Gynaecological cancers, from ovarian to cervical; we’ve come so far, but we’ve got so far to go. 

A little bit about me:

Hello! My name is Dr Amy Wilson and I’m a scientist researching ovarian cancer at the Hudson Institute of Medical Research in Melbourne/Naarm. I’m originally from Gippsland (Gunai Kurnai land), I love painting, making earrings and lots of other crafty things, I sing in a choir (I just sung with the Night Chorus at the RISING festival in Melbourne!), I like to dance (even if I’m not good at it!) and mindlessly sitting on the couch watching various kinds of competition reality shows.

My current research is focussed on characterising a rare sub-population of ovarian cancer cells called “leader cells”.

Follow the leader: researching and targeting the drivers of ovarian cancer

Unfortunately, the majority of ovarian cancers are diagnosed at a late stage when the cancer has already spread to other organs. Treatment is usually initially successful, but a large number of patients will relapse, meaning their cancer comes back. When this happens, the cancer is much less likely to respond to chemotherapy (‘chemo-resistance’) and there are limited alternative treatment options. As a result less than 30% of patients with ovarian cancer will survive for more than 5 years.

A few years ago, our laboratory discovered a small but deadly population of ovarian cancer cells called “leader cells”, and rightly so. These cells are responsible for “leading” the spread of cancer cells from the ovary to healthy organs. Leader cells also don’t die when treated with chemotherapy so are large contributors to disease relapse and chemo-resistance.

Because leader cells were only recently discovered, there are no treatments that specifically target them. Our research at the Hudson Institute is looking at ways to target and eliminate leader cells as a way to allow the cancer to become responsive to chemotherapy again and subsequently eliminate the cancer for good. This project is so important because it addresses the now – the people that already have ovarian cancer – in the hopes that it provides an alternative for those who have exhausted all other treatment options.

My journey to becoming an ovarian cancer research scientist

When I left school, I had no idea what I wanted to do; I had several interests and I actually started a music degree! After a year I decided it wasn’t for me and I transferred to science where I discovered a passion for uncovering the unknown. I was drawn particularly to cancer biology because it was wild to me that the very cells that sustain us can also develop a ‘mind of their own’ of sorts, go rogue and take over.

The real driver for me becoming a research scientist was my grandmother. We lost her to Motor Neurone Disease (MND), and at the time I became frustrated because there was no treatment or cure. There are so many diseases that have disproportionate survival rates in addition to gaps in funding and awareness. What could I do to help?

After finishing my undergraduate degree in 2014, I decided to explore different laboratories where I could commence my research journey. After interviewing with several labs, I landed an interview with an ovarian cancer group. As a woman with ovaries and a science degree, I was shocked to find out the alarming statistics around ovarian cancer: there’s no early detection test, there are limited treatment options, and under 30% of people diagnosed with late-stage ovarian cancer will not survival long term. If I had such little knowledge about ovarian cancer, what chance does the average person have? 

 

Common misconceptions about ovarian cancer

There are two major misconceptions surrounding ovarian cancer. A survey conducted several years ago found that over 50% of Australians believe a Pap smear or cervical screen could detect ovarian cancer, or they didn’t know (1). This is untrue – Pap smears detect cancerous or pre-cancerous changes in cervical cells (cells from the bottom of your uterus) and cervical screening detects HPV, a type of virus that can cause cervical cancer.

The other misconception is that the HPV (Gardasil) vaccine many Australians get during high school protects against ovarian cancer. This is also untrue – these vaccines protect against the strains of HPV that are likely to cause cervical cancer.



The importance of cervical screenings for cervical cancer

We are lucky to live in a time and place that we are able to screen for several cancer types, one being cervical cancer as part of the National Cervical Screening Program. Cervical cancer is largely preventable as screening can detect abnormalities while cells are in the pre-cancerous stage, allowing for treatment prior to cancer progression. Now hang with me here while I cover some boring but important statistics! The 5-year survival rate for cervical cancer is around 92% when detected at an early stage (localised to the cervix / uterus); however, this drops to ~59% when the cancer has spread to close by lymph nodes and ~17% when it has spread to distant organs (2). Survival rates are even lower for those who live in regional or remote areas and for Indigenous Australians (3). Additionally, 90% of cervical cancer cases occur in people that had either never screened or were overdue for their screen (4). It’s also important to point out that a positive HPV test doesn’t mean cancer; most HPV infections go away on their own not every strain is known to cause cervical cancer development (5). These stats highlight the importance of detecting cervical cancer early and keeping up to date with cervical screening, even if it is a little awkward and uncomfortable!


References

1. State of the Nation: Research Audit. Ovarian Cancer Research Foundation; 2020.

2. 2012-2018 Cancer Stat Facts: Cervical Cancer.  Surveillance, Epidemiology and End Results Program, National Cancer Institute.

3. Diaz A, Baade PD, Valery PC, Whop LJ, Moore SP, Cunningham J, et al. Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012). PLoS One 2018;13:e0196764

4. Cervical screening in Australia 2019. Australian Institute of Health and Welfare; 2019. Report nr 1039-3307. 107 p.

5. Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev 2003;16:1-17

Leave a comment

Please note: comments must be approved before they are published.