Women’s Health: Q&A with Dr. Jo Marie Tran Janco, director of the gynecologic cancer program at Scripps


Tennis star Chris Evert recently going public with her stage 1C ovarian cancer diagnosis highlighted the dangers of a disease that can arrive silently with seemingly innocuous symptoms in the early stages.

Dr. Jo Marie Tran Janco
(Courtesy )

Carmel Valley resident Dr. Jo Marie Tran Janco is the director of the gynecologic cancer program at Scripps MD Anderson Cancer Center and a Scripps Clinic physician. In a Q&A, she talked about raising awareness for ovarian cancer, signs and symptoms to look out for, and treatment options.

This interview has been lightly edited for clarity and conciseness.

Q: What is your background and how did you end up at Scripps?

A: I’m the director of the gynecologic cancer program at Scripps MD Anderson Cancer Center. I joined the Scripps Clinic medical group when I moved back to Southern California from finishing up my fellowship training in Minnesota about six years ago. I was really looking for a program that would provide evidence-based, comprehensive care, really individualized, and with colleagues I could trust

Q: Given the recent news about Chris Evert sharing her ovarian cancer diagnosis, how important is it to raise awareness about ovarian cancer?

A: I think with gynecologic cancer in general, especially ovarian cancer, there could be a lot more awareness out there. Many women I treat have fairly vague symptoms when they are first leading up to their diagnosis, and because the symptoms are abdominal, things like bloating can be confused with other things like intestinal symptoms. So sometimes there can be a delay in recognizing it. So I think it’s very important for women to have more awareness about the signs and symptoms of ovarian cancer, and also be empowered to think about their health history, their family history, to inquire about genetic testing — which is how Chris Evert got her diagnosis.

Q: Are there any misconceptions about ovarian cancer or anything people would be surprised to learn about it?

A: I think there is a misconception that it is a silent cancer. Most women, by the time they’re diagnosed, if they look back there were symptoms for several months preceding their diagnosis. But they do tend to be vague, so I think raising awareness about increasing frequency of symptoms — like bloating, pelvic and abdominal pain, changes in urinary habits like frequency or urgency that are different and more frequent is fairly typical from what we study and what we hear from patients — I think would lead to earlier diagnosis and more awareness for patients.

And then I think the other thing that is important to know is how important it is to consider family history and genetic testing. Most ovarian cancers are not associated with gene mutations, but probably somewhere between 20-25% are. If women know about their mutational status, if they’ve had genetic counseling and testing and they have that information, it can empower them to do things to prevent cancer and also for their family members to get tested.

Q: Are there any more key risk factors people should know about?

A: Age is a risk, so as women get older they’re more at risk for ovarian cancer. But there’s a whole structure and different types of ovarian cancer. Women who are younger should pay attention to symptoms as well. There are some subtypes of ovarian cancer that are associated with other conditions, like endometriosis. Reproductive history is important. Women who have not had children or haven’t been pregnant are at increased risk when you look at big populations. Anybody with a family history of ovarian cancer, either a direct close relative or even a great aunt or a grandparent, could have some increased risk.

When you read about risk factors for ovarian cancer, one thing that comes up sometimes is race or ethnic background. It’s true for the most part that White women are at higher risk, but anybody of any background can potentially be at risk. I have patients from all different backgrounds. So it’s important to know the signs and symptoms and really be in communication with your physician to have those symptoms investigated.

Q: What treatment options are available for women who have ovarian cancer?

A: It really depends on what stage, what subtype. That’s why I think it’s important to be treated at a comprehensive cancer center like Scripps MD Anderson Cancer Center. Generally treatment involves surgery. That should be done with a gynecologic oncologist. I think what a lot of people don’t know is gynecologic oncology is a subspecialty as well. We’re specific cancer oncology surgeons that are trained to treat and take care of gynecologic cancers, as well as really comprehensively taking care of women through their cancer journey, and afterward as well.

Oftentimes treatment starts with surgery, sometimes that’s all women need. Oftentimes chemotherapy is involved. We do have more targeted treatments that are available. There’s a whole new class of medication called PARP inhibitors that we’re incorporating more and more often into cancer treatments. So there have been a lot of exciting new developments.

For more information, visit scripps.org/cancer.