UAB Insight Gynecology Volume 2 - Page 2

Progress for Ovarian Cancer, and More to Come UAB Medicine News More sophisticated chemotherapeutic and surgical “We are excited about sophisticated upper abdominal surgery performed in collaboration with our liver surgeons to eliminate Painless Pursuit of Parenthood treatments are raising new hope for better ovarian cancer survival rates, says UAB gynecologic oncologist Ronald Alvarez, cancer in areas we previously couldn’t effectively reach. We’re Infertility (REI) recently has partnered with the Department of Charles Leath III, MD, associate MD, who heads one of the nation’s busiest such programs. “More now starting some patients directly on chemotherapy, then Anesthesiology to enhance the experience of women needing professor, previously was on the work remains, but treatment for ovarian cancer and hope for the coming back in the middle of the treatment to perform debulking assisted reproductive technology or in vitro fertilization. In many faculty of the F. Edward Hébert women who have it have made major strides over the past 20 surgery in order to more effectively resect all ovarian cancer.” IVF center s, women are provided only a mild sedative for their School of Medicine, Uniformed years,” he says. n e w p h ys i c i ans Services University of the Health Treatment with chemotherapy previously was one-size- “Now that ovarian cancer has a specific set of symptoms that UAB’s Division of Reproductive Endocrinology and procedure. However, UAB now offers faculty anesthesiology fits-all, he says. “Before, everyone got standard intravenous MD, codirects the clinic with breast surgeon Helen Krontiras, MD. There, a team of physicians, nurse practitioners, genetic counselors, and research nurses gives patients comprehensive, individualized care. The Southeast’s first program of this kind offers research, screening, clinical care, access to clinical trials, advanced screenings, genetic assessment, and lifestyle counseling. services to women during their procedure. REI faculty members Sciences, Bethesda, Maryland, women can monitor, it is no longer the ‘silent disease’ of 20 therapy, but we can now give chemotherapy directly into the Wright Bates, MD, and Janet McLaren, MD, and fellows Estes Named APGO Scholar while stationed at Brooke Army years ago,” says Alvarez, who also is president of the Society of abdomen or on a weekly ‘dose-dense’ schedule. We also have Meaghan Bowling, MD, and Mamie McLean, MD, perform Jacob Estes, MD, has been named to the Association of Medical Center in San Antonio, Gynecologic Oncology. “We know better how to identify women great hopes for targeted therapeutics such as antiangiogenic Texas. He earned his MD at IVF in a new procedure suite adjacent to the state-of-the-art IVF Professors of Gynecology and Obstetrics Academic Scholars who harbor genetic alterations in the BRCA1 and BRCA2 genes agents or PARP inhibitors.” the Medical University of South that put them at high risk of ovarian cancer and who should have Carolina and completed research prophylactic surgery after completing childbearing.” and clinical fellowships at UAB. He Just as important, he says, is the emerging evidence from laboratory at the Women and Infants Center. “The Department and Leaders Program. Since January 2012 Estes has been Clinical trials for promising additional therapies are a of Anesthesiology provides outstanding service to our patients,” participating in a rigorous 15-month curriculum to prepare him priority at UAB. Many trials are investigating several novel says Bates, REI division director. “UAB’s painless approach to to be an outstanding teacher and educational administrator. He is antiangiogenic or cell-surface receptor targeting agents. UAB IVF reflects our commitment to providing the very best care for the third UAB faculty member to be named an APGO Scholar, the women of Alabama and their future families.” including faculty member Alice Goepfort, MD. Richter Is SGS President-Elect OCNA Recognizes Alvarez for Excellence is a member of the NCI Cervical the Cancer Genome Atlas project that ovarian cancer may be is known for its pioneering work in gene therapy, and a trial Cancer Task Force and serves on several different diseases, each with a unique biologic pathway. investigating delivery of a gene that encodes for the cytokine “Today we also recognize that some of these ovarian cancers IL-12 is in progress. the GOG’s Cervical Cancer and Safety committees. His clinical and research interests include cervical and ovarian cancer, novel therapeutics for malignancies, and surgical aspects of cancer management. actually originate in the Fallopian tubes. From there, we These developments mean that patients with advanced cancer Holly Richter, MD, PhD, is president-elect of the Society Ronald Alvarez, MD, director of the UAB Division of expect to have more individualized treatments based on how are living longer, but there’s more to be done. “We’ve made of Gynecologic Surgeons, a group of more than 300 select Gynecologic Oncology and senior scientist in the experimental the cancer appears under the microscope and on what biologic moderate progress in extending life, but we’re never satisfied physicians involved in teaching, practicing, and research in therapeutics program at the UAB Comprehensive Cancer Center, pathways may be involved.” with just that—we are working to see more people survive advanced gynecologic surgery. Richter, director of the Division was awarded the Rosalind Franklin Excellence in Ovarian Cancer ovarian cancer long-term,” says Alvarez. of Urogynecology and Pelvic Reconstructive Surgery, also is Research Award by the Ovarian Cancer National Alliance. Ovarian cancer surgical techniques also continue to advance. Fused F-18 FDG PET- Fused F-18 FDG PET-CT director of the Genitorectal Disorders Clinic and holds the J. OCNA advocates for US women with ovarian cancer. His Kerri Bevis, MD, assistant CT through the mid through the upper pelvis Marion Sims Endowed Chair in Obstetrics and Gynecology. research interests include the development of novel therapeutics professor, is a graduate of the UAB abdomen shows nodular implants along She is principal investigator in the NICHD-sponsored Pelvic for ovarian cancer and new screening and prevention strategies School of Medicine, where she carcinomatosis in the both paracolic gutters Floor Disorders Network and the NIDDK-sponsored Urinary for cervical cancer. He is a coprincipal investigator in cervical also completed her training. Her anterior left abdomen (arrows) with the F-18 Incontinence Treatment Network and has renewed a mid-career neoplasm vaccine projects of the cervical cancer SPORE. with marked FDG uptake FDG uptake. Normal, mild (arrow). Normal F-18 activity is present in the research award in clinical research on pelvic floor disorders. She FDG excretion is present small bowel (B). K research interests include advanced or recurrent endometrial carcinoma, K palliative and supportive care, and in the kidneys (K). medical education. Margaret Boozer, MD, assistant B be handled using stan dard laparoscopy. UAB gynecologists resect Health, is a graduate of Duke perform procedures as fast as a robotic surgeon, but for the average submucosal uterine fibroids, lyse intrauterine adhesions, and University School of Medicine and gynecologist the blood loss, infection rate, and other metrics all are perform sterilization procedures hysteroscopically, often in an holds an MPH in maternal and child improved with robot utilization, he adds. office setting. Some patients, such as those with extremely large health from the University of North UAB gynecologists now are broadening the parameters for uteri or those with extensive scarring from previous surgeries, may Carolina School of Public Health. robotic surgery to include the removal of larger masses and Boozer trained at the Medical performance of more complex procedures. The surgical robot University of South Carolina, is especially useful for complex cases that require extensive robot, but also have the ability to perform procedures using where she later joined the faculty. dissection and suturing and allows maximal surgery with minimal multiple minimally invasive platforms,” Jenkins says. She also was medical director of incisions for the patient. a community health clinic in San Antonio, Texas. The surgical robot expands the capabilities of standard laparoscopy, but even so, says Jenkins, many gynecologic still require open surgery. “UAB is unique in that our surgeons not only use the surgical FOR YOUR PATIENTS: procedures—such as removal of ovarian cysts, resection of endometriosis, sterilization, and many hysterectomies—can easily 2 A webinar about the benefits of robotic hysterectomy as a treatment option is hosted by Drs. Brian Gleason and Heather Greer at uabmedicine.org/uabmd-webinars/robotic-hysterectomy F or ref err a l s: 1- 8 0 0 - 8 2 2- 6 47 8 A Randomized Trial of Vaginal Surgery for Uterovaginal Prolapse: Vaginal Hysterectomy with Native Tissue Vault Suspension vs. Mesh Hysteropexy Suspension. The primary purpose of this randomized clinical trial is to compare the effectiveness and safety of two transvaginal apical suspension strategies for uterovaginal prolapse: a mesh augmented hysteropexy vs. vaginal hysterectomy and uterosacral ligament suspension. PI: Holly E. Richter, MD, PhD. Contact: Velria Willis, RN,BSN,CCRC, 205.975.8522; vwillis@uab.edu A Research Study of Two Dual PI3K/ mTOR Inhibitors, PF-04691502 and PF05212384 in Patients with Recurrent Endometrial Cancer. This Pfizer trial is an open-label, phase 2, four-arm, optimal Simon two-stage noncomparative, multicenter study to assess the safety, efficacy, pharmacokinetics and pharmacodynamics of PF-04691502 (an oral PI3K/mTOR inhibitor) and PF05212384 (an IV PI3K/mTOR inhibitor). This study will be conducted in parallel arms in adult patients with recurrent endometrial cancer for whom no standard therapy is available. NCT01420081. PI: Ronald D. Alvarez, MD. Contact: Rachel Richardson, research coordinator, 205.934.6308 also recently was appointed to the Urologic and Genitourinary Physiology and Pathology Study Section at the NIH Center for Scientific Review. continued from cover professor in Women’s Reproductive F e atu r e d c l inica l t r ia l s Huh Receives Cancer Society QOL Award Gynecologic oncologist Warner Huh, MD, has been awarded the American Cancer Society’s 2012 Lane W. Adams Quality of Life Award, recognizing that his innovation, leadership, and M e asur e s o f S u c c e ss UAB Gynecologic Oncology’s Ovarian Cancer Patient Statistics consistent excellence provide compassionate, skilled care and counsel to patients and their families. Huh has played a major role in the development of the first proven cervical cancer vaccine. He is on the steering committee of the Johns Hopkins/ UAB/University of Colorado SPORE in Cervical Cancer. Clinic Assesses Ovarian Cancer Risk UAB provides risk assessment and counseling to women at increased risk for ovarian or breast cancer through its Lynne Cohen and Norma Livingston Preventive Care Program for Women’s Cancer. Gynecologic oncologist Jacob Estes, Over the last 4 years, the UAB Gynecologic Oncology Service has experienced a steady increase in both ovarian cancer surgical cases and infusion therapy visits. M o r e inf o r mati o n : u a b m e d i c i n e . o r g / p h y s i c i a n 3