CCE Gynecologic Oncology: M.D. Anderson Cancer Center

University of Texas M.D. Anderson Cancer Center
Houston

, Texas

M.D. Anderson Cancer Center in Houston has become a Clinical Center of Excellence through innovative treatment, cutting-edge research, comprehensive education, and research-based prevention of common and rare cancers. Its gynecologic cancer department earns additional accolades for its commitment to exemplary patient care.

David M. Gershenson, MD, professor and chairman of the Department of Gynecologic Oncology, describes his unit’s approach as “research-based patient care.”

“We’re not only providing state-of-the-art care, but we’re doing it in the context of promoting clinical trials for patients,” he says. “Clinical trials are the instruments by which we make advances. We learn more, we develop better treatments.”

The department has a robust clinical trials program encompassing prevention, early detection, innovative treatment, and surgical techniques. Current high-priority trials include intraoperative lymphatic mapping in vulvar, vaginal, and cervical cancers; fluorescence spectroscopy screening for cervical cancer; new drug combinations for treatment of both newly diagnosed and recurrent cancers; and trials using stem cell rescue, high-dose chemotherapy, hormonal therapy, and biologic therapy for cervical, ovarian, and endometrial cancers.

Gershenson feels the center’s strongest suit is research, especially translational research. The department’s work in RNA interference has garnered accolades from the scientific community, as has its research on and targeted therapies for rare ovarian malignancies.

The T. Boone Pickens Foundation, a charitable organization formed by Dallas-based oil and gas industry leader and philanthropist T. Boone Pickens, in 2007 donated $50 million to the cancer center – with one catch. The donation was put into a special fund and will have to grow within 25 years to $500 million from outside donations and earnings on the principal before the money can be touched.

While this trust is meant to fund future initiatives, the University of Texas in 2009 is launching short-term projects that will complement M.D. Anderson, including the new Red and Charline McCombs Institute for the Early Detection of Cancer. The most aggressive expansion of research in M.D. Anderson’s history, the institute includes six separate centers focused on genomics, proteomics, screening, diagnostic imaging, biotechnology, and drug testing.

Gershenson, who has published more than 300 peer-reviewed articles, mostly on ovarian cancer, says such advanced technology  allow his department to compete with other top-quality gynecologic oncology programs in the country.

For example, led by Karen Lu, MD, a departmental team from M.D. Anderson this year plans to conduct a randomized, open-label endometrial cancer chemoprevention study of metformin, a type 2 diabetes medication in obese, insulin-resistant women.

The chemoprevention study is supported through a $10 million National Cancer Institute Specialized Programs of Research Excellence grant for uterine cancer. It’s one of 10 such grants, totaling more than $107 million, which have been awarded to M.D. Anderson by the NCI since 1996.

In 2008, M.D. Anderson received a $52.7 million, five-year renewal award from NCI to support 19 specific cancer research programs, including gynecologic oncology.

The gynecologic oncology department’s staff includes medical, radiation, and gynecologic oncologists, complemented by pathologists, radiologists, and surgical oncologists. It’s all part of the multidisciplinary approach to patient care that provides access to additional comprehensive technologies at M.D. Anderson.

M.D. Anderson’s expertise is found in clinical medicine as well.  The center saw 1,900 new cases of gynecologic cancer in 2008 – 75 percent of them patients who were new to the center. M.D Anderson’s Gynecologic Oncology Department specializes in uterine, ovarian, vulvar, fallopian tube, pelvic, cervical, and vaginal cancers.

“I think our ultimate goal is personalized medicine or personalized treatment for patients where we don’t just treat everyone with the same diagnosis, with exactly the same regimen, but we individualize their therapy based on their individual profile,” Gershenson says.

The center has extended its reach beyond Houston with gynecologic cancer treatment programs in Orlando, Florida, and Madrid, Spain.

At the M.D. Anderson Cancer Center in Orlando, for example, recently performed a robotic-assisted  laparoscopic radical trachelectomy – a fairly new procedure  that spares the patient’s uterus, keeping alive the possibility of future pregnancies.

Internationally, M.D. Anderson has forged relationships with 16 sister institutions in Asia, Europe, the Middle East, and North and South America. For instance, M.D. Anderson partners with the Federal Republic of Nigeria to collaborate on cancer research, education, and training programs in that country.

John Jennings, MD, a general obstetrician/gynecologist in Odessa, Texas, has referred several patients.

“Referring physicians can be confident  that their patients will be thoroughly evaluated and offered a treatment protocol at the very cutting edge of oncologic care,” says Jennings, regional dean of  Texas Tech University Health Sciences Center, School of Medicine in Odessa. “Patients comment about the personalized service they have received and feel comfortable that they are in very good hands.

“Texas is fortunate in having a number of excellent institutions offering comprehensive oncology care, but M.D. Anderson is often top of mind for the difficult case referral,” he says.