Miss USA Supports Ovarian Cancer Awareness
By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.
Miss USA Susie Castillo is representing the United States in the annual Miss
Universe pageant. Whether or not she gets that crown, she'll still be a winner.
Castillo knows that her health is far more important in life.
That's why Castillo and the Miss USA organization are helping promote ovarian
cancer awareness through a partnership with 1-800-Flowers.com and the joint
sponsorship of the annual Bring Your Mom to Work Day. The event held every May
has raised nearly $150,000 for ovarian cancer research.
"Breast and ovarian cancer awareness are the official causes of Miss USA,"
Castillo says. "I am the fifth title holder to promote this cause. I'm working
with the Ovarian Cancer Research Fund to help raise money and awareness."
"Ovarian cancer affects so many lives each year," Castillo says. "Not just
the women who have the disease but their families as well. With the support
of companies like 1-800-Flowers, we can facilitate the advance of ovarian cancer
research and save the lives of thousands of women across our country."
The most serious of the female reproductive malignancies, ovarian cancer kills
approximately 14,500 of the estimated 25,000 women who are diagnosed every year.
According to the OCRF, a woman's lifetime risk of developing ovarian cancer
is 1 in 55.
Ovarian cancer usually develops in the thin layer of cells covering the ovary.
As the tumor grows and the ovary swells, cancer cells shed into the abdominal
cavity and can spread to other intra-abdominal organs.
And virtually all the time, this cancer develops silently -- without symptoms.
"There are often no obvious symptoms so we really need to increase understanding
about ovarian cancer," Castillo notes. "Most ovarian cancer patients catch it
too late. This is a really frustrating and terrible disease because there is
no screening for it."
"The most important thing for women is to know your body," Castillo adds. "Because
ovarian cancer is a silent killer, women need to be almost intuitive about their
body and any changes they feel."
"Unfortunately, most of the women are diagnosed with advanced disease," says
Andrew Berchuck, a cancer specialist and professor of gynecologic oncology at
Duke University Medical Center. "With improved surgery and chemotherapy women
are living longer but we're really not curing a lot of people. The ultimate
survival rate is still pretty poor."
The OCRF reports that less than 46% of all ovarian cancer patients survive
more than five years after diagnosis. But like all cancers, survival rates increase
dramatically if the disease is detected and treated early. The five year survival
rate is 95% given a timely diagnosis.
"The biggest problem is we don't have a screening test," Berchuck notes. "We
don't have the means of identifying the high risk population. We have a long
way to go here. For the women who do have a strong family history, genetic testing
is certainly recommended - but that is a small minority of women."
The good news for those 10% of patients with the hereditary form of ovarian
cancer is researchers have identified two genes - BRCA 1 & 2 - responsible
for this type of malignancy.
"The identification of BRCA 1 and 2 as genes responsible
for hereditary ovarian cancer is very exciting," Berchuck says. "We can do genetic
testing in families and this may give us the opportunity to prevent ovarian
cancer. In women who carry these mutations, the ovaries can be removed at about
age 40 prior to the development of ovarian cancer."
Other possible risk factors besides a strong family history of breast or ovarian
- Use of fertility drugs
- Talcum powder on sanitary napkins
But certain factors decrease the risk of ovarian cancer including:
- Use of oral contraceptives
- Tubal ligation, a sterilization procedure to prevent pregnancy
- Hormone replacement therapy
"One of the most important points is that many women don't understand the protective
effect of the pill," Berchuck stresses. "Women need to understand that oral
contraceptives have an additional side benefit of some ovarian cancer protection."
"We know from epidemiologic studies that birth control pills and pregnancy
are profoundly protective against ovarian cancer," Berchuck explains. "One of
the focuses of our research is to understand at a molecular level why pregnancy
and the pill have this effect."
According to Berchuck, a woman who has three children or uses the pill for
five years has half the ovarian cancer risk.
"That's pretty dramatic," Berchuck says. "We need to understand what is happening
at the molecular level and learn to exploit it better. We think it's a direct
effect to some extent of the progestin on the ovaries."
Progestin is the hormone produced by the placenta during pregnancy. Half the
birth control pill is progestin, the other half is essentially estrogen.
While much of the ovarian cancer news can seem bleak, Berchuck puts a positive
spin on it.
"Twenty years ago the average woman with ovarian
cancer only lived about a year and a half," Berchuck says. "Now they are living
about 3.5 - 4 years because the surgery and chemotherapy has gotten a lot better.
And we're learning a lot about the genetics of ovarian cancers. There is definite,
measurable progress occurring in our understanding of the disease."
While Berchuck readily admits there's still a long research road ahead, he
credits OCRF as having been instrumental in raising money for ovarian cancer
research. Over the past few years OCRF has annually funded about $1.25 million
Castillo is hopeful that a cure will emerge.
"This year's Bring Your Mom to Work Day was a lot of fun and it's something
I encourage everyone to do," Castillo says. "But even though the events are
over we need to care our mothers and our own health every day. I hope people
will contribute throughout the year so that hopefully we can find a way to screen
for the disease and ultimately a cure."
• Ovarian Cancer Research
• American Cancer Society
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Created: 6/5/2003  - John Morgan & Stephen A. Shoop, M.D.
Reviewed: 6/5/2003  - Donnica Moore, M.D.