by Dr. Paola Gehrig
Volume 4/Number 1
|  | | Dr. Paola Gehrig in the lab with Dr. Young Whang and Dr. John Boggess | My decision to become a gynecologic oncologist arose from a series of many influences. As I prepared for medical school, I felt destined for a career in surgery. As a child I learned the ideal of fixing that which was broken. While in medical school, I was exposed to general surgery and oncology. While fascinating, these individual rotations did not encompass my complete interests. I then had the opportunity to rotate on the gynecologic oncology service and I felt that I found my career, as these physicians performed surgery, administered chemotherapy and conducted research. Over the subsequent years as I have matured as a physician, it has become clear that the ideal of “fixing” problems cannot always be attained. However, within a sometimes “imperfect” outcome, I know that my efforts can help mend the lives of my patients and their families at an often difficult time. A patient of mine who was on hospice remarked to her pastor that she and her family needed to come see me one more time. He asked, “Why, you have decided to not undergo any additional therapy?” Her reply was, “I need her to help me die, ‘cause I have never died before.” There is a great deal of truth in this statement, and while I could not “fix” her, I could still serve.
My interest in endometrial carcinoma grew out of my desire to help my patients. While endometrial cancer is the most common gynecologic malignancy in the United States, it has not benefited from the research interest and funding that other malignancies have due to its lower mortality. However, statistics estimate that the number of women dying from endometrial cancer has risen 200 percent. The current treatment modalities for endometrial cancer involve surgery, radiation and chemotherapy.  | | Dr. Paola Gehrig with her children, Lauren and Joseph | While we enjoy a moderate amount of success in the treatment of this disease, all the modalities carry significant risks and side effects. Our lab has sought to describe potential molecular targets, which may prove beneficial with modest toxicities.
The majority of endometrial cancers have a mutation in PTEN, a tumor suppressor gene. These mutations lead to an upregulation of other cellular pathways that may give pre-malignant and malignant cells a survival advantage. Rapamycin, an antibiotic, has shown promise as a potential antineoplastic agent. Rapamycin is currently used as an immunosuppressive agent for patients who have undergone organ transplantation and is also being used to coat coronary stents and subsequently decrease the risk of subsequent blockages. As an antineoplastic agent, rapamycin blocks a target (mTOR, mammalian target of rapamycin) and can modulate the survival advantage that cells have as a result of PTEN mutations.
Our previous work suggests that the majority of endometrial cancers, including those without a PTEN mutation, may respond to rapamycin. With the support of The V Foundation, we hope to continue our work investigating rapamycin in the lab, as well as developing a clinical trial to better define the women who may benefit most from this drug. This agent, and others like it, may lead to increasing interest in targeting therapies for endometrial carcinoma and improving our success in treating this disease. Each life is precious, and while I may not be able to “fix” the problem that all of my patients have, I want to know and I want them to know that we are doing everything possible for each and every one of them. I want to be a part of reversing the statistic of increasing numbers of women dying from this disease. I appreciate The V Foundation’s support of our research and their commitment to finding a cure for cancer. | ..............................................................................................................................
Editor's Note: | | Dr. Paola A. Gehrig is the recipient of a cancer research grant funded by the 2004 Jimmy V Women's Basketball Classic. She is a member of the UNC Lineberger Comprehensive Cancer Center and Assistant Professor of Gynecologic Oncology in the Department of Obstetrics and Gynecology at the UNC School of Medicine. She received her B.S. and her M.D. from the University of Florida. Dr. Gehrig lives in Chapel Hill with her husband Tom, her three-year-old daughter Lauren and her one-year-old son Joseph. |
|
My V Grant - Funded Researchers Tell Their Stories 
