Women's Research Day 1: Discoveries in Cancer
Cass discussed her research involving mutations in the BRCA1 and BRCA2 genes, which are associated with increased risk for ovarian cancer and breast cancer. Cass focuses on ovarian cancer, a relatively rare but deadly type, in which inheritable genetic mutations account for about a fifth of the cases.
Cedars-Sinai provides a major opportunity to study BRCA1 and BRCA2 mutations because they are more common in Jewish women than in non-Jewish women, and about 30 percent of Cedars-Sinai's female patients are Jewish, Cass explained. Ovarian cancer in patients with these mutations has specific characteristics.
Research has shown that some ovarian cancers originate in the fallopian tubes or the peritoneum—a single cell layer that lines the pelvic and abdominal cavity. In her own work, Cass said, she has shown that women with BRCA1 mutations are more likely than other women to have hidden cancer developing in the fallopian tubes. "Removing the fallopian tubes in BRCA1 mutation carriers could prevent a lot of cancer after age 40," she said.
One concern about such surgery, which is sometimes performed along with ovary removal as a risk-reducing measure by women with this mutation, is that it can have negative side effects, especially in younger women. Cass and colleagues are currently studying the short-term impact of so-called surgically induced menopause on cognitive function, cardiovascular disease and other aspects of well-being.
Cass concluded her talk by tracing changes over the years in the state of knowledge about cancer.
"Twenty years ago we understood how to take care of cancer just by looking at the patient and the histology of her cancer," she said. "Now, by understanding the genetic mutations that underlie these cancers, we can move towards targeted therapies, maximize outcomes, minimize side effects and ultimately try to understand better prevention in this patient's family."