“We can help ovarian cancer patients see their children grown, graduate, have a wedding—experience important life moments.” – Monique Spillman, MD, PhD
Dr. Monique Spillman is the gynecologist you never want to have to meet.
She is one of just eight gynecological oncologists in Colorado and about 900 nationwide. GYN oncologists are required to complete three to four years of regulated fellowship after their residencies and take two additional board-certification tests. Throughout their advanced training, they must prove themselves not only as researchers but also as clinical care providers and surgeons, with a specified amount of time devoted to cervical and endometrial cancers. Unlike cancer specialists who might only handle chemotherapy or do surgery, GYN oncologists do both.
“We take care of patients from diagnosis through their survival or death,” said Spillman, assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine. “We’re with them through the whole process.”
Spillman has devoted her career to identifying the biological underpinnings of ovarian cancer, once referred to as the “silent killer.” The disease was thought not to have symptoms and could therefore go undetected until it had advanced.
This year, Spillman received the Liz Tilberis Scholars Award from the Ovarian Cancer Research Foundation. The competitive award, a $450,000 three-year grant, is given to early-career researchers who are developing techniques for early diagnosis and improved care for women with ovarian cancer.
Away from the lab, surgery suite and bedside, Spillman advocates for women on a national level, as vice-chair of the government relations committee of the Society of Gynecological Oncologists. SGO was one of the key sponsors of the 1997 Johanna’s Law. The law, spearheaded by the surviving sister of fashion editor Johanna Silver Gordon, sets up federal funding for an ovarian cancer awareness campaign.
Last September, Spillman and her committee presented an educational program to Congressional staffers who, largely due to their young age, “had very little exposure to the disease. They didn’t realize how much research had been done and how much could be done. It was astounding.”
Within days, Congress doubled appropriations for ovarian cancer research.
Ovarian Cancer Symptoms
Ovarian cancer has been called the “silent killer,” because doctors didn’t think the disease had symptoms. But in 2007, the American Cancer Society, the Gynecologic Cancer Foundation and the Society for Gynecologic Oncologists issued a consensus statement based on medical studies that show symptoms do exist, even in early stages, including:
- pelvic or abdominal pain
- trouble eating or
- feeling full quickly
- urinary symptoms, such as urgent or frequent feelings of needing to go
These symptoms can also be caused by non-cancerous diseases. In ovarian cancer, the symptoms are generally a change from normal or are more severe than usual. Women who have these symptoms daily over several weeks should consult a doctor who specializes in women’s health, if possible.
Spillman became interested in ovarian cancer because she was “in awe” of the enormity of the disease and the way it presents.
“We have pounds of tumor,” she said, describing how the disease can float in the abdomen rather than being attached to specific organs like other cancers. “It has free rein.”
Ovarian cancer patients today have more hope than every for longer life after diagnosis. Drugs have improved. Aggressive treatment such as interperitoneal chemotherapy is used in appropriate patients, like survivor Elizabeth Corless. Five recent clinical trials have shown that this treatment, in which a mixture of chemotherapy drugs and saline is injected into a woman’s pelvic cavity and abdomen, at least doubles the time women survive after diagnosis.
“Survivor is a good word,” Spillman said, adding that ovarian cancer “can almost be managed as chronic disease. We may not be able to cure patients, but we can help them see their children grow, graduate, have a wedding—experience important life moments.”