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 centers, 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 standard 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 ro bot 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
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