In partnership with the Foundation for Women’s Cancer, the National Ovarian Cancer Coalition provided funding for two Young Investigator Research Grants, which accelerate the research of young investigators to promote the long-term success of the gynecologic oncology field.
Two awards were granted to young investigators who focused on areas of research that align closely with our mission, to save lives through the prevention and cure of ovarian cancer and to improve quality of life for survivors and their caregivers. Dr. Sushmita Gordhandas was awarded the NOCC Research Grant for Early Detection of Ovarian Cancer, and Dr. Katharine Esselen was awarded the NOCC Research Grant for Quality of Life.
We sat down with our two awardees to discuss their current work and the impact they hope to make on the ovarian cancer community.
What research are you working on, and what does it address?
Dr. Sushmita Gordhandas (SG): My research focuses on risk-reducing surgery in patients at high genetic risk for epithelial ovarian cancer (e.g., HBOC, Lynch syndrome). Removal of fallopian tubes and ovaries prior to natural menopause is recommended for these patients to reduce ovarian cancer risk by up to 96%. There are studies underway to assess quality of life and cancer risk reduction after the removal of fallopian tubes with the delayed removal of ovaries. The decision to undergo risk-reducing surgery is complex and multifactorial; our research funded by NOCC aims to identify common themes and influential factors surrounding risk-reducing surgery in this patient population.
Dr. Katharine Esselen (KE): I am examining the financial impact that an ovarian cancer diagnosis has on patients and their families. National surveys have shown that ~50% of individuals with cancer experience “financial toxicity.” Financial toxicity is defined as the financial distress or hardship caused by a cancer diagnosis and its associated treatments. Our research confirms that up to 50% of patients with gynecologic cancers experience “financial toxicity.” We have learned that patients who have high financial toxicity are twice as likely to need to use savings, five times more likely to reduce spending on basic necessities, and up to 12 times as likely to need to borrow money or apply for financial assistance to pay for their medical care. Further, increasing financial toxicity is associated with worse quality of life. In one national survey study, we found that ovarian cancer patients with financial toxicity were seven times more likely to delay or avoid medical care as compared to those without toxicity. Further, we have shown that patients with severe toxicity were 4.6 times as likely to report not taking their medicines as recommended. Our research seeks to better understand the drivers of financial toxicity and find ways to intervene and mitigate the potentially devastating impact on patients, their families, and their cancer outcomes.
What is your connection to ovarian cancer? Why ovarian cancer?
SG: I am currently a second-year gynecologic oncology fellow at Memorial Sloan Kettering Cancer Center. A commitment to improving care for women with cancer has guided my entire career in medicine, leading to my current research on hereditary gynecologic cancers. I have a particular interest in early detection, risk reduction, and improving quality of life for patients with a high risk for gynecologic cancer. The field of genetics within gynecologic oncology has transformed our understanding of ovarian cancer. The opportunity to identify patients before they develop cancer or at an early, curable stage is exciting for its capacity to save lives and empower patients.
KE: I am a gynecologic oncologist and have had the privilege of caring for many women with ovarian cancer over the last 14 years. Of all the cancers we treat, ovarian cancer remains the most deadly gynecologic malignancy in the United States. Thus, unsurprisingly, it is one of the most costly for our patients. I am always inspired by the grace and dignity with which my patients approach their ovarian cancer diagnosis and all of its associated treatments and disease-related complications. As providers, we are accustomed to supporting our patients through major surgery, chemotherapy, and associated adverse effects and complications. However, what we often don’t recognize is the financial toll the disease takes on patients and their families, negatively impacting quality of life and cancer outcomes. Therefore, just as we are striving to find ways to detect ovarian cancer earlier, improve surgical and therapeutic options, or find novel approaches to treat recurrent disease, we should also be screening for and addressing financial toxicity to improve our patients’ health outcomes.
What is the potential impact of your research on patients, etc.?
SG: There is limited published literature on the decision-making process in this patient population. Our study will provide invaluable information from the patient perspective to better understand and help guide our patients and providers in this decision-making.
KE: Our current work is closely examining the implementation of a novel financial navigator program. Through this program, all new patients will be screened for financial toxicity and other important social determinants of health. In addition, to pro-actively identify patients suffering from financial toxicity, the program will enable us to understand the source of their financial distress and efficiently connect them with resources and tools to manage the financial hardship. Through close evaluation of this program, we hope to develop best practices that might be applied to other institutions and broader cancer populations. The work will further elucidate the drivers of financial toxicity and its associated downstream effects. By deepening our understanding of ovarian cancer-associated financial toxicity, we also hope to raise awareness and provide further evidence to inform policy-level interventions to reduce the financial burden of disease for all patients.