Kerri BevisA research team in the University of Alabama at Birmingham Department of Obstetrics and Gynecology, in partnership with Brown University, has been approved for a three-year, $2 million funding award by the Patient-Centered Outcomes Research Institute to study better ways to coordinate the care of endometrial cancer patients among gynecologic oncologists and urogynecologists in an effort to improve long-term quality of life for these women.
The impetus for the study, says Kerri Bevis, M.D., principal investigator and assistant professor in UAB’s School of Medicine, is that women with endometrial cancer also often experience pelvic floor disorders, including urinary incontinence and prolapse. In most cases, the surgeries to remove the cancer and to correct the pelvic floor disorders are performed months or even years apart. The grant will give Bevis and others at UAB an opportunity to develop protocols where both issues can be surgically managed simultaneously.
“It will take a lot of coordination between gynecologic oncologists and urogynecologists to make this program effective, but this is a big step forward for endometrial cancer care in general,” Bevis said. “This is a comprehensive approach to cancer care. It is not only about the isolated treatment of endometrial cancer, but about taking that next step toward maximizing the patient’s ability to live her life to the fullest after her cancer therapy is complete. It really is about caring for the whole patient — more than just her cancer.”
Holly Richter, Ph.D., M.D., director of UAB’s Division of Urogynecology and Pelvic Reconstructive Surgery, is supportive of this research effort.
“Coordination of care for these patients is vital to improving long-term outcomes, and the UAB divisions of Gynecologic Oncology and Urogynecology are committed to this partnership in optimizing care of these women,” Richter said.
| The American Cancer Society estimates about 54,870 new cases of cancer of the uterus are diagnosed each year. Of those, about 10,170 women will die from uterine cancer. While there is nothing life-threatening about urinary incontinence, it is an important predictor of quality of life after cancer treatment in these patients. |
The American Cancer Society estimates about 54,870 new cases of cancer of the uterus are diagnosed each year. Of those, about 10,170 women will die from uterine cancer. While there is nothing life-threatening about urinary incontinence, it is an important predictor of quality of life after cancer treatment in these patients. Stretching two surgeries out over months or years — one to remove the cancer and one to repair pelvic floor disorders — is not in the best interest of the patient, Bevis says.
“Finding effective ways to jointly manage endometrial cancer and urinary incontinence provides the opportunity to reduce patient risk, cost and inconvenience, and to prevent the discomfort and recovery from two distinct surgical procedures,” Bevis said. “We understand that the risk for mortality in women with early stage endometrial cancer stems primarily from comorbidities like obesity, heart disease and diabetes. Urinary incontinence can be a strong deterrent to physical activity for these women, so effective management of their incontinence may reduce barriers to the critical lifestyle changes needed to improve their future health. Hopefully, we can prove that managing both removing the cancer and repairing pelvic floor issues at the same time is something that is feasible and results in a longtime improvement in quality of life.”
The study is one of 46 proposals that PCORI approved for funding April 21 to advance the field of comparative clinical effectiveness research and provide patients, health care providers and other clinical decision-makers with information that will help them make better informed choices.
“This project was selected for PCORI funding, not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Joe Selby, M.D. “We look forward to following the study’s progress and working with UAB to share the results.”
Bevis’ study and the other projects approved for PCORI funding were selected through a highly competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor, among other criteria.
PCORI is an independent, nonprofit organization authorized by Congress in 2010 to fund comparative clinical effectiveness research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health and health care decisions. PCORI is committed to seeking input from a broad range of stakeholders to guide its work.
PCORI has approved $854 million to support 399 research studies and initiatives since it began funding research in 2012. More information about PCORI funding is online.