By Julie Poucher Harbin, Duke Cancer Institute
The commemoration of the 50th anniversary of Duke Cancer Institute (DCI) and the 50th anniversary of the Division of Gynecologic Oncology is underway. A half century ago, in 1972, William T. Creasman, MD, established the division, becoming its first chief. This coincided with Duke becoming an officially designated Comprehensive Cancer Center by the National Cancer Institute.
(Above: Daniel Clarke-Pearson, MD, then chief of the Division of Gynecologic Oncology (left), consults with John Soper, MD (middle), and Andrew Berchuck, MD (right), in 1990.)
Four years before, Duke had already made its first big mark in the field of gynecologic oncology.
In 1968, the late Charles B. Hammond, MD, then a clinical associate, founded the Southeastern Regional Trophoblastic Disease Center at Duke, the first center of its kind in the region to combat gestational trophoblastic disease, the development of abnormal cells inside the uterus in the tissues surrounding the fertilized egg that can go on to form cancerous and benign tumors. Using what he learned at the National Institutes of Health, Duke gynecologists were able to offer patients chemotherapy treatment to prevent the malignant form of the disease from spreading. Today, this rare disease is considered a curable condition.
This milestone is one of countless others that have impacted the treatment of gynecologic cancer patients at Duke. The commitment of the division and DCI to research and innovation continued throughout the 20th century and entered a new era of discovery in the 21st century.
“There have been a number of spectacular advances in the past 50 years that have had a dramatic impact on the field. Perhaps the most significant has been the development of cervical cancer screening and the HPV vaccine, which almost completely prevents the development of cervical cancer,” said third and current division chief Andrew Berchuck, MD. “In the U.S. and other developed countries, this has reduced cervical cancer death rates by over 90%. A significant development that is easy to pass over has been the development of treatment guidelines by the National Comprehensive Cancer Network. Duke was one of the founding members of the NCCN, and these widely available guidelines provide an evidence-based approach to treatment. Several members of our group are involved in the various guidelines committees.
“In addition, there has been a movement to institute quality improvement programs in which the results of patient care are tracked and analyzed. This provides the opportunity to introduce changes that reduce infections, development of blood clots in major veins, would-be infections and other complications.
“One legacy I hope to leave behind is a program in perpetuity that will allow our former trainees to return to Duke to share experiences and perspectives.”
Probably the thing I’m most proud of is, I was lucky enough to go to the National Institutes of Health in the mid-60s at a time when malignancy was being treated that grew from the placenta, or the afterbirth — a universally fatal disease. Someone there had just made a discovery that showed it could be cured with drugs, and while I was there, we refined those drugs; expanded the cure rate to approach 100%. The fundamental idea of using drugs in that disease was a radical new one. It had been tried but really hadn’t been proven. And when I was there, we were able to try it on nearly 100 patients … and then expanded to the center here [at Duke]. It transformed a disease, one of the first diseases that was ever cured with chemotherapy.
— Charles B. Hammond, MD, chair of Duke Ob/Gyn from 1980 to 2002, pictured above circa the 1970s (photo courtesy of Duke Medical Archives)