A Gynecologic Oncologist Speaks: An interview with Ashlee Smith, D.O.

Ovarian Cancer Updates and So Much More

By Pat Battaglia

As a recent addition to the gynecologic oncology health care community in our region, Ashlee Smith, D.O. treats patients within the Rochester Regional Health Care system. She kindly agreed to share her thoughts with our readers.

Question: I want to welcome you to the Rochester region. Would you mind providing a little background on yourself and share what brought you to our area?

Dr. Smith: I am originally a “Central-New-Yorker”. In the past several years, I have completed medical school, residency, fellowship, and worked in various locations across Pennsylvania. When the opportunity to practice in Rochester presented itself, we were happy to relocate closer to family.

Question: We’re happy to have you here. What drew you to specialize in treating people with gynecologic cancer?

Dr. Smith: I was drawn to the field of gynecologic oncology because it provides the opportunity for me to develop relationships not only with my patients, but with their families as well. In this specialty, I am able to care for women from the time of their diagnosis, through their surgery, through their chemotherapy/radiation treatment, and sometimes when necessary, to the end of their lives. I treat my patients like they are my family. I am thankful they allow me to care for them during such a challenging time and therefore make it my promise to them to do the best I can for them each day.

Question: I’ve read and heard about recent updates to the NCCN guidelines for ovarian cancer treatment. What changes might patients see in their care as a result?

Dr. Smith: Recent updates to the NCCN guidelines for ovarian cancer treatment primarily focus on the ability to individualize cancer care for women with this diagnosis. There have been advancements in studying tumor biology, molecular alterations, and tumor pathways identified that we can now try to specifically target with some of the newer therapeutic agents. Newer classes of medications such as immunomodulators and anti-angiogenic agents have been well studied in other disease sites and are now available to us for use in certain gynecologic malignancies. There have been new developments and recommendations regarding maintenance therapy following completion of standard chemotherapy. Also, we have made advancements in our ability to offer fertility-sparing surgical options for women who desire to retain their fertility. Additionally, we continue to make advancements in genetic testing, which is essential for patients with the diagnosis and their family members.

Question: Are there any recent developments in the detection or treatment of other gynecologic cancers?

Dr. Smith: Advancements in the detection of gynecologic cancers have been helped in part by the expansion of genetic testing. Identifying patients with genetic mutations and knowing which cancers they may be predisposed to help us to enhance screening for those patients and, in some cases, complete risk-reducing surgeries in an effort to ensure these people will not develop particular cancers. Much like for ovarian cancer, there are some newly developed treatment strategies that are showing promise in some other gynecologic cancers as well. There has been a resurgence in the interest of some intraperitoneal chemotherapy techniques [in which chemotherapy drugs are infused directly into the abdominal cavity] that are already standard for other disease sites.

Question: Which of these recent advances do you feel have the greatest potential to impact lives for the better?

Dr. Smith: In my opinion, genetic testing has brought about the most advancements and has the greatest potential to impact lives at this time. Regular health maintenance is essential for the general population, and is something we often overlook – for example, screening mammograms, colonoscopies, and pap smears. The real ability to impact disease outcomes lies in the ability to catch these cancers when they are in their earliest stages, as that is when they are most treatable.

Question: What gives you hope?

Dr. Smith: At the end of the day, I am hopeful! We are all facing some challenging times. I think that the “unknown” is what is most scary for people. Having a team of people around you to love you and support you is essential. As we weather the unknown together, we can all find strength from each other in varying ways. I encourage everyone to remain vigilant about their health and their care. We are all our own best advocates. My family gives me hope. My patients give me hope. I am hopeful that someday we will be able to beat cancer…for everyone!