Our impact on ovarian cancer

Some women inherit genetic changes that put them at greater risk of developing ovarian cancer. Our researchers have played a starring role in uncovering these changes.

In the 1990s, our scientists led the world in tracking down the BRCA1 and BRCA2 genes. Women with faults in these genes have a much higher risk of both breast and ovarian cancer. Thanks to our research doctors can now identify women most at risk, and offer them tailored advice and screening.

An international study led by our scientists in 2009 revealed inherited ‘spelling mistakes’ in the DNA that slightly increase a woman’s risk of ovarian cancer. Discoveries like this will improve our understanding of the disease, and could lead to better treatments.

And in 2011, our researchers showed that rare faults in a gene called RAD51D greatly increase a woman’s risk of ovarian cancer. This is one of the most significant ovarian cancer gene discoveries for over a decade, and further work could lead to tests to identify women carrying the fault as well as treatments that directly target this genetic change.

The search for genes that contribute to ovarian cancer is underpinned by help from families with a history of the disease. In 1991 our researchers set up a database to record information from these families. This invaluable registry now holds details of over 400 families, and is helping scientists to unravel the causes of the disease.

Our researchers also developed clear guidelines to help doctors advise women who have a history of ovarian cancer in the family. This work has given women access to essential information about their inherited risks and how doctors can help to manage these risks.

Thanks to our research, we now understand some of the key risk factors that affect women’s likelihood of developing ovarian cancer. This knowledge is helping women to understand the choices they can make to reduce their risk.

Our scientists provided definitive proof that the contraceptive pill can protect women from ovarian cancer, reducing the risk by up to half1. This research estimated that the contraceptive pill has already prevented many thousands of deaths from the disease, and will continue to help prevent ovarian cancer in the future.

And as part of a worldwide study, our researchers have shown that hormone replacement therapy (HRT) slightly increases a woman’s risk of developing ovarian cancer. This discovery has enabled doctors and the women they are treating to make better informed decisions about HRT. Women are now only advised to take HRT when they have a clear medical need, and for no longer than necessary.

One of the biggest challenges in tackling ovarian cancer is late diagnosis. Many women only discover that they have the disease when it is already advanced, making it more difficult to treat.

Ovarian cancer used to be called ‘the silent killer’ because many people believed that women did not have obvious symptoms until the disease was advanced. But in 2008 our researchers showed that there are clear signs that can alert women and their doctors to the disease2. Identifying key symptoms, such as bloating that persists over time, is an important step towards diagnosing more women at a stage when their cancer is easier to treat.

Screening is another powerful weapon in the battle to diagnose cancer earlier – but currently there is no screening programme for ovarian cancer in the UK. We are helping to fund a pivotal trial of ovarian cancer screening – the largest of its kind. More than 200,000 women nationwide are taking part in the UK Collaborative Trial of Ovarian Cancer Screening, testing whether ultrasound scanning combined with a blood test can help save lives.

Early results are promising, and we await the full findings of this crucial study, expected in 2015. If successful, this research should lead to a national screening programme that will help to detect the disease earlier and save many more lives.

One of Cancer Research UK’s goals is to develop better treatments for cancer with fewer side effects. Our scientists have already made huge strides in developing new drugs to improve treatment for women with ovarian cancer.

In the 1980s, our researchers discovered a chemotherapy drug called carboplatin3, now the ‘gold standard’ for treating ovarian cancer. Since then, carboplatin has helped many thousands of women to live longer lives.

Our scientists went on to develop the ‘Calvert formula’4, a way of calculating the correct dose of carboplatin for a particular patient. This calculation is a central part of treatment with carboplatin, ensuring that each person receives the maximum benefit from the drug. The Calvert formula is now used worldwide, and is named after Professor Hilary Calvert, one of our researchers who helped to develop carboplatin.

And our scientists have led the world in developing a new generation of drugs called PARP inhibitors. These drugs could be used to treat women with ovarian cancer in the future, particularly those with faulty BRCA genes. PARP inhibitors are already showing encouraging results in early clinical trials, and could make a big difference for many women with ovarian cancer in the future.

Although chemotherapy has helped to change the outlook for many women with ovarian cancer, some tumours can become resistant to treatment over time and continue growing.

Our scientists are developing molecular tests which they hope doctors can use to predict how each woman’s cancer will respond to treatment5. Research like this will help to tailor treatment more effectively, and could lead to ways to overcome drug resistance.