Straight talk about cancer
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Straight talk about cancer

Dr. Sharyn Lewin discusses women’s health for Sharsheret

Dr. Sharyn Lewin
Dr. Sharyn Lewin

September is Gynecologic and Ovarian Cancer Awareness Month.

Something to know: Every five minutes, someone is diagnosed with a cancer of the female reproductive system.

Another sobering fact: More than 33,000 women will die from a gynecologic cancer this year, according to the Foundation for Women’s Cancer.

Ovarian cancer accounts for more deaths than any other cancer of the female reproductive system. It is the fifth leading cause of cancer-related death in American women. Although ovarian cancer is one-tenth as common as breast cancer, it is three times more lethal.

This is why Dr. Sharyn Lewin, the medical director of the gynecologic oncology division at Holy Name Medical Center in Teaneck, was invited to speak at a free national webinar about updates in the symptoms, diagnosis, and treatment of ovarian cancer last week.

Holy Name sponsored the webinar with Sharsheret, a 20-year-old nonprofit organization that’s based in Teaneck with branches across the country. Sharsheret offers services in support of Jewish women diagnosed with breast and ovarian cancer and their families.

“I want to educate people about the signs and symptoms of ovarian cancer because we know it’s not as silent as we once thought,” Dr. Lewin said.

“Unfortunately, we don’t have a good screening mechanism for ovarian cancer, so it’s important for women to know their bodies and if there’s a change, to seek medical attention with their gynecologist right away. Symptoms include ongoing bloating, abdominal or pelvic pain, feeling full too quickly, and difficulty with urination. Often the symptoms have been going on for many months before women are actually diagnosed with ovarian cancer.”

Dr. Lewin, who also is an assistant clinical professor at the Icahn School of Medicine at Mount Sinai Hospital, urged any woman with a family history of ovarian or breast cancer to get genetic testing for the presence of a mutation in the BRCA1 or BRCA2 gene, which is more common among people of Ashkenazi Jewish heritage than the general population.

“We may be able to intervene before a cancer develops,” Dr. Lewin said, adding that gynecological oncologists are best equipped to treat cancers of the female reproductive tract.

According to the National Cancer Institute, about 1.2 percent of women in the general population will develop ovarian cancer at some point, but 39 to 44 percent of women with an inherited BRCA1 variant and 11 to 17 percent of women with an inherited BRCA2 variant will develop ovarian cancer by the time they’re between 70 and 80 years old.

The hopeful news is that some new treatments are available, Dr. Lewin said. After surgery and chemotherapy for ovarian cancer, many women are eligible for maintenance treatment with a pill called a PARP inhibitor.

“There’s a lot of great data that not only women with BRCA mutations but also those whose tumors have something called homologous recombination deficiencies are now eligible for treatment with PARP inhibitors,” she said.

“It’s very important for any woman who has, or had, ovarian cancer to have genetic testing to look for the BRCA gene and also to have tumor testing to look for these homologous recombination deficiencies. We are now able to treat them with these amazing maintenance drugs that are delaying, preventing a recurrence, and even curing some women. These drugs became available about a year ago, but because a lot of the data was released during the pandemic, it didn’t get as much publicity as it should have, and we need to arm patients with this information.”

While immunotherapy so far has proved disappointing in treating ovarian cancer, Dr. Lewin said, she encourages women with ovarian cancer to participate in clinical trials available to local residents through her division’s collaboration with the Gynecologic Oncology Group, a nationwide cooperative.

“One exciting multicenter national trial is for newly diagnosed women, using standard chemotherapy with the addition of immunotherapy during and after chemotherapy,” she said. “We also have a lot of trials for patients with recurrent ovarian cancer, and I’ve seen some promising results.”

Dr. Lewin addressed the pressing issue of how covid has affected the early diagnosis of cancer.

“Since the pandemic, we have seen across the country a real drop-off in screening exams – mammograms, Pap smears, colonoscopies – and that leads to a lot of missed cancer diagnoses. When women are not getting these important screening exams they get diagnosed at much more advanced stages.”

She assures women that “especially here where we live, the hospital is definitely safe. People are wearing masks and are vaccinated. We really urge women to get their screening exams and not neglect their health.”

Elana Silber, Sharsheret’s chief executive officer, echoed that statement.

“We hear so much in the news about covid and cancer, including the risks associated with being immunocompromised and pushing off checkups and appointments during the pandemic,” Ms. Silber said.

“Regular checkups and screenings are the best way to detect cancers at an earlier stage, when they can be treated and even cured. If you are living with cancer or if it’s time for your routine cancer screening, do not delay. Reach out to your healthcare professional and schedule your appointment. It can save your life.”

On the topic of covid, Dr. Lewin stressed that “everyone needs to be vaccinated. But patients who are immunocompromised – including anyone receiving cancer treatment or who completed cancer treatment in the past six months — need to have a third dose or booster of an mRNA vaccine.”

Sharsheret has been hosting interactive webinars with medical experts approximately every other month during the pandemic, Ms. Silber said. Webinars are also organized “on demand if a new study or data point comes out that is relevant to the Sharsheret community.”

There’s information about Sharsheret, including its webinars, on its website, www.sharsheret.org

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