The Fox Chase Cancer Center proposes to conduct research in ovarian cancer prevention and control focusing on familial risk of cancer, the behavioral factors influencing the decision to undergo prophylactic oophorectomy, and the effect of chemopreventive agents on precancer structural and molecular markers of carcinogenesis.

The goals of the research are: (1) to study the cause and prevention of ovarian cancer; (2) to recruit women with a family history of ovarian cancer who might benefit from screening and prevention; (3) to study women who elect prophylactic oophorectomy; (4) to collect tissue samples and blood samples for laboratory studies; (5) to initiate behavioral research that could decrease stress, improve understanding, and facilitate the management of high-risk women; (6) to develop a comprehensive cancer center-community hospital consortium to improve the management of ovarian cancer; and (7) to collect and manage clinical and laboratory data in a confidential manner.

By working cooperatively with a number of ovarian cancer treatment facilities in the Fox Chase Cancer Center service area, we will be able to study patients with the rarely occurring hereditary ovarian cancer syndrome and to compare the risk factors and environmental exposures in the high-risk women with women who develop ovarian cancer without a family history of cancer. This consortium of institutions also provides us an opportunity to study women who have requested or are recommended to have prophylactic removal of the ovaries as a cancer prevention strategy. We will characterize the psychosocial profile of these high-risk women and study this decision-making process so that a counseling intervention can be developed to fit their needs. In addition, we will recruit women who are scheduled to undergo prophylactic oophorectomy to a chemoprevention study using a promising antiproliferative drug (fenretinoid). The treated patients will have their ovaries evaluated for a beneficial effect on markers of carcinogenesis such as nuclear size, proliferation rate, mutation rate, and presence of apoptosis (programmed cell death) as well as pathological chances which we have previously identified in high-risk women. These changes include surface epithelial papillomatosis, surface epithelial invaginations, surface epithelial pseudostratification and inclusion cysts.