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Pittsburgh: Center of Aggressive Ovarian Cancer Research
By April Terreri

Many professionals in Pittsburgh are working diligently to discover treatments for women with ovarian cancer. Robert Edwards, M.D., is vice chair of clinical affairs for the OB-GYN department at Magee-Women's Hospital. He is also director and senior investigator for gynecologic cancer research in Pittsburgh, helping other researchers implement projects – and he participates in a large practice specializing in ovarian cancer treatment.

One collaborative study currently underway at the University of Pittsburgh Cancer Institute and Magee-Women's Research Institute could make a big splash nationally, says Dr. Edwards. He adds the work is still very early in development. "Working together with a strong proteomics group at the University, we are attempting to identify potential markers of the various earliest stages of ovarian," Dr. Edwards explains. "We are collecting fluids found with these early cancers to evaluate them with extremely powerful protein screening techniques. We are also looking for the sources of these proteins in the tissues themselves."

In another study, Dr. Edwards and his colleagues are aiming to identify new chemotherapy drugs that would be easier for women to tolerate in peritoneal therapy, which involves administering treatment into the abdominal cavity. The current chemotherapy medications used in this therapy are perceived to be difficult to use and receive, so only about 20 percent of women are offered this regime even though it has been demonstrated to be more effective.

Once the study is completed and the appropriate doses have been determined for the two drugs involved in the study, the conclusions may be incorporated into a national study, explains Dr. Edwards. "Our hope is the study would provide new agents for possible testing nationally by the Gynecological Oncology Group, a cooperative group dedicated to studying women's cancer. The group is funded by the federal government."

Heidi Donovan, Ph.D., R.N., is another of many researchers in the Pittsburgh area involved in diverse ovarian cancer research. Her research focuses on helping women get answers to the many questions they have about their symptoms and side effects of treatment. "It is very difficult for patients and physicians to find the time necessary to really focus on symptoms and side effects," says Donovan, assistant professor at the University of Pittsburgh School of Nursing.

Donovan explains that women undergoing treatment for ovarian cancer may have 10 to 12 concurrent symptoms they are trying to deal with. "During an office visit, there often is not enough time for them to get answers to their questions about symptoms and symptom management. Other issues, such as how they are responding to treatment, whether the treatment is working, and whether they should switch treatments take top priority."

Therefore, Donovan and her colleagues created a research program that connects ovarian cancer patients with nurses via using Internet message boards. "This allows back-and-forth interactions around improving symptom management," she explains. "It is a psycho-educational program – part education and part counseling – that teaches women how to better manage the multiple symptoms they are dealing with such as nausea, fatigue, sleep problems, and pain."

Women using the message boards report that the process is cathartic. "We ask detailed questions about how their symptoms affect their lives. Writing in detail about their disease and symptoms on the message boards helps them organize their thinking about what they need to do and it gives women a better sense of control over their symptoms. They tell us it's important to have someone who understands what they are going through, but who doesn't have an emotional investment in them."

The pilot study proved promising in improving symptom management and Donovan has received positive reviews on a grant to the National Institutes of Health. This grant would allow her research team to expand the study across the country to evaluate if this model of helping women manage their symptoms really does improve outcomes. "The long-term goal is to develop a nurse-guided computer-interactive program that could relieve some of the time pressures involved in face-to-face clinic interactions."

Leslie Hoffman is the chapter coordinator for the Pittsburgh Chapter of the National Ovarian Cancer Coalition. "The research Heidi is doing regarding symptom management for survivors is very relevant to our mission to improve the quality of life for women with ovarian cancer," says Hoffman.

Dr. Edwards reports that Magee operates a high-risk clinic and a strong clinical program in gynecologic cancer. "We have eight gynecologic oncologists that visit other hospitals in the area. We also have a high-risk screening clinic at Magee and at Hillman Cancer Center overseen by my colleague Dr. Kristin Zorn. So women at risk, or who have ovarian cancer, or who need a second opinion are encouraged to talk to us about potential research studies. Women with a family history of ovarian cancer should be evaluated to see if they have one of the genes that could increase their risk for the disease. We have over 30 ongoing studies in ovarian cancer and we are the only center in Pittsburgh with that breadth of ongoing research."

Dr. Edwards oversees the ongoing research and he encourages women to call (412) 641-5411 for more information. Dr Edwards can be reached at (412) 641-5418. Heidi Donovan can be reached at (412) 624-2699.

Ovarian Cancer Facts

  • All women are at risk
  • 1,300 women are diagnosed and almost 800 die each year in PA
  • Deadliest of all gynecologic cancers
  • Fifth leading cause of cancer related deaths for women ages 35-74
  • Currently No early detection test exists
  • Women who have had breast cancer or have a family history of breast or ovarian cancer are at an increased risk
  • Approximately 80% of cases are diagnosed at a late stage
  • Early detection increases survival rates
  • Costliest of all cancers to treat

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