percent effective in detecting early-stage ovarian tumors. On the treatment side, gene therapies look promising. Scientists at the University of Pennsylvania are hoping to start clinical trials next year on a so-called suicide gene that could be inserted into cancer cells, causing them to self-destruct. The team at Penn is also testing genetically engineered herpes viruses that seek out and destroy ovarian-cancer cells–at least in mice. These innovations may be a decade away from common use. But together, they could rob ovarian cancer of its deadly reputation.
