Ovaries got me thinkin'

PALB2 is sometimes referred to as ‘BRCA3 (weird right) BTW anything underlined in blue will take you to the research study or website I got the info from.

Risk reducing surgery to remove the ovaries and fallopian tubes should include shared decision making and should rarely be considered before the age of 50

Ovarian cancer prevention

There are several ways you can reduce your risk of developing the most common type of ovarian cancer, epithelial ovarian cancer. Much less is known about ways to lower the risk of developing germ cell and stromal tumors of the ovaries, so this information does not apply to those types.

• The National Comprehensive Cancer Network (NCCN) guidelines recommend that ovarian cancer risk be managed based on family history.

• Some experts recommend risk-reducing salpingo-oophorectomy after age 50 to their patients with PALB2 mutations.

Using oral contraceptives (birth control pills) decreases the risk of developing ovarian cancer for average risk women and BRCA mutation carriers , especially among women who use them for several years. Women who used oral contraceptives for 5 or more years have about a 50% lower risk of developing ovarian cancer compared with women who never used oral contraceptives. Still, birth control pills do have some serious risks and side effects such as slightly increasing breast cancer risk. Women considering taking these drugs for any reason should first discuss the possible risks and benefits with their doctor. (so this is good for the ovarian cancer side of things, as long as you've already taken the necessary steps to try to avoid breast cancer)

Both tubal ligation and hysterectomy may reduce the chance of developing certain types of ovarian cancer, but experts agree that these operations should only be done for valid medical reasons -- not for their effect on ovarian cancer risk.

If you are going to have a hysterectomy for a valid medical reason and you have a strong family history of ovarian or breast cancer, you may want to consider having both ovaries and fallopian tubes removed (called a bilateral salpingo-oophorectomy) as part of that procedure.

Even if you don’t have an increased risk of ovarian cancer, some doctors recommend that the ovaries be removed with the uterus if a woman has already gone through menopause or is close to menopause. Another option for average risk women who do not wish to have their ovaries removed because they don’t want to lose ovarian function (and go through menopause early) is to have just the fallopian tubes removed (a bilateral salpingectomy) along with the uterus (a hysterectomy)

Generally, salpingo-oophorectomy may be recommended for high-risk women after they have finished having children. This operation lowers ovarian cancer risk a great deal but does not entirely eliminate it. That’s because some women who have a high risk of ovarian cancer already have a cancer at the time of surgery. These cancers can be so small that they are only found when the ovaries and fallopian tubes are looked at in the lab after they are removed. (Ovarian cancer is Sneaky)

Research has shown that premenopausal women who have BRCA gene mutations and have had their ovaries removed reduce their risk of breast cancer as well as their risk of ovarian cancer. The risk of ovarian cancer is reduced by 85% to 95%, and the risk of breast cancer cut by 50% or more.

Predicted Risks by Family History

The most parsimonious models included a residual familial component for BC or OC. As a result, the predicted absolute risks of developing BC or OC differed by cancer family history. For example, the predicted absolute risk of developing BC by age 80 years varies from 52% (95% CI, 42% to 62%) for a female with an unaffected mother at age 50 years and unaffected maternal grandmother at age 70 years to 76% (95% CI, 69% to 83%) for a female with two affected first-degree relatives (Table 3). Similarly, the predicted risk of developing OC by age 80 years varies from 5% (95% CI, 2% to 10%) for a female with no family history of OC in first- and second-degree relatives to 16% (95% CI, 8% to 28%) for a female whose mother and sister developed OC at age 50 years

PALB2 mutation carriers had a significantly higher risk of ovarian cancer

• Women with a PALB2 mutation have an increased risk for ovarian cancer. The estimated lifetime risk is between 3 - 5 percent.

Inherited Mutations in Women With Ovarian Carcinoma Mutations in PALB2 are associated with an elevated risk of breast cancer and have been identified in families with both breast cancer and OC29-31 but have not been clearly associated with OC risk.28,29 An analysis of germline mutations in high-grade serous OC from the Cancer Genome Atlas project identified PALB2 as the only gene other than BRCA1 and BRCA2 to be significantly more frequently mutated compared with a subset of ESP controls from the Women’s Health Initiative. The PALB2 mutation frequency in our larger series was significant compared with population rates and was associated with similar odds ratios for OC as RAD51C, RAD51D, and BRIP1

There is no known way to prevent ovarian cancer, but these things are associated with a lower chance of getting ovarian cancer—

• Taking birth control pills. Ovarian cancer risk is estimated to be 50 percent lower in women who’ve taken birth control pills for 5 years or longer. Risk is reduced for years after you stop taking combined birth control pills.. - Yup this is me, Birth control for like 20 years then IUD kind

• Finding alternatives to hormone replacement therapy (HRT). Consider talking with your doctor about alternatives to HRT after menopause.

• Having had a tubal ligation (getting your tubes tied), Tubes tied, way before I knew I had this PALB2 gene, because my mom did it cause Grandmas mom died that way. both ovaries removed, or a hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).

• Managing weight. If you have overweight or obesity, take with your doctor about ways to manage your weight.- don’t have enough fat for the flap procedure so still doing ok with weight despite the covid 20

• Having given birth. Me me pick me, actually does a c-section count as "giving birth"?

• Breastfeeding. Some studies suggest that women who breastfeed for a year or more may have a modestly reduced risk of ovarian cancer. Did this exclusively for 6 months with both kids, then in combo with food for another year.

Would I consider an oopherectomy? yes

would I consider a mastectomy? the sooner the better

Will I be getting my kids the HPV vaccine when old enough?

of course.

The more cures or preventions for cancer the more I will take. I trust the scientific community and if one more uncle Kev or grandma can be saved I’ll do what I can to make it happen.

miss you guys, you were pretty frickin’ awesome

xo