Q&A with Dennis S. Chi, MD, FACOG, FACS
Deputy Chief of the Gynecology Service and Head of the Ovarian Cancer Surgery Section, Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
Q: What role does a gynecologic oncologist play in the diagnosis and treatment of ovarian cancer?
The gynecologic oncologist is the only specialist/subspecialist trained to diagnose and treat patients with ovarian cancer. They are trained to do the appropriate surgery for diagnosis and the first step of treatment, called surgical staging surgery or primary cytoreductive surgery. Gynecologic oncologists also have the expertise to know which drugs to give patients, and how to give them, for those who need chemotherapy after surgery.
Q: Have there been advances in screening for ovarian cancer that are providing benefit to patients?
The biggest advance in screening for ovarian cancer is the realization that the most common ovarian cancer, high-grade serous carcinoma, starts in the tips of the fallopian tubes, not in the ovaries themselves. I believe that preventive methods, such as removal of the fallopian tubes when women are done with child bearing, has promise, but currently I do not believe there are any screening methods that provide benefit to the general population.
Q: For a woman newly diagnosed with ovarian cancer, what questions are important to ask as she and her doctor evaluate treatment options?
Numerous studies have demonstrated that both higher-volume physicians and higher-volume centers have better outcomes than lower-volume physicians and lower-volume centers. So a key question to ask is not just how much experience the individual physician has in treating ovarian cancer but also what the volume is
of ovarian cancer patients treated at that specific institution.
Q: What role might genetic testing play in treatment planning for ovarian cancer?
Currently, genetic testing does not help all patients in treatment planning for ovarian cancer, but the information obtained may be able to help up to one-quarter or more of those diagnosed with the most common ovarian cancer, high-grade serous carcinoma.
Q: What recent advances in the treatment of ovarian cancer are showing promise for patients today?
The two most promising areas of treatment include the use of poly (ADP-ribose) polymerase (PARP) inhibitors and immunotherapy. PARP inhibitors are a class of oral therapies already approved by the US Food and Drug Administration for the treatment of patients with inherited ovarian cancers; these therapies are showing promising results in studies of patients with noninherited ovarian cancers.
Immunotherapies—drugs that mobilize the immune system to attack cancer—have shown promising and prolonged benefit in early-phase clinical trials for patients with ovarian cancers and are therefore undergoing more extensive study in patients with advanced ovarian cancers.
Q: What trends in treatment do you feel will continue to provide new options for patients in coming years?
As we learn more about the genetic and molecular profiles of ovarian cancer, we hope to develop more-targeted therapy for a specific patient’s exact abnormality.
More Questions About Ovarian Cancer? Join the Conversation.
The National Ovarian Cancer Coalition (NOCC) now offers a social network for women with ovarian cancer. The NOCC CancerConnect Community offers these women a safe, secure, and private online resource, where they can find peer-to-peer support, share their experience, and build community. This new online platform is now available at nocccommunity.ovarian.org.
“Women with ovarian cancer and their families need ongoing access to information and support—not just during a brief office visit with their physician. They need help during sleepless nights, as well as busy days,” explains Charles H. Weaver, MD, a medical oncologist and chief executive officer of OMNI Health Media. “We are pleased that leading advocacy groups like the NOCC continue to select CancerConnect as the preferred social media application. Increased awareness, improved genetic testing, and access to new management strategies—all are important for women at risk of developing ovarian cancer, as well as those battling the disease.”
Registering with the NOCC CancerConnect Community is fast, free, and confidential.
Join today at nocccommunity.ovarian.org.
Dennis S. Chi, MD, FACOG, FACS, has served as a faculty member of the Gynecology Service, Department of Surgery, at Memorial Sloan Kettering Cancer Center (MSKCC) since 1997. He is currently the deputy chief of the Gynecology Service and head of the Ovarian Cancer Surgery Section. He was co-director of pelvic reconstructive surgery and director of the Gynecologic Oncology Fellowship and the Pelvic Reconstruction Clinical Research Fellowships from 2001 to 2014. He helped establish the International Gynecologic Oncology Fellowship program at MSKCC. His experience in population-based and patient-oriented research has led to more than 200 peer-reviewed publications and international presentations that have demonstrated the safe use of advanced minimally invasive surgical techniques in the management of early ovarian cancer, the beneficial effects of the use of extensive surgical procedures for advanced and recurrent gynecologic cancers, and the establishment of clinical guidelines to determine appropriate candidates for second and third operations in cases of recurrent uterine and ovarian cancer. Dr. Chi is the principal investigator of four current MSKCC Institutional Review Board–approved prospective clinical protocols, including a randomized, multicenter Phase II trial comparing secondary cytoreductive surgery with and without heated intraperitoneal chemotherapy in patients with recurrent ovarian cancer. On a national level, he has served multiple times as the director or a faculty member of the Society of Gynecologic Oncology’s annual postgraduate courses aimed at instructing gynecologic oncologists throughout the world on the most up-to-date surgical treatments for women with gynecologic malignancies.