Key to detecting ovarian cancer early may be in the fallopian tubes

A lack of early detection or prevention strategies for ovarian cancer is a major cause of poor outcomes for patients, and most do not have a family history or inherited genetic risk, so there is a pressing need for the development of earlier detection methods.

According to the American Cancer Society, ovarian cancer is the fifth leading cause of cancer in women, accounting for more deaths than any other cancer of the female reproductive system. Impacting as many as 250,000 women each year, ovarian cancer is referred to as a silent disease because most women do not experience symptoms until its later stages. But when caught early and before the disease spreads, 90% of women can be cured. Late stage ovarian cancer, where the disease has spread beyond the ovaries, is more difficult to treat, and survival rates are low for patients.

A doctor talking with a patient.

Early detection of breast cancer is possible due in large part to screening methods including mammograms, self-breast exams, and annual visits with a doctor. While ovarian cancer is not as common as other women’s cancers, a lack of early detection or prevention strategies is a major cause of poor outcomes for patients. For some, knowing family history and seeking out genetic testing to identify mutations in genes such as BRCA1 and BRCA2 is one way to detect risk for this cancer early. But most people with ovarian cancer do not have a family history or inherited genetic risk, so there is a pressing need for the development of earlier detection methods.

Penn Medicine’s Ovarian Cancer Research Center (OCRC) serves as a catalyst to promote comprehensive and interdisciplinary research on ovarian cancer. The center is focused on understanding how ovarian cancers begin, and translating those insights into potential approaches for early detection and ovarian cancer therapies. What’s more, the OCRC recently received a new $2.8 million grant from the Department of Defense (DoD) to further these efforts.

In the past, most doctors and scientists naturally assumed that ovarian cancer develops in the ovaries. However, about fifteen years ago, Penn researchers helped make an exciting discovery and found that the most common and deadly form of ovarian cancer, called high grade serous carcinoma (HGSC), actually often begins as tiny groups of abnormal cells in the fallopian tube. These “precursor lesions,” called serous tubal intraepithelial carcinomas (STICs), are so tiny that they can only be found by careful, microscopic examination of the fallopian tubes. Ever since this discovery, Penn has been dedicated to studying STICs and how these cells eventually spread to the ovaries where they can quickly form tumors that further spread to the rest of the body.

Learning about STICs lesions themselves is the beginning. Now, with support from the DoD grant, Penn experts are studying how STICs interact with surrounding tissues, and why they form in the first place.

“For a long time experts studied the ovaries in the hopes of finding answers to assist with earlier diagnosis and detection of ovarian cancer, so knowing that these tumors start in the fallopian tubes opens up so many possibilities for prevention and detection, which can have a tremendous impact on standard of care for these patients,” says Ronny Drapkin, director of the OCRC, an associate professor of pathology in obstetrics and gynecology, and a gynecologic cancer researcher with the Basser Center at Penn.

“It’s important for individuals with a family history of cancer to get tested. While those who have mutations are considered high risk for developing breast cancer and ovarian cancer, not everyone who inherits these genes will get cancer. Furthermore, once they have this knowledge, patients can make plans to help lower their risk,” says Susan Domchek, executive director the Basser Center for BRCA at Penn. “Knowing that there is risk means you can choose different types of surveillance or prevention options to decrease your chances of developing and dying of cancer.”

Read more at Penn Medicine News.