September is ovarian cancer awareness month. Ovarian cancer is a silent killer. Approximately 80% of women diagnosed with ovarian cancer are diagnosed at an advanced stage when the prognosis is poor. More than 14,000 women lose their lives to ovarian cancer in the United States each year. For these reasons, it is imperative that women become more knowledgeable about the disease.
There are three main types of ovarian cancer tumor types based upon the type of cells in which it originates: epithelial, germ cell and stromal ovarian cancers, with epithelial ovarian cancer accounting for approximately 90% of ovarian cancers. Epithelial ovarian cancer originates in the cells covering the outer surface of the ovaries or fallopian tubes. While there are also subtypes of epithelial ovarian cancers, the most prevalent is high grade serous and accounts for approximately 70% of all ovarian cancers.
Only 10-15% of ovarian cancers are caused by inherited genetic mutations. Mutations in the BRCA1 and BRCA2 genes are the most prevalent risk factors for ovarian cancer. Other risk factors associated with an increased risk of ovarian cancer include perineal talcum powder use, asbestos exposure, pelvic inflammatory disease, polycystic ovarian syndrome, endometriosis, nulliparity (never having given birth), infertility, and increasing age. Factors that exert a protective effect and are associated with a decreased risk of ovarian cancer include tubal ligation, prior pregnancy, oral contraceptive use and history of breastfeeding.
Ovarian cancer is the fifth leading cause of death from cancer in women. Approximately 22,530 new cases of ovarian cancer are diagnosed annually. Symptoms of ovarian cancer include abdominal bloating or swelling, sudden and unexplained weight loss, pelvic or abdominal pain or discomfort, back pain, abnormal vaginal bleeding, feeling full quickly when eating, increased frequency of urination and constipation.
Statistically, the five-year survival rates for women diagnosed with ovarian cancer are around 46%, in part due to the advanced stage in which it is usually detected due to lack of testing specificity and vagueness of symptoms.
Treatment options are mainly restricted to surgery and chemotherapy, which can be intravenous or intraperitoneal. Currently, approximately 60% of women with an advanced stage of ovarian cancer have a recurrence, so an aggressive surveillance program is followed post-treatment.
The role of talc in ovarian cancer risk
Women have used talcum powder products for more than a century, both to care for infants as well as for personal hygiene. Johnson & Johnson has marketed talcum powder products such as Shower to Shower and Baby Powder as safe and encouraged use by women for genital hygiene, specifically targeting African American and Hispanic women in the South. What Johnson & Johnson failed to communicate was their awareness of studies linking talcum powder and ovarian cancer as early as the 1960s. Johnson’s Baby Powder and Shower to Shower have been shown to contain asbestos.
Since the 1980s, epidemiological studies on the association between talcum powder use and ovarian cancer indicate an approximate increase in ovarian cancer risk of approximately 20-60% with talcum powder use. A study done in 2016 at the University of Virginia found that African American women who used talcum powder products for feminine hygiene had a 40% increased risk of developing ovarian cancer over non-talc users.
Talc without asbestos or other mineral fibers has been designated a Group 2b “possible” carcinogen by the International Agency for Research on Cancer (IARC). It has been shown to cause an inflammatory reaction in the body, creating an environment that contributes to genetic mutation and leads to carcinogenesis. It is a mineral often found in close proximity to asbestos underground. The asbestos is extremely difficult to extract or sometimes even detect during the mining process, leading to product contamination. IARC has concluded that asbestos and fibrous talc are carcinogenic to humans.
While talcum powder products are marketed for hygienic purposes, there is no medicinal benefit from them. Cornstarch-based powder products that do not increase the risk of ovarian cancer have been on the market for decades and are a safe alternative to talcum powder products.
Beasley Allen is working on cases of ovarian cancer linked to use of Johnson & Johnson’s Baby Powder, Shower to Shower body powder and other talc products for feminine hygiene. For more information about these cases, contact Ted Meadows or Leigh O’Dell.
This story appears in the September 2019 issue of The Jere Beasley Report. For more like this, visit the Report online and subscribe.