Non-BRCA Ovarian Cancer - Causes, Symptoms, and Management

Introduction

The fatal gynecologic cancer in the Western world is ovarian cancer. Since most instances are first discovered after they have progressed, existing screening techniques are unreliable. The most significant risk factor is family history. Women have a 1.6 percent lifetime risk of acquiring ovarian cancer in the general population. Still, their risks increase to about 5 percent and 7 percent, respectively, if they have one or more first-degree relatives who have the disease. Ovarian cancer is a disease that develops in the ovaries, the female reproductive organs responsible for producing eggs.

While most ovarian cancer cases are related to inherited mutations in the BRCA genes, many cases of ovarian cancer are not associated with these genes. These non-BRCA ovarian cancers are less well-known, but they still represent a significant health threat to women worldwide. In the United States, approximately 22,280 new cases occur annually, and the projected number of deaths for 2016 is 14,240. The annual incidence of ovarian cancer was reduced by two percent for women less than 65 years of age and by 1 percent for women greater than 65 between 1998 and 2008. Although ovarian cancer is caused due to many factors, genetic factors remain on top. This article will discuss the different types of ovarian cancer.

What Is Non-BRCA Ovarian Cancer?

Ovarian cancer can be split into various histological subtypes, each of which has unique clinical characteristics, risk factors, cell origins, molecular makeups, and treatments. These histological subtypes include epithelial malignancies such as serous, endometrioid, clear-cell, and mucinous carcinomas, which make up about 90 percent of ovarian cancers.

Non-BRCA ovarian cancer is a complex disease that can be difficult to diagnose and treat. There are several different subtypes of non-BRCA ovarian cancer, each with its own unique characteristics and treatment options. The following are types of non-BRCA ovarian cancer:

• Endometrioid Ovarian Cancer: In developed nations, epithelial ovarian cancer is the main factor in gynecologic cancer-related fatalities. Because patients frequently present with an advanced stage of the disease, the five-year overall survival rate is low, ranging from 30 percent to 40 percent. Endometrioid carcinoma of the ovary can be connected to endometriosis and frequently manifests in younger women and at an earlier stage than serous carcinoma. This type of ovarian cancer is similar to endometrial cancer, which develops in the lining of the uterus. In addition, endometrioid ovarian cancer is often linked to the presence of endometriosis, a condition in which tissue similar to the lining of the uterus grows outside of the uterus.

• Clear Cell Ovarian Cancer: Ovarian clear cell carcinoma (CCC) accounts for approximately 10 percent of all ovarian carcinomas, with an incidence ranging from 5 to 25 percent depending on geographic, ethnic, or racial factors, with the highest incidence in Asian women. This subtype of ovarian cancer is often associated with a poor prognosis, as it tends to be resistant to chemotherapy. The presence of clear cells in the tumor tissue characterizes clear-cell ovarian cancer. Patients with ovarian CCC usually present with a pelvic or abdominal mass. Ovarian CCC can be detected by clinical and gynecological examination or imaging. Ovarian CCCs are usually large, up to 30cm in diameter, with a mean size of 13–15cm, and are unilateral in more than 90 percent of the cases.

• Mucinous Ovarian Cancer: Mucinous ovarian cancer is the most frequent histological subtype in women under 40 years. The risk factors for mucinous ovarian cancer are nulliparity, early menarche, late menopause, and lack of breastfeeding. This type of ovarian cancer is relatively rare, accounting for only a small percentage of all ovarian cancer cases. Mucinous ovarian cancer is characterized by the presence of mucin, a substance produced by certain types of cells. The prognosis is better in early disease but worse in the advanced stage.

• Serous Ovarian Cancer: This is the most common subtype of ovarian cancer, accounting for around 70 percent of all cases. Serous ovarian cancer can be further divided into high-grade and low-grade subtypes, each with its own unique characteristics and treatment options.

What Are the Causes of Non-BRCA Ovarian Cancer?

The exact causes of non-BRCA ovarian cancer are not fully understood. Several risk factors have been identified. The following are the risk factors of non-BRCA ovarian cancer:

• Age.

• Family history of ovarian or breast cancer.

• Obesity.

• Certain genetic mutations, other than BRCA genes.

• Hormone replacement therapy.

• History of infertility.

• Endometriosis (inflammation of the layer of the ovary).

• Tobacco.

• Nulliparity.

• Post-menopausal women have a 13 % risk of having ovarian cancer.

What Are the Symptoms of Non-BRCA Ovarian Cancer?

The symptoms of non-BRCA ovarian cancer can be similar to those of other types of ovarian cancer. The following are the symptoms of ovarian cancer:

• Abdominal pain or bloating.

• Difficulty eating.

• Feeling full quickly.

• Frequent urination or urgency to urinate.

• Changes in bowel habits such as constipation.

• Pain or discomfort in pelvic areas.

• Abnormal vaginal bleeding or discharge.

• Unexplained weight loss or weight gain.

• Fatigue or low energy.

• Back pain.

• Pain during sex.

However, because non-BRCA ovarian cancer is less well-known than BRCA-related ovarian cancer, it can be more difficult to diagnose. Therefore, women who experience these symptoms should consult with their healthcare provider to determine the underlying cause.

How Can Non-BRCA Ovarian Cancer be Treated?

Treatment for non-BRCA ovarian cancer depends on the subtype and stage of the disease. Surgery to remove the tumor is often the first step in treatment, followed by chemotherapy or radiation therapy. Hormone therapy and targeted therapy may also be options for some patients. Because non-BRCA ovarian cancer is less well-understood than other types of ovarian cancer, patients need to work closely with their healthcare team to develop an individualized treatment plan. In addition, proper treatment intervention and prompt diagnosis are needed for non-BRCA ovarian cancer patients.

Conclusion

Non-BRCA ovarian cancer is a complex disease that can be difficult to diagnose and treat. While it is less well-known than BRCA-related ovarian cancer, it still represents a significant health threat to women worldwide. The tumor stage is the most important prognostic factor for the ovarian cancer patient. The emerging new treatment therapies for non-BRCA ovarian cancer gives excellent prognosis. By understanding the different subtypes of non-BRCA ovarian cancer and the risk factors and symptoms associated with the disease, women can work with their healthcare providers to develop a personalized treatment plan that meets their individual needs.