Talcum Powder Ovarian Cancer

Ovarian Cancer

To understand ovarian cancer it is helpful to review the fundamentals of cancer itself. Cancer is essentially the out-of-control division of cells in the body. Under normal conditions, new cells are created by the process of cell division. This process, as well as cellular death, is carefully regulated by the cell’s operating instructions, which are contained in its genetic material, a chemical compound known as DNA, or deoxyribonucleic acid. However, in cancer, the cells divide without stopping because the DNA has been altered or damaged.

Ovarian Cancer

The DNA instructions are written in four chemical “letters,” called bases, that are made of carbon, nitrogen, hydrogen and oxygen atoms. The bases are joined in pairs and the pairs combine to form longer chemical structures, “words” and “sentences,” that we call genes. Genes are linked together in larger DNA strands —or “paragraphs,” to extend the analogy—called chromosomes. Each cell contains 23 pairs of chromosomes that are made up of an estimated 20,000 – 25,000 genes. When the DNA is damaged, cells may divide without stopping and cell death may also be affected. This results in the growth of abnormal cells that do not die resulting in the formation of a tumor. Not all tumors are cancerous. Some remain in one place and do not spread to surrounding tissue. In cancerous tumors, the cell growth is “invasive.” It grows into nearby healthy cell tissue and can spread (“metastasize”) to other parts of the body.

Ovarian Cancer Symptoms

Experts say that in the early stages of ovarian cancer, there may be no obvious symptoms. However, there are four key symptoms that may appear even in the beginning stages:

  • Abdominal bloating or swelling
  • Abdominal or pelvic pain
  • Frequent need to urinate
  • Difficulty eating or feeling full quickly

A 2009 British study found that the first three symptoms were reported at least six months before the diagnosis. Early symptoms start suddenly, feel different and are persistent—they happen nearly every day and don’t go away.

Other symptoms of ovarian cancer include:

  • Weight loss
  • Constipation
  • Fatigue
  • Back pain
  • Pain during sex
  • Menstrual changes
  • Vaginal bleeding after menopause

Several sources point out that these symptoms are often symptoms of non-cancerous conditions. Nevertheless, it is important to consult with your doctor, since early diagnosis is a key to treatment success.

Types of Ovarian Cancer

In most ovarian cancers, the tumor begins on the surface layer of cells inside the ovary. The medical term for this surface layer is epithelium. The most common type of ovarian cancer is epithelial. Ninety percent of ovarian cancer tumors are epithelial and it is this type of cancer that talcum powder cancer risk studies have investigated.

Epithelial ovarian cancers are further subdivided into the following main subtypes:

  • High-grade serous
  • Clear cell
  • Endometrioid
  • Mucinous
  • Low-grade serous

High-Grade Serous Ovarian Cancer

The word “serous” comes from “serum,” a clear fluid that is one component of blood. Here the word refers to a fluid that is secreted by the thin double layer of epithelial cells—the serous membrane—that lines the ovaries. Many organs of the body have serous membranes.

Cancerous cells are graded after being examined under a microscope. Generally speaking, high grade cancers are more abnormal looking. They grow and spread faster than lower grade cancers, which look more like normal cells.

Seventy percent of all ovarian cancers are high grade serous cancers. Most cancers of this type are now known to originate in the fallopian tubes, though some may originate in the ovary itself. This has critical implications for the link between talcum powder [link to talcum powder subpage] and ovarian cancer, as the fallopian tubes connect the uterus to the ovaries. This offers a pathway by which talc powder can migrate from the vagina to the fallopian tubes and ovaries and cause cancer. In fact, researchers have found talc particles in ovarian cancer tumors. By the time they are detected, serous cancers are usually in the advanced stages of their development and the outcomes are generally poor.

Clear Cell Ovarian Cancer

This type of cancer is called clear cell because the inside of the cell looks clear when viewed under a microscope. Clear cell cancer is the second most common form of ovarian cancer representing an estimated 4% to 14% of ovarian cancers. Five-year survival rates (the percentage of patients who are still alive after five years) for this type of cancer are excellent if detected early, but may be worse than rates for serous cancers in the later stages of development.

Endometrioid Ovarian Cancer

These cancers make up about 2% to 4% of ovarian cancers. They are generally low-grade and are detected at early stages (meaning the cancer has not spread and the tumor is relatively small).

 Mucinous Ovarian Cancer

This type of cancer represents only about 4% of ovarian cancers. It gets its name from the tumor, which is filled with mucus. Mucinous ovarian cancer does not respond well to chemotherapy.

Low-Grade Serous Ovarian Cancer

This type of cancer is the least common. It is slow growing, but it is commonly diagnosed at advanced stages and is very resistant to chemotherapy.

“We believe the observations made here present a good case for talc carcinogenicity…”

– Researchers in the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA and Department of Epidemiology, Harvard School of Public Health, Boston. Their study, “The Association Between Talc Use and Ovarian Cancer,” was published in May 2016 issue of Epidemiology

Talcum Powder Cancer Risk

Scientists have studied how baby powder use influences the risk of the ovarian cancer mentioned above. It is noteworthy that many studies have found the genital use of talcum powder to be associated with an even higher risk of serous cancers than ovarian cancer overall. This is significant since serous cancer is by far the most common form of ovarian cancer.

  • A 1997 study published in the American Journal of Epidemiology found that perineal use of talcum powder was associated with a 60% increased risk of all ovarian cancers and a 70% elevated risk of serous cancers.
  • A 1999 study found a 40% increased risk of invasive serous ovarian cancer.

In 2008, investigators at the Harvard Medical School and Harvard School of Public Health published research that found that regular talc powder use was associated with a 36% increased risk of ovarian cancer. For serous invasive ovarian cancer the risk increased to 60%. The authors found “highly significant trends” between the frequency of talc powder use and the risk of ovarian cancer overall and serous invasive cancer. They also reported that variations in certain genes may contribute to a higher risk of ovarian cancer associated with genital baby powder use.

A 2013 study published in Cancer Prevention Research reported that genital talc powder use was associated with a “moderate increased risk of epithelial ovarian cancer.” Risk was also elevated for serous invasive, endometrioid and clear cell tumors.

“These results offer support for the hypothesis, raised by prior epidemiologic studies, that powder exposure from perineal dusting contributes to the development of ovarian cancer…”

– Researchers at the Fred Hutchinson Cancer Research Center, Seattle, WA and Department of Epidemiology, University of Washington School of Public Health. Their study, “Perineal Powder Exposure and the Risk of Ovarian Cancer,” was published in the March 1997 issue of the American Journal of Epidemiology.

In the most recent study, published in the May 2016 issue of Epidemiology, researchers supported by a National Institutes of Health grant reported that genital talc use was tied to:

  • 33% increased risk of epithelial ovarian cancer overall
  • 42% increase in serous invasive cancer overall and an 85% increased risk for premenopausal women
  • 38% increase in endometrioid invasive cancer

Use for more than 20 years increased the overall risk of epithelial ovarian cancer by 49%. The researchers found a dose-response relationship for serous invasive cancer, particularly among premenopausal women. Dose-response findings are important because they are evidence of a direct cause-effect relationship.

Borderline Ovarian Cancer

There is yet another type of cancer that has been linked to talc use in some studies. It is called borderline ovarian cancer. Borderline tumors are considered to have low malignant potential because they do not grow into the surrounding tissue. They are most often diagnosed at an early stage, before they have migrated to other parts of the body. Even if they do migrate, they do not invade local tissue at their new location.

Nevertheless, surgery, sometimes extensive, is required to remove these tumors. According to the American Cancer Society, for women who no longer want, or are able, to have children, the surgery involves removal of the uterus, both fallopian tubes and both ovaries. If the tumor has spread to other locations in the abdomen or pelvis, surgeons will remove those tumors as well. The most recent study in Epidemiology found that genital baby powder use increased the risk of serous borderline tumors by 40%. For premenopausal women who used talc powder for more than five years, the risk of serous borderline tumors increased by 66% and the risk of mucinous borderline tumors was more than doubled (128% increase).

What Causes Ovarian Cancer?

Cancer, as explained above, is the result of alterations or damage to the genetic material inside a cell. Some people inherit genetic changes from their parents that predispose them to certain types of cancer. According to the American Cancer Society, several inherited genetic mutations are known to increase the risk of “a small portion” of ovarian cancers. Genetic testing can determine whether a person is carrying one of these mutated genes.

However, most of the genetic mutations tied to ovarian cancer are not inherited. They happen sometime during a woman’s lifetime. The question, of course, is how was the mutation acquired? What element in the environment damaged the cells and caused cancer to begin developing?

Scientists know that the DNA in cells can be damaged by exposure to radiation, chemicals and other toxic substances in the environment. We are all aware that smoking can cause lung cancer and too much exposure to the sun can increase the risk of skin cancer. There is increasing evidence that exposure to the pesticide Round-Up can increase the risk of lymphoma.

The evidence is mounting that talcum powder is also carcinogenic. In addition to the many studies that have found an increased talcum powder cancer risk, there is the biological fact that talcum powder can travel from the vagina to the fallopian tubes and ovaries, where the majority of ovarian cancers are thought to originate. Also, several case-control studies have found a dose-response relationship between genital talcum powder use and ovarian cancer.

Ovarian Cancer Treatments

Ovarian cancer is treated by means of several different interventions.

  1. Surgery – to determine if and where the cancer has spread and remove, as much as possible, any tumors. This usually involves removal of the uterus, ovaries and fallopian tubes and may involve removal of parts of other organs in the abdomen, including the colon, bladder, stomach, spleen and liver.
  2. Chemotherapy – the use of drugs that kill cells, shrink tumors or stop the cancer from spreading.
  3. Hormone therapy – the use of hormones or drugs that block hormones. This treatment is rarely used for epithelial ovarian cancer.
  4. Targeted therapies – drugs that specifically attack cancerous cells and avoid damaging normal cells.
  5. Radiation – the use of X-rays to kill cancerous cells.

Filing a Talcum Powder Ovarian Cancer Lawsuit

If you, a family member, or a friend has been diagnosed with ovarian cancer and there is reason to believe that talcum powder is a contributing factor, the team at Baum, Hedlund, Aristei & Goldman would like to hear from you. You may contact our attorneys for a free review of your case by filling out our case review form or calling us at 800-827-0087.