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How clinical trials change gynecologic cancer survival

January 19, 2017 | UCI Health
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Lorena Medina of Corona was diagnosed with advanced cervical cancer in 2012. Despite surgery, radiation and chemotherapy, she suffered several relapses while under the care of her local doctors.

After she relapsed a second time and the cancer spread into her lungs, the 39-year-old mother of two young children consulted UCI Health gynecologic oncologist, Dr. Krishnansu S. Tewari.

Life-saving treatment

He recommended Avastin, a new drug he helped to pioneer and which was in clinical trials. At the time, the doctor Medina was seeing at another hospital recommended only chemotherapy.

It was only after Medina’s cancer returned a third time that she was able to switch her insurance and obtain care from the gynecologic oncology experts of UCI Health. Tewari put her on chemotherapy and Avastin, an anti-angiogenesis drug that inhibits a tumor’s ability to form new blood vessels. 

“Dr. Tewari was so positive,” says Medina. “He told me, ‘You’re going to get through this.’ He believed in the clinical trial, and I believed in him.”

Medina’s cancer is now in remission.

Nationally recognized experts

Indeed, significant progress has been made in recent years for all types of gynecologic cancers, which include cancers of the:

UCI Health patients treated at the Chao Family Comprehensive Cancer Center — Orange County’s only National Cancer Institute-designated comprehensive cancer center — receive care from a gynecological oncology team that includes nationally recognized experts.

These doctors have a history of excellence to live up to, one established by the Division of Gynecologic Oncology’s founding director, Dr. Philip J. Di Saia, and Dr. Robert E. Bristow, an internationally recognized expert in ovarian cancer.

Others in the division include Tewari, Dr. Ramez N. Eskander, Dr. Kristine R. Penner and Dr. Michael Krychman.

Clinical trial leaders

How prestigious is UCI Health?

Of 35 large, national clinical trials that inform the body of evidence on treatment of gynecological cancers, 31 of them involved contributions from UCI Health investigators.

  • Eskander recently became the third member of the UC Irvine gynecologic oncology faculty in the past four years to receive the Society of Gynecologic Oncology’s Presidential Award. The honor recognizes the most outstanding oral presentation at the society’s annual meeting.
  • In 2012, Bristow was recognized for his research on racial and economic disparities in access to ovarian cancer care and survival.
  • Tewari was recognized in 2013 for his findings that the drug Avastin combined with chemotherapy prolongs survival in advanced cervical cancer patients.

Cervical cancer treatment advances

Treatment of early-stage cervical cancers also has seen progress.

Women with early-stage cancers can undergo a robot-assisted surgery to remove the cervix and uterus. This minimally invasive operation carries fewer risks of complications than traditional surgery and speeds recovery time.

“Many patients get treated too aggressively even for small cancers,” Tewari notes.

UCI Health also offers robot-assisted surgery for uterine cancer. This approach limits surgical complications and pain, and patients can proceed to chemotherapy with no delays.

Fertility preservation

UCI Health surgeons are among only a handful of specialists nationwide who offer a procedure for cervical cancer treatment that preserves a woman's fertility, called a trachelectomy.

Only the cervix and a small part of the uterus are removed. Although infertility is sometimes an inevitable result of cancer treatment, patients can be referred to oncofertility specialists to discuss their options prior to treatment.

“We want to offer fertility preservation whenever possible,” Tewari says. “Trachelectomy is such a complicated operation that only a few centers offer it.”

Treating the whole person

Cancer may be the diagnosis, but UCI Health physicians and nurses focus on the patient’s entire well-being, not just the cancer, Bristow says.

Patients have access to Ann’s Clinic, funded by the Queen of Hearts Foundation, which offers genetic testing and support for ovarian cancer patients to improve their quality of life.

“That is the essence of that holistic approach,” Bristow says.

“When patients come to see us, we’re not just looking up lab values and plugging in medication dosages. We’re asking how they are coping, is their support network functioning or not functioning? What is their exercise regimen, their dietary habits? We talk about overall wellness and management of complications, about menopausal symptoms and sexual health. We’re treating the whole person.”

Learn more about gynecologic oncology treatments and research ›

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