Most forms of ovarian cancer are considered deadly because of their poor survival outcomes. In addition, the most effective method of prevention is currently drastic surgery in which women have their ovaries and reproductive organs removed, which prevents them from naturally conceiving a child and also means they immediately start to go through the menopause.
As ovarian cancer often presents at a late stage it is difficult to study how ovarian cancer develops at the very earliest stage, explaining why there are currently no tests available to detect the disease early.
However, new research from the Department of Women’s Cancer at University College London (UCL) represents a significant step forwards in uncovering how ovarian cancer develops in women, opening up new opportunities for ovarian cancer prevention.
In the study, Professor Martin Widschwendter, Head of Department of Women’s Cancer at UCL, and colleagues, examined tubal tissue from women who have a BRCA gene mutation that increases their risk of developing the disease and those without the genetic mutation. For each woman, the researchers compared tissue from opposite ends of the Fallopian tube, i.e. they compared the end of the tube that is nearest to the ovary with the end that is nearest to the womb. They discovered altered subcellular events in the tubal cells close to the ovary only in women with the genetic mutation, but not in women without the BRCA genetic mutation. The events affected the cells in two ways: 1) by ‘re-setting’ the cells such that they have the capacity to develop into multiple cell types other than tubal cells, and 2) by increasing the production of a protein within the cells that is known to cause damage to DNA. Importantly, the subcellular changes that were specific to the tubal cells from women with BRCA gene mutations were also seen in ovarian cancer cells.
The study is important as it tells us more about the earliest stages of ovarian cancer development. Additionally, the cellular events discovered are also potentially reversible because they are not engrained within the DNA code, which would be very difficult to correct. Instead, they could be corrected by clinical drugs and therapies that would offer less drastic means of prevention, i.e. an alternative to surgical removal of the Fallopian tubes and ovaries in women at high risk of the disease.
The next steps for Professor Widschwendter and his team include looking at whether it could also benefit women who do not have a BRCA gene mutation through a non-invasive test which could potentially predict the occurrence of these cell changes in the Fallopian tubes – bringing us a step closer to understanding how ovarian cancer develops both in those carrying the BRCA gene mutation and in those without the mutation.