Dr Rebecca Brooks Gives Expert Advice, Resources for Patients With or at High Risk of Ovarian Cancer

Rebecca Brooks, MD | Image Credit: UC Davis Health

While September is Ovarian Cancer Awareness Month, it's important to highlight research and treatments for ovarian cancer year-round. In the second part of this interview, Rebecca Brooks, MD, told The American Journal of Managed Care^® (AJMC^®) about recent advancements in ovarian cancer care, gave advice for patients at higher risk, and highlighted resources for women with ovarian cancer.

Brooks serves as professor at and division director and fellowship program director of gynecologic oncology at UC Davis Health. Check out part 1 of our interview here.

This transcript has been edited lightly for clarity.

Transcript

AJMC: What are some new developments or advancements in the diagnosis and treatment of ovarian cancer that you think are important to highlight?

Brooks: We've made some really impressive advances in the last several years for ovarian cancer. One statistic that has stuck with me is that we've had more drug approvals and more treatments become available since 2014 than we did in the preceding 60 years combined, so that really shows how much velocity we've been able to accomplish. We've learned to understand the disease better and understand some of the molecular drivers behind ovarian cancer, and we've come up with new classes of drugs. There's a whole bunch of things out now that were not around when I was in training, and it's been really exciting to see this progress.

Some of those things are PARP inhibitors, which are an oral class of medications that can be used and have really great effects, especially in people who have a BRCA mutation. I think we're also starting to understand now that it's important to profile a patient's tumor and try and understand things like homologous recombination deficiency and other molecular drivers of the cancer, and that not all ovarian cancer is created equal. There are a lot of things that can cause it, so if we can identify what those specific things are in each patient, we can potentially find ways to attack that.

Other kinds of exciting drugs are some antiangiogenesis approaches. The way that I describe it to my patients is that chemotherapy usually kills cells that are quickly dividing like cancer cells, and some of the more targeted therapies like angiogenesis inhibition basically blocks the blood vessels [that support tumor growth] and not the cells. How else can we find other ways to block cancer growth, invasion, spread, etc?

AJMC: What advice would you give to women who may be at a higher risk of developing ovarian cancer, such as those with a family history?

Brooks: I'd say 100% get tested. See a genetic counselor or talk to your doctor and have genetic testing done. I see a lot of patients who are afraid of getting tested because they don't want to find out if they have a positive result and they think they'd rather just not know, and if they get this information, they think it's a death sentence. That's not true at all. The whole point of doing the testing is so that we can do things to intervene beforehand, or if you are somebody who has a mutation like BRCA, it's actually kind of a silver lining in some ways because patients with a BRCA mutation oftentimes live longer and the cancer is less likely to develop chemotherapy resistance. We have classes of medication that work great in that group of patients, like the PARP inhibitors that I talked about. Getting tested is really not a bad thing; it's actually an opportunity to understand the cancer better and have more treatment available.

AJMC: Are there any resources or support groups available for women diagnosed with ovarian cancer or their families that you'd like to mention?

Brooks: My favorite one is the Foundation for Women's Cancer. This is a really great organization and I'd encourage all patients to go to the website. They have some really important information and tools, they also have survivor courses intermittently online and throughout the country that you can go to and really educate and arm yourself to understand ovarian cancer better. I think that's a great resource. It's also really important to see a gynecologic oncologist, because there are studies showing that women with ovarian cancer who are treated by a gynecologic oncologist have better outcomes, live longer, [and] are more likely to result in a surgery with no cancer left over at the end of the case. There are just a lot of benefits.

AJMC: How can we proactively support ovarian cancer awareness and research throughout the year, not just during this awareness month?

Brooks: In addition to finding novel treatments for patients, we also want to try and help continue to move the field forward, seeing a gynecologic oncologist if you're somebody who is at risk of or has ovarian cancer, and just finding support in each other.

I'm humbled every day and just touched by the amazing women that I see, and I feel very blessed to be able to take care of a really inspiring and special group of patients that reminds me every day of what's important. I'm just always impressed by their courage and their fight. Things that I would recommend would be don't discount your symptoms, be your own advocate, and never hesitate to ask "Why?" or "What about this?" Second opinions are always out there too. There shouldn't be any ego in medicine, so it's important that you feel comfortable with your provider and your treatment plan.