Season 2 Episode 1: Catching Up with the Gynecologic Cancer Initiative

Welcome back to the GOSH Podcast!

To start off Season 2 we are joined again with Dr. Gavin Stuart, strategic lead of the Gynecologic Cancer Initiative. In this episode, Dr. Stuart summarizes what the GCI has accomplished over the past three years, discusses pandemic highs and lows, and shares what's next for the GCI.

For more information on the Gynecologic Cancer Initiative, please visit https://gynecancerinitiative.ca/ or email us at info@gynecancerinitiative.ca

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Transcript

Introduction 

Thanks for listening to the GOSH podcast. Gosh stands for the gynecological oncology sharing hub in open space for real and evidence based discussions on gynecological cancers. We'll share the stories of garnie cancer patients and survivors, and hear from researchers and clinicians who are working behind the scenes to improve the lives of people with gynecological cancers. Our podcast is produced and recorded on a traditional unceded territories of the Musqueam, Squamish and Sweet Tooth nations. It is produced by the Gynecological Cancer Initiative, a province wide initiative in British Columbia, with the mission to accelerate transformative research and translational practice on the prevention detection, treatment and survivorship of gynecological cancers. 

Hi I'm Nicole K and I'm Stephanie Lam, and you're listening to the Gosh podcast. 

Stephanie 

Welcome back to season two of the Gosh podcast. So after taking off a few months over the summer, Nicole and I are back to share more patient stories and talk more about gynecological Cancer Research in BC. 

We have a lot of exciting episodes and exciting guests coming onto the podcast, so stay tuned for what's to come. Now before we dive into these stories, we thought that this would be the perfect time to get an update on the Gynecological cancer initiative. 

So for those who don't know, the GCI is a provincial research initiative that works across institutions and across all 5 gynecological cancers to accelerate transformative research in prevention, detection, treatment, and survivorship. 

So the GCI has been around for a few years now, so we thought it would be a good time to connect and hear about what some of the major accomplishments of the GCI has been and some of the challenges that the group has encountered, particularly over the last year, with the COVID-19 pandemic. So this guest joined us back in episode 2 when we talked about the GCI’s bold mission of reducing the incidence, death and suffering by 50% by 2034. So we're really looking forward to reconnecting and hearing more about the GCI, so Nicole, would you like to go ahead and introduce our first guest? 

Nicole 

I would love to! Welcome back Doctor Gavin Stewart a professor in the Department of Obstetrics and Gynecology at the University of British Columbia. 

He previously served as the Dean of the Faculty of Medicine at that institution from September 2003 to September 2015 and UBC's, vice Provost health from 2009 to 2016. 

Doctor Stewart remains an active teacher, clinician and researcher at UBC as an academic clinician, he works with the gynecological oncology team at Vancouver General Hospital and BC Cancer. His research and publications are focused on clinical trials in the prevention and treatment of gynecological cancers. 

Doctor Stewart is also the strategic lead for the Gynecological cancer initiative. 

So thank you for coming back onto the Gosh podcast and sharing all this important work that you do. 

Gavin 

You're more than welcome. 

 Nicole 

So before we get started and dive into the serious stuff we're going to have some fun, so we got a few icebreaker questions to get started. 

Are you ready? 

Gavin 

I I hope so. 

Nicole 

OK, first one. 

Are you an early bird or a night owl? 

Gavin 

Oh, that's easy. I'm an early bird. I usually get up at 5:30 every morning, and unless it's summer and I might get up at 5:00 o'clock to go bike riding. 

Nicole 

Even on the weekends? 

Gavin 

Yes! 

Nicole 

True early bird. Okay if you could eat only one item of food for the rest of your life, what would it be? 

Gavin 

Oh my goodness. 

I'm a foodie and I love eating. So this is hard. 

But I think I would say either halibut or salmon. 

Nicole 

Good choice. 

All right, last one. 

Would you rather live where it only snows, or the temperature never falls below 40 degrees? 

Gavin 

That's easy, I feel like sort of one of those cartoon characters when it's over 40 degrees I just melt in a blob on the ground, so I'll take the snow any day. 

Nicole 

Perfect all right onto the serious stuff. 

Thanks for having some fun with us, so why don't you start and tell us about some of the major accomplishments that the GC the GC has had over the last three years? 

Gavin 

Gosh, that's so well I shouldn't say Gosh that's the name of the recording, but we've had a lot. 

I mean, all of this ultimately is about patients. So certainly for patients we and the women in British Columbia at risk for gynecological cancer, we've had 17 episodes of this gosh podcast for season one all between October 2020 and July 2021 and and this is the start of Season 2, so I hope that's a good aid to patients and trying to understand the landscape of their diagnosis and treatment. 

Additionally, for patients, we've with the leadership of Stephanie Lam, really advanced the patient and Family Advisory Council. We're now starting a patient journey mapping project with BC cancer and it's in collaboration with the BC Cancer Patient Experience Program. That's a a patient LED project, and I'm particularly pleased that it's a provincial project with input from across the province. 

And we have planned now two retreats to include patients, one on survivorship and one on cancer risk stratification and prevention in order to help us develop a provincial strategy for that. 

And then I I'd be remiss if I didn't mention that we did have a survivorship summit in collaboration with the Women's Health Research cluster, another cluster at UBC and that was attended by 56 patient partners, health care practitioners and scholars, and we have released a uh, summit report following that. So, uh, a number of offerings for for patients that I hope are are good from the GCI. 

And it next to patients trainees are so important. That's the next generation of knowledge creates, and I'm particularly pleased what we've been able to do here, so we've had GCI research rounds. We had twelve sets of round presentations, again between October 2020 and June this year we've had the GC Webinar series, which was a series of eight weekly webinars. With over 300 registrants, including international attendance and that was, I'm particularly proud of that.  

We've had a trainee research day which was the first ever we had 27 trainees in in the broad area of gynecological oncology doing presentations about 60 attendees. We had six prize recipients. 

And we were able to offer the Barber berthon award. So that was a really a powerful day and the trainees, I think we're very excited as a result. 

We've set up a training education committee with 15 members working on exciting new projects, a blog and professional developments there. We hope that that will be something that helps support trainees in BC researching gynecological cancers. 

Some of the nitty gritty accomplishments are research funding. You know this group the Gynecological Cancer Initiative has acquired from 2018 until right through till 2025. A total of $88 million committed funds for gynecological Cancer Research. 

So that's all in all sorts of grants and professorships and Canada research chairs and the likes, but $88 million for gynaecologic Cancer Research, incredible second of which is we've been able to establish the Gynaecologic Cancer Nation Clinical Trials group. We've been able to have a competition called the accelerating grants program and we've funded now 7 maiden BC clinical trials and the idea of this is to take those ideas in British Columbia and develop them into clinical trials, generates some data to feed into large national and international trials with BC leadership. 

A number of funding opportunities we've had caressesi, a competition and for that there were six recipients identified. That we have something called the Miller Mendel Fellowship, which is laboratory based training, or at least additional training for qualified gynecologica on call. We've been able to work with industry, Glaxo Smith Kline and they have funded a one to two year term for training in medical oncology in the domain of gynecology. 

So that's a a number of funding opportunities, clinical informatics and tissue banking. We want to make sure that we have the opportunity to look at cancer and understand at a molecular and genetic level why those cells turned left at the intersection instead of right. 

And so to do that we need, we need the tissue. So we have more than 8000 consented patients and we now have more than 63,000 specimens available to look at and I'm most grateful to the women of BC that have allowed us to collect those specimens, and then finally I'll say that gynecological cancer initiative for the third year in a row has been selected as one of the successful UBC research excellence clusters for this academic year, and I think we've had a, uh, a banner year. 

Nicole 

Amazing work, wow. 

Stephanie 

Thanks Gavin, that that's a really good overview of kind of all of the activities that happen. 

You know, within the cluster there's so much collaborations and funding opportunities and events and stuff that have been happening and I really like that you highlighted how important the patient role is within the cluster. 

So thank you for that amazing overview. 

I'm I'm also curious, you know how has the gynecological cancer initiative kind of overcome any challenges over the last year. You know, with the COVID-19 pandemic happening in 2020, you know what were some of the challenges. 

Has the pandemic impacted some of the work that has happened within the GCI and some of the researchers work within the GCI? 

Gavin 

So certainly the pandemic has impacted the work of the GCI, but I'm reminded of the expression of my grandmother when you close the door and you open a window, and truly there have been opportunities that have arisen as a result of COVID, so for example, that rainy day we had hoped that would be an in person fun event for the trainees and that wasn't to be so we had to turn it into a virtual event and suddenly we had trainees from across the province and some from across the country and it just took off. 

Second of which is our research seminars we'd hoped a lot of those would be in person, and Stephanie Lam and others were able to work to make that virtual, and as a result we had people patching into the research seminars from across the country from other universities, Dell, housing, McGill, and so on, so. 

Yeah, yes there is an impact. 

There has been an impact on some of the library work. Most of the scientists have done being very resilient, they’ve recognized that they're not able to generate new data if they're not in the laboratory, but they have been very creative in mining the data that they have in the home setting and continuing to publish. 

And I think evidence of the work that continues to go on even during COVID are people like Janice Kwan who were promoted to professor and all this was during COVID. 

And so yeah, there there there were challenges. 

But also I'm I, I am incredibly impressed with the creativity of the team and their ability to turn a having been given lemons, they've been selling lemonade at a rapid rate. 

Nicole 

So you know, I think we talked about this in the first season. You know what has really made the GCI successful to date? And I remember one of the key things that you talked about was collaboration was a big piece of that. You know everyone coming together for one common initiative. 

Would you say that that is still what makes the GCI successful, or has anything changed in that space? 

Or what would you say? You know, really today what what's continuing to make it successful. 

Gavin 

Well, I think you're quite right, Nicole that that collaboration has been central to the success of the Gynaecologic Cancer initiative. And I have repetitively stated this is not about the GCI. This is about caring and looking after the women of British Columbia and can we all come together to do that, and I've been very impressed that the team has bought into that and and have come together. 

I think another a piece that is is changing and I hope it continues to change os the need to essentially demonstrate selflessness and this this isn't about an individual or an ego, or a a prize. Or whatever else. This is a cooperative attempt to see if we can actually impact the health of the women in BC. 

You either have gynecological cancer or risk for gynecological cancer, and that requires a selflessness that people can just continue to drive ahead knowing that it's not about them, it's about helping others and I I think oeople are starting to endorse that and and realize well if we're going to do that. Working together would allow us to be even more effective, and personally I get very excited about it. 

I I I celebrate with with individuals with all of them, Individual successes, but this is about the collective impact on the health of women. 

Nicole 

I think you know, as someone who is a patient partner and you know a bit of an outsider to the group, or really feel that that is what is at the core of what you're trying to do, like Stephanie does so much great work in including us as patient partners and giving us opportunities and even. 

Just blending us into that survivorship summit or, you know, the webinar series, just having opportunities for not only our voices to be heard but for us to just join in and hear what's going on and be a part of that journey. 

I think really highlights that truly are focused on us as patients and our well being and and providing solutions or improvements in treatment, research and really feel that as someone who represents that you know past patient community. 

Gavin 

Well, exactly and I I think, well, I'm very pleased to hear you say that Nicole, that that's what you see through the lens that you bring to the table, because it's exactly what I'd like to see reflected for the GCI. 

And I mean even down to the the academic environment is is a bit funny, sometimes it it can be very competitive and and who's the first author and who's the last author and who gets the credit. 

I've just been so pleased this past year that people are publishing papers where the first author maybe the trainee the the first author, maybe one of the hardworking persons in the middle and and that sharing of success really builds a team. 

Nicole 

Absolutely 

Stephanie 

Yeah, that's so important and and I absolutely see the patient partners as being part of a really important part of the GCI and all of the work that yourself Nicole, that you do and all the other patient partners definitely really make the GCI really special. So I'm really grateful for all the work that you folks bring into the team. 

You know Gavin now looking forward into the future. You know what, what is the goal for GCI over the next 3-5 years? What are you most excited about as the GCI continues to grow and move forward? 

Gavin 

Well, I'm excited and anxious all at the same time because I think the next three years, the GCI has to deliver the goods. 

So we need to be able to demonstrate that the work we're doing is actually improving the health of the women at affected by, or at risk of gynecological cancer. 

What am I excited about is we're starting to do this and there's a paper coming out in the very near future, led by Gillian Hanley, who's been looking at the outcomes of women who have had opportunistic salpingectomies in the province at the time of cesarean section, or at the time of a hysterectomy. 

To me, and those women are actually showing a reduced risk, a dramatically reduced risk of developing a cancer, and so we've now been doing this for more than 10 years, and we can actually show the impact of the strategies that we're putting into place now. 

There's a lot more to do, we're generating a lot of data around the use of HPV vaccine and the impact it has on cervical cancer. 

But the GCI is going to have to deliver over the next three years, and show evidence that what we're doing works, and I think we can do that. I'm very excited about it. 

I think you know, quite frankly. That's why there has to be a significant and substantial patient engagement because it doesn't matter what we think is what the patients think. 

Nicole 

One thing that I wanted to just I was curious about in terms of where you see the GCI going is I was talking to someone the other day and they were telling me about this clinic that exists within QQ, called the prostate Cancer Support care. 

I don't know if you're familiar with that. 

Gavin 

Yes, yeah very much so. 

Nicole 

And it seems like it's a really established program that exists. I I did some, you know, just checking it out, it's been around since 2013. It really focuses on survivorship and you know a lot of things that I think you know myself or or other women have gone through. 

Gyne cancers also struggle with, you know when we look at sexual health or requiring pelvic floor physio on our side, right? Menopause management. Those kinds of things. 

Is that something that you see possible happening in the gynae cancer space or or how? 

I mean, I don't know how something like that came to exist, but it seems like there's some correlation or some value that we'd see on our side and and how does a program like that actually get established? 

Gavin 

So I think this is something that's being discussed in the patient and Family Council, and I would hope that's where it would come through. 

One of the keys there, Nicole, is that in bringing persons together under the umbrella of survivorship, we have to be very sure that we have a culturally sensitive environment that people feel safe. 

Yeah, first and foremost because that's that that's a major issue for a lot of women in our province. 

If we can create that culturally safe environment, I think there's a very rich opportunity to do exactly what you were talking about. 

The prostate group did establish a support group some time ago, and that's being very, very popular. 

I don't know the demographics of that, how inclusive it is or or whatever else, but our focus is to create an inclusive, culturally safe environment that we can have those support groups in a meaningful way. 

NIcole 

Yeah, and thinking about like how COVID has kind of changed the way we all work we're doing so much more virtual now. 

There's more Telehealth that's existing, does you know the change in landscape with those technologies and us getting more comfortable in, say, meeting with a health provider via zoom or some other platform. 

Uhm, it opens up doors for, you know, having a more inclusive support system when you're thinking about support groups and not do you feel like that changes the landscape to make it more? 

Uhm, you know supportive for all inclusive for all those in BC, regardless of whether you're in a metropolitan center or somewhere more rule you know, does it open more doors for us to explore those opportunities? 

Gavin 

It it it opens a lot of doors because what we're finding with Tele health is. A kind of interesting inclusivity that we didn't have before. 

In particularly for patients coming to Vancouver for particular specialized treatments. 

We now know that the Tele business beforehand can include the woman, son, her auntie or Granny. And many times I'll do a zoom or or a phone call and and and there's four persons in the room, all ask questions at the same time. But I think that creates an environment of inclusivity that is very helpful. 

And also when I speak of cultural sensitivity, I think it also starts to set the or establish the message that we want you to feel safe. And so I think that's been a very positive impact. 

Nicole 

Perfect well thank you so much for joining us today. It's always a pleasure to have you on the podcast and hear about you know the really great work that you are doing and we we appreciate it. We enjoy having you here, so thank you for joining us for our first episode back in season 2. 

Gavin  

Delighted to be a part of it and I thank you too for your leadership in this. I think this is a an extremely important project and I really appreciate what you're doing. 

Outro 

Thanks for joining us on the Gosh podcast. To learn more about the Gynaecologic Cancer initiative and our podcast, make sure to check out our website at gynecancerinitiative.ca.