A Crisis in Clinical Trials for Gynecologic Cancers
Dr. Laurel Rice is chair of the nationally ranked Department of Obstetrics and Gynecology at the University of Wisconsin School of Medicine and Public Health and a member of the UW Carbone Cancer Center, where she treats women with gynecologic cancers. When she takes over as president of the Society for Gynecologic Oncology (SGO) in March, she will also be leading a national effort to address a “crisis” in clinical trials for gynecologic cancers.
How common are gynecologic cancers?
Every six minutes an American woman will be diagnosed with one of several gynecologic cancers, adding up to 105,000 cases per year. The most common is endometrial cancer, which accounts for more than half of those cases and recently took the life of esteemed PBS news anchor Gwen Ifill. Ovarian cancer, while less common, is more lethal, in large part because there are few symptoms in the early stages.
What is the most important part of your job?
Caring for women with gynecologic cancers—including surgery, chemotherapy and end of life care—allows me the privilege of being a part of their lives, and the lives of their families, in a very intimate manner. The joy and satisfaction that I continue to derive from caring for patients, educating the physicians of the future, advancing the field through research and advocacy for the patients I care for, cannot be quantified. Every day I recognize how very fortunate I am to have a path in life that provides so much to me personally.
What is this “crisis?”
In the USA, women are underrepresented in clinical trials, and thus are not afforded the same improvements in health outcomes provided to men. An editorial I published with Dr. Marcela del Carmen from Massachusetts General Hospital (Harvard Medical School) specifically highlighted the fact that the number of phase III clinical trials available for women with gynecologic cancers has dropped by 88 percent over the past seven years. This is primarily a result of a decrease in NIH funding and alterations made in the NIH clinical trials infrastructure. As a physician dedicated to women’s health, I find this disparity unacceptable.
Why does this matter?
Improved health outcomes for both men and women can only be realized by conducting clinical trials. For example, recent trials have shown that adding chemotherapy to radiation therapy in the treatment of women with cervical cancer improves survival by approximately 50 percent. Another example is a clinical trial investigating a specific subset of women with ovarian cancer who received chemotherapy via the intraperitoneal route: survival improved from 50 to 65 months when compared to standard treatment. Without clinical trials, the medical community is not able to provide the advances in treatment that allow our patients to live longer, with a better quality of life.
What can be done about it?
Along with the entire SGO leadership team, I’m convening a multi-disciplinary retreat in Washington D.C. during the SGO annual meeting in March, 2017. Leading researchers, patient advocates, patients and (pharmaceutical) industry representatives from all over the United States will gather to strategize about increasing the availability of clinical trials. We have also organized a National Cancer Institute course during SGO for 50 young investigators to hone their skills in developing clinical trials.
What are we doing to advance knowledge at UW Carbone Cancer Center?
We’re a cutting-edge cancer center, and because UW Carbone is a National Cancer Institute-Designated Comprehensive Cancer Center, our patients have access to a number of trials for uterine, ovarian, cervical and vaginal and vulvar cancers. The Division of Gynecologic Oncology, which is a vital component of the Carbone Cancer center, is pushing the envelope in clinical investigation, with the singular focus of improving health outcomes for the women we care for.
Under the leadership of Dr. David Kushner, we are leading the country in research to improve quality of life and sexual health after a cancer diagnosis. Our WISH (Women’s Integrated Sexual Health) program applies this research to improve quality of life for our patients. Dr. Kushner is also known for his work on physician wellness.
Dr. Ellen Hartenbach has established the first ever rural Ob-Gyn residency program in the USA to train doctors in caring for women in rural America.
Dr. Stephen Rose studies humor and communication with patients, and is recognized as the national leader in this rapidly evolving field.
Dr. Ahmed Al-Niaimi is recognized as a national leader in the development and utilization of large data sets. Here at UW, he established the Gynecologic Oncology Longitudinal Data Collection and Utilization Project (GOLD-CUP), focused on tracking and understanding treatments and outcomes for women with gynecologic cancer. He also leads the Midwest if not the country in performing minimally invasive single port laparoscopic surgery.
Dr. Ryan Spencer is developing a research platform focused on better understanding the link between obesity and cancer.
Dr. Lisa Barroilhet is focusing her research efforts on novel imaging techniques of women at high risk for ovarian and breast cancer, with an eye towards prevention.
Advancing the field of gynecologic oncology is at the heart of this committed division.
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Date Published: 01/30/2017