A Geneticist Looks at Ovarian Cancer

A geneticist looks at ovarian cancer with a perspective that is different from a gynecologist or gynacologic oncologist. The primary focus of the geneticist is on the process of cancer development and not on its diagnosis and treatment. In ovarian cancer, a mutation can be inherited or developed spontaneously in the somatic target cell, known as an ovarian epithelial cell. The inherited change or the initial mutation commonly known as first hit, occurs by itself and is insufficient to produce malignant transformation of the target cell. Additional gene changes occur, before the ovarian epithelial cell becomes transformed and continues to divide to produce the cancer. Though the first hit is generally within a family and can be transmitted to successive generations, the subsequent gene changes contributing to malignant transformation are different in different family members. The differences in the patterns of mutations thus accumulated, contribute to the variations seen in the ages at which cancers develop within families. Genetics provide us with a tool that helps in identifying persons and families at highest risk to develop certain diseases, including several cancers. The chapter provides opportunities to institute surveillance, preventive treatments, and prophylactic surgeries that can reduce the clinical consequences for high-risk individuals and families. With advancement in research knowledge of the genetic basis of diseases can lead to new approaches to treatment.