Expert interviewed
Nicole Tasker, MSN, APN, FNP-BC - a gynecologic oncology nurse practitioner. She has been compensated by GSK for her participation in this article.
Feeling full quickly after eating. Pelvic or abdominal pain. Lower back pain. Changes in bowel or bladder habits. For many women, these are everyday ailments. But, in some cases, they can also be signs of ovarian cancer.
The symptoms of ovarian cancer are often vague and mimic those of other common, less serious conditions, or they may not show up at all until later stages of the disease — meaning it’s usually diagnosed late when it’s harder to treat. That makes education, awareness, and self-advocacy even more crucial. So, to learn about the risk factors, genetic testing benefits, and some potential treatment options in ovarian cancer, we spoke to Nicole Tasker, MSN, APN, FNP-BC, a gynecologic oncology nurse practitioner with 12 years of oncology experience.
What can someone do to spot ovarian cancer early?
“While there is no known exact cause of ovarian cancer, there are several factors that may increase one’s risk of developing it,” Tasker says. These include:
Older age (the median age of diagnosis is 63)
Starting your menstrual cycle before age 12
Starting menopause after age 52
Inheriting certain genetic mutations such as BRCA1, BRCA2, or Lynch syndrome
No personal history of giving birth
Endometriosis (abnormal growth of tissue that lines the inside of the uterus)
Radiation exposure to the pelvis
If someone has a family history of cancers often linked to these genetic mutations — like breast, ovarian, thyroid, colorectal, or endometrial — it’s important that they ask their doctor about genetic counseling and testing. This may help determine whether they’re more likely to have one of the gene mutations associated with an increased risk of certain cancers, including ovarian cancer.
“However, even for someone who has a family history of being genetically positive, whether that's BRCA1 or BRCA2, we don’t have reliable screening for patients without symptoms,” Tasker points out.
Many women think Pap smears screen for several cancers, including ovarian. In reality, they only screen for cervical cancer. Diagnosing ovarian cancer involves a combination of tests, such as imaging, biopsies, and blood work. If someone notices any new signs, symptoms, or risk factors, they should let their healthcare provider know right away so they can run the right tests. If cancer runs in their family, they should ask their doctor if genetic testing makes sense.
How can genetic testing help inform a patient’s treatment path?
Tasker also encourages women who have already been diagnosed with ovarian cancer to understand if they have any genetic risk factors, as this information may help inform their treatment path. “We look at BRCA1, BRCA2, and even BRCA-like mutations, so anyone who’s diagnosed with ovarian cancer, whether they have a family history or not, should be tested,” Tasker explains.
Then, biomarker testing can be done on the tumor. “We send off tumors for testing to check for certain biomarkers. One biomarker is called homologous recombination deficiency, or HRD,” Tasker notes. Normally, DNA repair occurs through homologous recombination. HRD happens when this DNA repair system no longer works properly, so the DNA is unable to repair the damage. When that happens, gene mutations and instability can occur, which contributes to the cancer’s growth.
Once testing is complete, the patient’s medical team works with them to map out next steps in their treatment journey — making sure decisions are made with an understanding of available options.
What else does genetic testing influence?
Genetic testing can also help a gynecologic oncologist determine if the patient will eventually receive maintenance therapy for their ovarian cancer — or ongoing treatment after initial chemotherapy treatment for those who have had a positive response — to try and help delay the time before the cancer comes back.
Poly (ADP-ribose) polymerase (PARP) inhibitors are an FDA-approved class of maintenance therapy available for patients with ovarian cancer. “And prescribing them depends on the patient’s genetic tumor testing results,” Tasker says.
ZEJULA (niraparib) is a once-daily oral PARP inhibitor medication available in 100, 200, or 300 milligram (mg) strength tablets.
APPROVED USES
ZEJULA is a prescription medicine used for the:
maintenance treatment of advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer with a certain type of abnormal BRCA gene or a positive laboratory tumor test for genomic instability called homologous recombination deficiency (HRD). ZEJULA is used after the cancer has responded (complete or partial response) to treatment with first-line platinum-based chemotherapy.
maintenance treatment of ovarian cancer, fallopian tube cancer, or primary peritoneal cancer with a certain type of inherited (germline) abnormal BRCA gene that comes back. ZEJULA is used after the cancer has responded (complete or partial response) to treatment with platinum-based chemotherapy. Your healthcare provider will perform a test to make sure that ZEJULA is right for you.
It is not known if ZEJULA is safe and effective in children.
Maintenance therapy options, like ZEJULA, may help delay certain types of advanced ovarian cancer from coming back.
Tasker ensures that her patients understand the potential side effects of ZEJULA. This includes the more serious side effects like bone marrow problems called MDS (myelodysplastic syndrome) and a type of blood cancer called AML (acute myeloid leukemia), which may lead to death. ZEJULA has also been associated with high blood pressure and PRES (posterior reversible encephalopathy syndrome), which may cause headaches, vision changes, confusion, or seizures. These are not all the potential side effects of ZEJULA; please review the additional Important Safety Information below.
ZEJULA is used for advanced ovarian cancer patients who are BRCA or HRD-positive, and may inhibit cancer cells from repairing their damaged DNA, according to Tasker. “I tell my patients — if they have any little specks of possible cancer that we can’t see on their post-chemotherapy imaging, ZEJULA may help to stop those cells from growing.”
How do you help your ovarian cancer patients cope during and after treatment?
Tasker says she educates her patients up front, and encourages them to find resources like dietitians, social workers, mental health professionals, and palliative care. “I think a lot of patients group palliative care in with hospice, but they are different,” she describes. “I see palliative care as long-term symptom management; the department can help with pain, with symptoms from chemotherapy, and with different factors that patients might not even be aware of.”
She also stresses the importance of a support system. “I do have patients that want to keep to themselves, and that is best for them as a patient — but I think having at least one person for support can help you through the diagnosis and your treatment and thereafter,” she encourages. “To just have that listening ear, that second person to just be a reminder, can make a big difference.”
theSkimm
Ovarian cancer is often diagnosed in later stages. Genetic testing can play a crucial role in determining risk and a treatment plan - including for maintenance therapy. ZEJULA is a one-a-day oral maintenance therapy option for certain advanced ovarian cancer patients. Learn more about how it works here.
IMPORTANT SAFETY INFORMATION
ZEJULA may cause serious side effects, including:
Bone marrow problems called Myelodysplastic Syndrome (MDS) or a type of blood cancer called Acute Myeloid Leukemia (AML). Some people who have ovarian cancer and who have received previous treatment with chemotherapy or certain other medicines for their cancer have developed MDS or AML during treatment with ZEJULA. MDS or AML may lead to death.
Symptoms of low blood cell counts (low red blood cells, low white blood cells, and low platelets) are common during treatment with ZEJULA. They can be a sign of serious bone marrow problems, including MDS or AML. These symptoms may include the following:
Weakness
Feeling tired
Weight loss
Frequent infections
Fever
Shortness of breath
Blood in urine or stool
Bruising or bleeding more easily
Your doctor will do blood tests to check your blood cell counts before treatment with ZEJULA. You will be tested weekly for the first month of treatment with ZEJULA, monthly for the next 11 months of treatment, and as needed afterward.
High blood pressure is common during treatment with ZEJULA, and it can become serious. Your doctor will check your blood pressure and heart rate at least weekly for the first two months, then monthly for the first year, and as needed thereafter during your treatment with ZEJULA.
Posterior reversible encephalopathy syndrome (PRES) is a condition that affects the brain and may happen during treatment with ZEJULA. If you have headache, vision changes, confusion, or seizure, with or without high blood pressure, please contact your doctor.
Before starting to take ZEJULA, tell your doctor about all of your medical conditions, including if you:
Have heart problems
Have liver problems
Have high blood pressure
Are pregnant or plan to become pregnant. ZEJULA can harm an unborn baby and may cause loss of pregnancy (miscarriage)
If you are able to become pregnant, your doctor should perform a pregnancy test before you start treatment with ZEJULA
If you are able to become pregnant, you should use effective birth control (contraception) during treatment with ZEJULA and for 6 months after taking the last dose of ZEJULA
You should tell your doctor right away if you become pregnant
Are breastfeeding or plan to breastfeed
ZEJULA may harm your baby. You should not breastfeed your baby during treatment with ZEJULA and for 1 month after taking the last dose of ZEJULA
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
The most common side effects of ZEJULA include the following:
Nausea
Tiredness
Constipation
Pain in your muscles and back
Pain in the stomach area
Vomiting
Loss of appetite
Trouble sleeping
Headache
Shortness of breath
Rash
Diarrhea
Cough
Dizziness
Changes in the amount or color of your urine
Urinary tract infection
Low levels of magnesium in the blood
If you have certain side effects, then your doctor may change your dose of ZEJULA, temporarily stop, or permanently stop treatment with ZEJULA.
These are not all the possible side effects of ZEJULA. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects.
Please see accompanying full Prescribing Information, including Patient Information for ZEJULA.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. You may also report negative side effects to GSK at gsk.public.reportum.com or call 1-888-825-5249.
Intended for US audiences only.
Trademarks are owned by or licensed to the GSK group of companies.
©2025 GSK or licensor.
PMUS-NRPCOCO250001 October 2025
Produced in USA.
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