Dr. Nita J. Maihle is the dean of a school you might not see but is hoping to make an impact on a deadly and underfunded cancer.
Maihle, associate director for education at Georgia Cancer Center at Augusta University, is dean of the national Ovarian Cancer Academy, a virtual academy for young investigators that is part of the Department of Defense’s Congressionally Directed Medical Research Program. The academy has a $2 million budget this fiscal year, part of $20 million Congress directed toward ovarian cancer research, to fund five-year grants for young investigators to go into the field.
From fiscal year 1997 through 2015, Congress directed $256 million through the program toward ovarian cancer research but that was dwarfed by the $3.2 billion for breast cancer research and the nearly $1.5 billion devoted to prostate cancer research through that same program.
“There’s really no dispute that it is way far behind the other solid tumor sites in terms of the amount of research, the amount of research funding,” Maihle said. When she went to her first ovarian cancer research conference hosted by the National Cancer Institute in 1990, hers was only one of two high-level grants funded by that agency for ovarian cancer.
“We were just stunned to learn that there were so few people studying ovarian cancer,” Maihle said. “And that was 25 years ago. There is no question that we have more funding now. Do we have the amount of funding that we need? Absolutely not.”
Part of the goal of her academy is to get more young researchers to go into the field.
“Part of the goal of the Ovarian Cancer Academy is to build the critical mass of investigators who are not only eligible but well-trained to do ovarian cancer research,” Maihle said. “It is still a very small community.”
The young investigators will need senior mentors as part of their grant application, and that might be a problem for some, she said.
“Because there are so few of us, that in and of itself is a challenge,” Maihle said.
Unlike breast cancer, where the identification of key mutations has led to targeted therapies that have greatly impacted care and survival, ovarian cancer research has not really seen that other than some key mutations that are also linked to breast cancer risk, she said.
“We are learning more about the genetics of ovarian cancer but we don’t yet have that translated into really any biologically targeted therapeutics,” Maihle said.
But that can also be enticement for young investigators to enter the field, she said.
“There is tremendous opportunity here for young investigators because the field is really understudied, even now,” Maihle said.
The difference in outcomes between breast and ovarian cancer is stark.
The American Cancer Society estimates there will be 22,280 cases of ovarian cancer and 14,240 deaths, about 5 percent of the cancer deaths in women this year; breast cancer will account for 246,660 cases this year and 40,890 deaths, or about 14 percent of cancer deaths in women.
The five-year survival rate for ovarian cancer at 46 percent is roughly half of that for breast cancer at 91 percent, according to the cancer society. Many of the young investigators entering the field have those personal connections or know families who have been impacted by it, Maihle said. Cancer is personal for her, too, after watching her father, a veteran of World War II, battle it for 18 months before he died when she was a teenager.
“He was a very robust guy and just melted away in our living room,” Maihle said. Two months before he died, President Richard Nixon declared his “War on Cancer” in 1971 and Maihle was ready to answer the call.
“I went to college knowing I wanted to do something about this disease,” she said.
Now having fought cancer for a long time, Maihle said she and other senior investigators can help their junior colleagues through the academy also understand the need to temper that passion, and even obsession, for science.
“I’ve seen a lot of careers go up in flames along the way because they haven’t been able to have the work-life balance,” she said. “It’s not always easy to find people who are going to say, ‘Yes, it is important to have a happy home life, too, and prioritize that quality of life time as well.’ There’s no question, from my standpoint, you do better work when you have that balance and you have that quality of life.”