Doctors at the Medical College of Wisconsin are reporting progress in treating two kinds of cancer affecting women — ovarian and cervical cancers. But those researchers say many challenges remain.
About one in every 75 women will develop ovarian cancer. There are 22,000 new cases reported in the U.S. every year, with most of those being in the advanced stage of the illness. Many women, from all walks of life, have died. One of the most high-profile deaths was comedian Gilda Radner in 1989. The diagnosis of her illness was mentioned in the CNN film Love, Gilda late last year.
Radner is quoted as writing, "The comedian, who does all this stupid stuff, gets the most unfunny thing in the world."
Doctors still don't know what causes ovarian cancer. But they have studied the types of human genetic mutation that increase the risk of developing the disease. There's also been progress in treatments beyond the traditional routes of surgery and chemotherapy. But cures remain rare, so the focus has been on managing the cancer.
A national study has shown that most post-surgery or post-chemo patients who took the pill olaparib have lived longer without the cancer coming back. Medical College of Wisconsin professor William Bradley led the clinical trial locally. Bradley says the drug inhibits the self-repair of cancer cells.
"And that means these rapidly dividing cells are much less able to repair themselves, as they're generating new DNA, and that becomes a fatal event for the cancer cell. So, in trying to generate new DNA, to have one cell divide into two, it can't do it. And then, the cell in turn dies," Bradley said.
Bradley says the Food and Drug Administration fast-tracked approval of olaparib earlier this year. But Bradley says tests are recommended before a cancer patient is prescribed the medicine.
"We certainly ... encourage our patients with ovarian cancer to undergo genetic testing to determine if they have this mutation. And, we treat it as a standard of care to give this medication to those women who do have these mutations, after they've completed their primary chemotherapy,“ Bradley said.
As for potential side effects, Bradley says about 1% of patients in the trial developed a blood disorder, while some others experienced gastro-intestinal problems that lasted a few weeks.
Another Medical College of Wisconsin researcher has been looking into genetic variations and cervical cancer outcomes.
Cancer of the cervix has become relatively rare in the U.S. thanks to preventive screenings like pap smears, and widespread vaccinations of younger women against the human papillomavirus (HPV). But the disease remains a big problem, killing about a quarter million women worldwide each year.
An international study published in 2017 identified genetic and molecular characteristics of cervical cancer. At the Medical College, Dr. Janet Rader has led some of the follow-up research.
“To refine and further identify markers that relate to outcome of patients, trying to understand subgroups of patients that can get different types of treatments," Rader said.
Rader says the latest research may also help treat other cancers.
"The virus that causes cervical cancer accounts for seven out of 10 of all cancers. So, understanding how the virus goes into the cervical DNA or any DNA where it causes cancer will really better understand the cancer changes that occur or the genomic changes. That will really fine-tune how we can treat women with cervical cancer and hopefully other cancers caused by HPV," Rader said.
One of Rader's patients, a Milwaukee County woman — who we're just identifying by her first name, Kimberlee — has been through radiation and chemotherapy treatments for cervical cancer. She's been cancer-free for two years. While the disease prevented Kimberleen from having children, she hopes the greater ability to look at the genetics of cervical cancer will help others.
"Hearing the words, 'You have cancer' is really life-changing. And if they can keep doing the research and trying to figure out new ways to treat it, hopefully eventually prevent it, that's a good thing," Kimberlee said.
Support is provided by Dr. Lawrence and Mrs. Hannah Goodman for Innovation reporting.
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