Q: My mother has had ovarian cancer and I understand it can be genetic. Should I have a preventive hysterectomy? Also, is the same gene involved in breast cancer, and would it be wise to have a mastectomy too? I’m 38.
A: The main potentially faulty genes are called the BRCA genes (BRCA 1 and BRCA 2). These inherited mutations occur in a small minority of cases of both ovarian and breast cancer. They account for about ten per cent of ovarian cancers, and five to ten per cent of breast cancer in white women. (Women from some ethnic backgrounds, such as Ashkenazi Jews, have a higher risk.) If your mother had a faulty BRCA gene, you have a 50/50 chance of inheriting it, explains Dr Emma Pennery, clinical director at Breast Cancer Care. ‘In the light of your
family history, if you inherit a faulty copy of either the BRCA 1 or 2 gene, it does increase your risk of developing both ovarian and breast cancer.’
Inheriting a faulty BRCA1 gene means the lifetime risk of ovarian cancer is 40 to 60 per cent (30 per cent for BRCA 2). Gynaecological oncologist Dr Sean Kehoe, medical advisor for Ovacome, says: ‘If one close relative has ovarian cancer, there is a slight increased incidence in other family members when compared to the overall population, but it is very small. Ovarian cancer is the fifth most common cancer in women in the UK, but it is still relatively rare, with 14 women in 1,000 being diagnosed.’ The lifetime risk of breast cancer if you inherit BRCA 1/2 may be higher, at up to 85 per cent compared to ten per cent for women without the faulty gene.
If your mother developed ovarian cancer before menopause it may suggest she inherited a faulty gene. This is more likely if other close members of your mother’s family have had breast or ovarian cancer.
Do discuss the situation with your GP, who will be able to assess your likely risk, in light of your family history, and if necessary refer you to a cancer geneticist for a more detailed assessment, a gene test and counselling about possible options regarding your individual situation. The first gene test is done on an affected relative to identify the mutation, before testing other unaffected relatives.
If the gene test is positive, risk-reducing surgery may be offered. ‘This means removing the ovaries and tubes and/or bilateral mastectomy,’ explains Dr Pennery. ‘Expert counselling is important because there are implications in terms of body image, fertility and relationships.’
Research into the value of screening for ovarian cancer is ongoing. According to Ovacome, it is not known whether screening for ovarian cancer makes a difference.
Helpful organisations include Breast Cancer Care (Freephone: 0808 800 6000, breastcancercare.org.uk), the Eve Appeal (eveappeal.org.uk) and Ovacome (tel: 0845 371 0554, ovacome.org.uk).
Shoulder The Pain
My column answering a reader’s query on a frozen shoulder elicited a big response. Advice included using physiotherapy, heat pads, hot-water bottles and wheat packs, the Bowen technique (bowen-technique.co.uk) – a gentle system of body balancing – and therapeutic yoga
(iyengaryoga.org.uk). Others recommended swimming, stretching in the shower and chiropractic: ‘I learned exercises and the chiropractor
manipulated my shoulders into complete mobility’(chiropractic-uk.co.uk).
Website Of The Week
About now I start fretting about hay fever. So I was delighted to see that the Healthy House, a favourite website, has launched new hay fever ‘solution packs’ for different situations. They offer hefty discounts and save you trawling through lots of products. The Out and About Hay Fever Pack, £19.80, contains a Sinus Buster homeopathic nasal spray, HayMax pollen trapper (for the base of your nose) and pharmaceutical mask. There are also packs for small bedrooms/offices (up to nine square metres), £75.32, and larger rooms (up to 19 square metres), £145.07, which include allergy sprays and air purifiers.
There’s more good news on the healthy choccy front. We’re tucking into daily Ohso probiotic chocolate bars, which claim (on clinical evidence) to be three times more effective at delivering your daily dose of ‘good’ bugs (about a billion lactobacillus and bifidobacteria) than probiotic drinks. They’re dairy-free, only 72 calories, based on really delicious darkish Belgian chocolate, and come in packs of seven bars, £3.95, from Harvey Nichols foodmarkets nationwide and harveynichols.com.