New cancer test for women with ‘Angelina Jolie gene' is being rolled out
Topics: Angelina Jolie, Health, Women's Health, Cancer
Jen Thomas
Featured Image Credit: Frazer Harrison/Getty Images
Topics: Angelina Jolie, Health, Women's Health, Cancer
A new type of test to pick up the risk someone has of developing cancer is being rolled out on the NHS.
It it being offered to women who have the so-called 'Angelina Jolie' gene.
The University College London Hospitals NHS Foundation Trust (UCLH) is now the first first to offer an ovarian screening service to women with the BRCA1 and BRCA2 gene mutations.
Women who have these gene mutations are at a much higher risk of developing can cancer, including breast cancer and ovarian cancer, and effects around 1 in 400 women.
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There are currently around 7,600 cases of ovarian cancer diagnosed every year in the UK.
Statistics show that around two percent of all new cancer cases are ovarian cancer, but the risk is much higher for those with the mutations.
For those with the BRCA1 gene the risk is between 40 and 60 percent, while those with the BRCA2 gene it is between 10 and 30 percent.
At present, many women who have these gene mutations face the dilemma of whether they should have their ovaries, fallopian tubes and breasts removed in an attempt to stop the cancer from forming.
The current NHS guidelines suggest that patients with the BRCA mutations are given the choice, but removing their ovaries means young women go through early menopause and cannot have their own children.
Because of these, women often choose to delay having surgery in order to try and have children, or because they don't want to go through the early menopause.
The gene is often referred to as the 'Angelina Jolie' gene as the star opted to have a double mastectomy as well as having her ovaries and fallopian tubes removed as she is a carrier of the gene mutation.
She revealed her decision in an op-ed she wrote for the New York Times back in 2013, explaining: "I decided to be proactive and to minimise the risk as much I could."
Speaking about her mastectomy, she wrote: "There have been many advances in this procedure in the last few years, and the results can be beautiful."
"I feel empowered that I made a strong choice that in no way diminishes my femininity," she continued, adding: "For any woman reading this, I hope it helps you to know you have options.
"I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices."
The new test is called the Risk of Ovarian Cancer Algorithm (or Roca for short), and clinical studies have found it can halve the rate of women receiving a late-stage ovarian cancer diagnosis.
This groundbreaking new test calculates the individual risk for each patient based on their own factors and circumstances.
These factors include menopausal status, their age, blood tests to monitor the levels of the protein cancer antigen 125, as well as the BRCA1 or BRCA2 gene alterations.
Women who are deemed at risk of developing the disease can have the Roca blood test every four months.
Professor Adam Rosenthal is a consultant gynaecologist at UCLH. He said: “At the moment, women face a very stark choice - preventive surgery, with the fact that if you’re pre-menopausal, that means you can then no longer have children; and surgical menopause, which has detrimental effects and HRT is not guaranteed to make you feel the same way as you feel now.
“Not surprisingly, women can find it a really difficult decision as to what age to go through the surgery, because if they leave it too late, there is a risk they will develop ovarian cancer before they’ve had the surgery.
“There hasn’t so far been any kind of organised surveillance programme for them, there hasn’t been anything systematic that actually works until now.”
He explained the tests 'builds up a picture of what a woman’s normal fluctuations are, what is normal for the individual woman'.
“That means, for example, if you had a woman whose level was running around, say, between five and 10 consistently for a year or two, and then it ticked up to 15, and then it ticked up from 15 to 20, then that would be alarming, even though the level is well below 35, which is sort of what the lab would typically tell you is a normal result,” he said.
“It’s picking up a rising level even within the normal range, which is saying ‘this is not normal for this woman’. What we do at that point is we arrange a scan and bring the patient in for a full examination and ask them lots of questions about their symptoms and so on.
“Then if the level continues to rise despite everything being normal, we will tell her, we think you may now have ovarian cancer, and we would like to do exploratory surgery for you.
“It means that we pick up cancers when they are smaller, when they aren’t yet causing symptoms, and that means we can remove those cancers with much less extensive surgery than would otherwise be necessary.”
The hope is that other NHS trusts will follow suit and roll out the tests, in order to avoid a dreaded 'postcode lottery' when it comes to treatment.