Ovarian cancer is a very difficult disease for oncologists to treat and would benefit tremendously from new investments in research. The major challenge is that ovarian cancer is usually detected after it has already spread to other parts of the body so it cannot simply be removed surgically. In addition, while it usually responds to chemotherapy treatment, the cancer usually comes back and is resistant to treatment. The question is how can we develop new and more effective treatments?
The answer may be related to where the tumor originates. For a very long time, it was thought that ovarian cancers actually started in the ovary, prompting researchers to focus their investigation there. However, we have recently determined that ovarian cancer may actually arise in the fallopian tubes, which carry newly produced eggs from the ovary to the uterus. The reason for this is thought to relate back to a concept first proposed more than 100 years ago by Dr. Stephen Paget. He proposed that for cancer to spread and grow two things are necessary - tumor cells, which can be thought of as seeds, and a hospitable environment where they can grow, which can be thought of as soil. In the case of some ovarian cancers, the “seeds” actually start in the fallopian tube and the “soil” is the ovary.
This realization has led to a sea change in ovarian cancer research, changing the focus of our investigation to understanding the changes that occur in the fallopian tubes that produce the cancer cells or “seeds” and are necessary to enable those seeds to take root and spread to the ovaries, which makes them appear as if they actually started in the ovary. Investigators at Fox Chase, including Dr. Denise Connolly, have developed experimental model systems to study the fallopian tubes and identify the changes necessary to support the growth and spread of ovarian cancer and to then exploit that knowledge to identify new therapeutic strategies to intervene and kill the resulting cancers. We are confident that this change in focus will enable us to gain a more accurate understanding of how normal ovarian and fallopian tube development goes awry to cause cancer and how to intervene and stop it.
David L. Wiest, Ph.D.
Deputy Chief Scientific Officer
Denise C. Connolly, Ph.D.
Director, Biosample Repository Facility