Tag Archive for: ovarian cancer

Ovarian Cancer Prevention: Within Reach but Unevenly Accessible

Authors: Emily Thorlakson, BSN RN (Vancouver Coastal Health) Alexandra Lukey, PhD(c), MSN, RN (University of British Columbia, Department of Obstetrics and Gynecology)  | Editors: Romina Garcia de leon, Janielle Richards (Blog Co-Coordinators)

Published: October 4, 2024

The current state of ovarian cancer

Ovarian cancer is ranked number five in the leading causes of cancer deaths among females. Screening is a key pillar in cancer prevention, but unfortunately, there are no effective screening options for ovarian cancer. This leads to the majority of cases being diagnosed at late stages which reduces the chance of surviving ovarian cancer. Interestingly, science has shown over the last twenty years that most ovarian cancers start on the fallopian tubes and later spread to the ovaries instead of starting on the ovaries as researchers initially thought. This recent understanding has led to a new primary prevention opportunity called “opportunistic salpingectomy.”

 Can Ovarian Cancer Be Prevented?

Opportunistic salpingectomy involves removing both fallopian tubes while leaving the ovaries intact; this procedure is typically completed during another scheduled surgery. Salpingectomy has gained traction as the latest research has proven that removing the fallopian tubes significantly decreases the risk of getting the most common and deadly type of ovarian cancer, called high-grade serous ovarian cancer. The most promising evidence of this comes from a population-based cohort study of people who received opportunistic salpingectomy for cancer prevention. This study found that individuals who had this particular surgery had no cases of serous ovarian cancer and significantly fewer than expected cases of other types of ovarian cancer. Also, researchers looked at the rates of different types of cancers that we would not expect salpingectomy to impact, and the study found that rates of other cancers, such as breast and colorectal cancers, were within the expected range. Therefore, these results increased the confidence that it was salpingectomy and not other confounding factors causing the lower ovarian cancer rates.

 Is Salpingectomy Accessible to Everyone?

As salpingectomy becomes a more common procedure, we must ensure that everyone has equal access to it. Studies have already shown that geographical location, race, ethnicity, and rurality influence whether or not patients are offered opportunistic salpingectomy. For example, people who live in rural locations have less opportunity to be offered an opportunistic salpingectomy. Lack of equity is evident in research, as a study discovered that Black females were nearly half as likely to receive opportunistic salpingectomy in contrast to tubal ligation when sterilization was being done at the same time as a caesarian section. So, while they received permanent contraception, they did not receive the full preventative benefit of salpingectomy. Barriers to salpingectomy are compounded further by healthcare provider bias, lack of insurance coverage, low awareness or lack of healthcare resources.

Equity regarding salpingectomy is further complicated by the history of injustices and reproductive violence, such as forced and coerced sterilization of immigrants, Black, Latina, and Indigenous people; people with disabilities; and people with chronic medical conditions. For opportunistic salpingectomy to be available and equitably accessible to everyone, we must face the root of the problem by getting researchers, clinicians, and policymakers to address historical injustices while maintaining patient autonomy.

 How Can We Make Opportunistic Salpingectomy More Accessible?
  • Understand Barriers in Rural Areas: Identify and address challenges in rural and remote areas to patients who want opportunistic salpingectomy.
  • Partner with Indigenous Communities: Collaborate with Indigenous leaders to have culturally safe discussions about ovarian cancer prevention.
  • Knowledge Mobilization: Provide education and bias training for healthcare providers to ensure they offer this option fairly to all patients.

Beyond Boundaries: Patient and Community Engagement Reshaping Research Training

Authors: Juliette Wilson-Sanchez, MSc Student, Queen’s Cancer Research Institute, Department of Biomedical and Molecular Sciences, Queen’s University and Farzaneh Afzali, PhD Candidate, Department of Biomedical and Molecular Sciences, Queen’s University | Editors: Romina Garcia de leon, Shayda Swann (Blog Coordinators) 

As graduate students, we’re often asked how we stay motivated to continue our work after all the long nights and endless failed experiments. For us, the answer was simple – the community of patients we have met throughout our training continuously pushes us to work harder. The opportunity to see beyond the bench and hear the stories of patients affected by what we are studying provides a more in-depth perspective of our research and its impact. Over the past few years, our involvement in the local patient community, organizing events such as the Walk of Hope, has informed us of the ways in which we can support our patient community, improve the communication of our work, and tailor aspects of our research questions. These conclusions are the result of close interactions with patients within our local community. These interactions have completely shifted the way we reflect on our work – but are these interactions beneficial to the patients?

A sense of community is beneficial for cancer patients in many ways. Patients who participate in support groups have been shown to have better quality of life and improved mental health. While these support groups remain an important source of community for patients, it is important that researchers work to provide a similar sense of support to patients. Initiatives such as the Queen’s Cancer Research Institute’s Patient Engagement Network (QCRI-PEN), work towards establishing meaningful connections and bidirectional exchange of ideas between researchers and patients in the local community. 

Patient engagement in initiatives such as the QCRI-PEN aims to follow Health Quality Ontario’s guiding principles of patient engagement. Patients are invited to share their ideas, concerns, and desires in a trusted circle. This patient-centric approach cultivates a sense of ownership and empowerment in the patient community, making them active players in their healing journey. Participating in patient partnerships in research can highlight pressing needs in the patient community that supporters may not be aware of. For example, patient partners associated with Ovarian Cancer Canada participate and provide guidance on clinical and basic research funded by Ovarian Cancer Canada. Over the years, this has ensured that patients from across the country have felt included and heard by the research community. Studies, such as the Every Woman Study, are examples of the outcome of mutually beneficial partnerships between researchers and patients as their successful recruitment was mainly conducted using their own collaborative networks and social media. Through the relationships fostered by patient engagement, studies are able to reach a diverse group of patients and reach an understanding of what issues are more pertinent to that specific community. This information is essential for the improving quality of life for cancer patients; however, many cancer patients do not participate in patient-oriented research. One study demonstrated only 5% of cancer patients were actively engaged in research and only 26% expressed interest in doing so. Low participation may be a result of a lack of trust or a sense of partnership between researchers and patients, further emphasizing the importance of reinforcing community engagement in research.

Bridging the trust gap between patients and researchers requires mutual endeavor that benefits both parties. Trust in science and the researchers conducting the studies remains one of the barriers to patient participation in research. Reinforcing a trusting relationship through the creation of a supportive community is key to improving research and subsequently patient experience. One of the main elements we have observed as a key component of a supportive community is effective and reciprocal communication. Unfortunately, one of the fundamental reasons we have observed that keeps patients away from the scientific community is complicated science terminology. This barrier not only keeps patients and caretakers away from participating in research but also hinders the process of making informed decisions and unleashes more opportunities for misinformation to spread. Trainees have been shown to benefit from science communication courses that prepare them for this important aim alongside support from health advocates and communicators who can translate complicated scientific terminology to lay terms and also help bridge this gap. As ovarian cancer research trainees, we have learned how to communicate our research using accessible language to our community through the Walk of Hope and QCRI-PEN events that established connections with patients and provided us with feedback from our community. 

As research trainees, we are committed to nurturing these bonds with our patient partners. The ongoing mutual support and shared insights from a more informed and involved community empower us to serve patients more effectively. We would love to be an inspiration for fellow trainees and researchers, encouraging them to foster these meaningful connections with their communities. These moments of connection are something we hold dear, forever grateful for the enrichment they bring to our scientific journey.  

 

Behind the Science: New Ways of Investigating Ovarian Cancer Prevention


Interviewee: Alex Lukey, PhD, University of British Columbia, School of Population and Public Health. Authors/Editors: Negin Nia & Romina Garcia de leon (Blog Co-coordinators).

Published: August 12th, 2022.

Alex Lukey, a previous Women’s Health Research Cluster (WHRC), Blog Co-coordinator is speaking to us about her work on ovarian cancer prevention. Lukey is working on preventing ovarian cancer using big data and machine learning. Read more to find out about her work and how she got into the women’s health field.

Could you please tell us about your current research?

The lab that I work in studies ovarian cancer, specifically the prevention aspect. So, the project that I am going to be working on focuses on using the big datasets that are in BC to try and predict ovarian cancer. This is to possibly make recommendations in a clinical setting regarding prevention efforts. 

My supervisor, Dr. Gillian Hanley, works around opportunistic salpingectomy. In the last 10 years or so the research found that a lot of ovarian cancers start on the fallopian tube rather than the actual ovaries. So, about 10 years ago a team in BC started doing opportunistic salpingectomies. This means if someone goes into another gynecological surgery, and they are done having kids (or don’t want any), they can have their fallopian tubes taken out by choice, at the same time.

We now have studies that show that removing the fallopian tubes is effective at preventing the most common and deadly form of ovarian cancer. My PhD will be looking at this and seeing if we can take this a step further by possibly targeting people who are at higher risk. I am also going to be doing qualitative research because it is a big decision to undergo surgery and to make that decision as a patient – but this is why the research is needed.

What sparked your interest to pursue this work?

I have always been interested in women’s health research. My Master’s in nursing at UBC Okanagan focused on improving heart failure self-care through gamified education which so my PhD work is pretty different, but even back in nursing school I volunteered at the Options for Sexual Health Clinic. So, I have always been interested in making women’s health research more equitable because there are so many big gaps.

Before my PhD I was working with Dr. Hanley on a project that was looking at hormone replacement therapy on a grant I was awarded called the CIHR Women’s Health Clinical Mentorship Grant. After that, I decided to keep working with Dr. Hanley as my PhD supervisor because she’s a fantastic researcher and her lab focused on my interests of ovarian cancer and population-based data. I knew I wanted to work in big datasets for my PhD because there are many opportunities to translate research into provincial, national and even international knowledge and answer important research questions. 

How do you hope this research will impact the women’s health field?

For me, the most tangible impact would be that we are allowing patients to make that decision regarding preventing ovarian cancer around their own bodies and health. Before we can offer salpingectomy at a greater scale for preventing ovarian cancer though more work needs to be done. This is totally an individual decision, but I want people to be able to take their health into their own hands.

The cancer survival rate has not really moved much in the last 30 years. There have been better treatments and drugs coming out. But the five year survival rate of ovarian cancer is still less than 50 per cent which is pretty abysmal. This also affects a lot of people on the younger side, in their 50 or 60’s. It’s a very deadly and devastating disease and often has major long term health impacts for those who do survive. Survivors can have their quality of life impacted through things like sexual dysfunction, bowel dysfunction, and continuing pain just to name a fewy. So, we are just trying to help prevent ovarian cancer from happening in the first place.

Did any of this tie into the work you did with the WHRC as a Blog Co-coordinator?

I definitely would say that, when I was a blog coordinator it was a really great experience to learn about a lot of different research areas. It was also really cool to see what other people were working on. I learned about so many impressive research projects going on in women’s health. And it’s really exciting to see so many really motivated researchers out thereIn research, you often have to just pick your little area and kind of stay focused on that. But I think it was really exciting to see how many different areas are being addressed even just in BC and Canada.

Is there anything else you are currently working on?

I am still helping out with the trainee research presentation for the WHRC. We just had one in June and we will likely have another in September. I love hearing about more research being done in the field of women’s health and it is an opportunity for trainees ranging from undergrad to post-doc to showcase their work and practice presenting. So, if anyone wants to participate in that, then they can reach out to me.

Where can people find you and your work?

I’d be happy to connect on Twitter so I can be found at @AlexandraLukey there for any questions. If people are more interested in the research aspect of things feel free to email me alukey@mail.ubc.ca