Research Grants Focus on Issues Impacting Breast Cancer Survivors

The annual University of Cincinnati Cancer Institute Cancer Survivorship pilot research grants were awarded to College of Medicine faculty members Thursday, April 6.

The two $50,000 grants, made possible through a gift from the Robert and Adele Schiff Family Foundation, were awarded to Ryan Gobble, MD, assistant professor of surgery, and James Whiteside, MD, associate professor of obstetrics and gynecology, and Jaime Lewis, MD, assistant professor of surgery. Their projects will examine issues that frequently impact the lives of breast cancer survivors.

Gobble’s study will look at the potential use of lipid-coated silicone breast implants to help eliminate infections in women undergoing mastectomy and then reconstruction.

"Sphingolipids, a class of lipids, control multiple cellular functions and have antimicrobial properties against bacteria,” he says. "We have demonstrated the ability to coat materials with sphingosine—a derivative of sphingolipids—and have shown that sphingosine-coated materials have significant antibacterial activity.

"Breast implants with a silicone shell are used in reconstruction for women undergoing mastectomy, but breast implants are sometimes plagued by bacterial infection, which often requires the removal of the implant. We think that coating the silicone shell of breast implants with sphingosine will decrease bacterial infection.”

In this study, antimicrobial activity of sphingosine will be tested against common bacteria in breast implant infection models and compared to antibiotics used in breast reconstruction, Gobble says.

"Antimicrobial activity of sphingosine-coated breast implants will be compared to uncoated controls in animal models by adding bacteria commonly encountered in breast implant infections to either uncoated or coated silicone implants. In addition, we will compare the effects of using current antibiotics in conjunction with sphingosine in breast implant reconstruction,” he says. "We think that sphingosine will have sufficient antimicrobial activity alone but will have a synergistic effect against infectious bacteria when used in conjunction with common antimicrobials. This could eventually lead to a change in silicone breast implants used as a standard treatment for reconstructive patients.”

Whiteside and Lewis are conducting a randomized clinical trial comparing the effectiveness of laser treatment versus topical lidocaine in managing painful sexual intercourse (dyspareunia) symptoms in breast cancer survivors.

"A large and growing population of breast cancer survivors experience burdensome urogenital symptoms including dyspareunia,” says Whiteside. "Studies have evaluated the feasibility and effectiveness of carbon dioxide (CO2) lasers for the treatment of vulvovaginal atrophy, which is thinning, drying and inflammation of the vaginal walls, in postmenopausal women, suggesting improvements in symptoms and favorable microscopic changes. There is little known about the effectiveness of CO2 laser therapy in breast cancer survivors.”

CO2 lasers can be used in soft tissue surgeries or skin resurfacing, with effects similar to those of chemical peels and dermabrasion, by removing skin layers or tissue by vaporization.

Lewis says patients in this study who are breast cancer survivors experiencing dyspareunia will be randomized into two groups: those treated with the laser or those using topical lidocaine gel.

"We will assess outcomes such as lubrication, satisfaction and pain using the Female Sexual Function Index survey instrument,” she says. "Secondary outcomes will be measured using other validated pain and pelvic floor symptom instruments.”

Both groups will follow up at one week, one month, three months and six months. 

"If outcomes are favorable, this could lead to a new treatment for survivors experiencing a painful condition and could improve their quality of life,” says Lewis.