• Dr. Karuna P. Murray

    Dr. Murray specializes in caring for women with gynecology and oncology concerns. Dr. Murray and her staff understand the anxiety and fear that is associated with these diagnoses. Women's Oncology Care provides comforting and compassionate care.
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  • Centrally Located

    The office of WOC is easy to get to. We are conveniently located near Mason Road and I-64/40. Our office is in the North Tower of the Walker Medical Building. We have provided detailed directions to help you find us easily.
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  • Caring For You

    Caring for you is our Top Priority at Women's Oncology Care. Through Compassion, Respect, and Education we are making positive influences for those in our care. We have provided a page of Empowering Knowledge especially for you.
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  • Friendly Staff

    Our helpful and friendly staff will help you on your path to well-being. We know you may have questions concerning your treatment, health and how Women's Oncology Care can help you. We are here to provide answers to your questions and to make your treatment a positive experience.
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Womens Oncology Care: 12855 North Forty Drive • Suite 325 North Tower • St. Louis, MO 63141 • Phone: 314-989-9244 • Fax: 314-989-9336

Genetic Testing for Ovarian Cancer

Ovarian cancer is the number one gynecologic cancer killer in the United States. Approximately 22,000 women will be diagnosed and nearly 16,000 women will die from the disease. One in five ovarian cancer patients is likely to be cured.

Currently, however, no test exists that allows cancer to be detected in its earliest stages. Complicating the diagnosis of ovarian cancer are the subtlety of symptoms such as bloating, pelvic and abdominal pain, urinary symptoms and early feeling of fullness when eating that lead to diagnosis usually in later stages.

During the 1990's the BRCA1 and BRCA2 genes were discovered. These genes contain protein that regulate the cells life cycle. When these genes are defective (or mutated) there is an increased risk for developing breast and/or ovarian cancer. It is estimated that 5 to 10 percent of ovarian cancers result from mutations in the DNA that are inherited. BRCA1 and BRCA2 are the most common mutations associated with hereditary breast and ovarian cancer. These mutations can be sporadic, meaning they occur spontaneously, or inherited from one or both parents.

BRCA mutations only occur in about one in 500 people in the general population. Testing is generally advised for high-risk patients - those with two or more first- or second-degree relatives who have ovarian cancer, early onset breast cancer (before the age of 50), breast cancer affecting both breasts, or male breast cancer. A family pedigree or family tree identifying those relatives affected by cancer and at what age can be helpful in determining risk.

Genetic counseling is necessary prior to performing genetic testing. Such counseling helps the individual psychologically to deal with unwanted results, and understand positive results are not a death sentence. Not everyone with the mutation will develop cancer, but by identifying individuals with the mutation measures can be taken to reduce the risk and identify the disease early. Individuals must understand that genetic testing only determines if an individual carries the mutation. If the test is negative, it does not mean the individual is without risk of developing ovarian cancer.

Patients must consider several issues when deciding to undergo genetic testing. Many health insurance carriers cover BRCA testing when indicated there are concerns about genetic discrimination. There are protections against such discrimination and to date there have been no cases of genetic discrimination identified. The knowledge gained by testing can provide a sense of empowerment and the initiation of preventative and early recognition practices such as:

Intensified screening including pelvic exams, ultrasound studies, and measurements of CA125. The National Comprehensive Cancer Network recommends transvaginal ultrasouns and CA125 every 6 months starting at age 35 or five to 10 years earlier than the age of the youngest family member diagnosed with ovarian cancer. Studies have shown that intensified screening has led to earlier diagnosis in women at increased risk for ovarian cancer.

Chemoprevention in the form of hormonal contraception or birth control pills. This should be discussed with your physician since birth control pills can increase your risk of other health problems such as blood clots especially if you smoke. Also, some studies have shown that in women with the BRCA mutation there may be a slightly increased risk of early breast cancer and women with the BRCA mutation are already at a higher risk of developing breast cancer.

Prophylactic surgery by removing both ovaries (bilateral salpingoophorectomy or BSO) may be the most effective way to reduce the risk of ovarian cancer. Occasionally, when women undergo a prophylactic BSO the ovaries have been found to contain an early cancer. The BSO does not prevent 100 percent of ovarian cancers, but the reduction in risk is probably greater than 95 percent. Usually it is recommended that women who have this procedure also have the uterus and fallopian tubes removed as well. This procedure can often be performed laparoscopically through three small incisions on the abdomen/pelvis making surgery and recovery quicker. Women who have this procedure will no longer be able to have children and will experience menopause.

Adapted from an article by Krishnansu S. Tewari, MD, FACOG, FACS

WOC Services

Chemotherapy
Colposcopy
Consultations/Second Opinions
Coordination of Hospice Care
Coordination of Radiation Therapy
Surgical Procedures
Minimally Invasive Robotic Surgery

Accepted Insurance Plans

AARP Medicare Complete
Aetna
Anthem
Blue Cross Blue Shield
Care Management
Champva
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