Women's cancers: Connecting the dots
City of Hope's Women's Cancers Program unites the efforts of physicians and researchers committed to ending cancers of the breast, uterus, ovary and cervix. These scientists seek to better prevent, diagnose and treat these diseases and help survivors live whole, healthy lives.
Joanne Mortimer, M.D., director of the Women's Cancers Program, recently answered a few questions about the connections between breast and gynecologic cancers — and how combining efforts to study these diseases may speed the quest for cures.
How do the risk factors for women's cancers overlap?
On one hand, you have genetically associated cancers. Women who have mutations in BRCA1 and BRCA2 genes have a higher rate of both breast and ovarian cancers. On the other hand, non-genetic risk factors known to be linked to breast cancer, like high estrogen levels, also are associated with uterine cancer. Women who are obese, who delay having children, who begin menstruating younger — they have greater risk of breast cancer and uterine cancer.
How do treatments overlap among women's cancers?
Some of the treatments that overlap are for women who carry genetic mutations. A group of drugs called PARP inhibitors are effective in women with breast or ovarian cancer who have mutations of BRCA1 and BRCA2 genes. We use hormone treatments for ovarian and uterine cancers just as we do for breast cancer.
How do the complications of women's cancers overlap?
Many common complications have to do with a side effect of treatment. Chemotherapy causes most women — about 90 percent — who have not yet gone through menopause to essentially become postmenopausal. Osteoporosis and issues with sexual functioning are common to these women.
We're trying to look at survivors who stop having periods because of chemotherapy, and determine if that means their ovaries aren't working. They have a constellation of symptoms related to menopause, but they may not have the same severity as for women who have their ovaries taken out. We hope to learn more about the biology of that and how that impacts the quality of life of survivors
How does an integrated women's cancers program benefit research to prevent and cure these diseases?
A lot of the issues are the same — the endocrine functioning, the inherited component, the drugs for treatment. It gives us a broader population to study. So, for instance, when researchers put together a study of drugs like the PARP inhibitors, they can include women with breast and ovarian cancers. The mechanism is common among patients with the same genetic mutation, so we expect new drugs to work in the same way. Having a larger population to look at benefits the research.
Are there other partnerships at City of Hope that contribute to research into women's cancers?
One of the unique things about being at City of Hope is the focus on diabetes and endocrinology, We want to look at the endocrine problems that result from therapies. Our partners in the endocrinology department can potentially help us develop interventions, whether it's for bone health issues or problems of sexual functioning or metabolic syndrome.
A problem that people may develop when they undergo chemotherapy is that their metabolism slows down and they can get metabolic syndrome: a combination of obesity, insulin resistance and elevated cholesterol. These women really have trouble losing weight. The thing that helps the most is exercise. I think we have a potential synergy between our endocrinology experts and our researchers looking at exercise as an intervention for women with breast cancer.
We have a lot of things we're talking about. Our colleagues studying diabetes can be very helpful to us, and we in turn can help them.
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Each year, more than 250,000 women in the U.S. are diagnosed with cancers unique to women. As a group, these are the most commonly diagnosed cancers among women, making up about 37 percent of new cases in 2009.
To find out more about breast and gynecological cancer research and treatment at City of Hope, please click on any of the links below.
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