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Fred Hutchinson Cancer Research Center epidemiologist Dr. Holly Harris was just awarded two grants to study endometriosis, an often painful disorder in which the tissue that lines the inside of the uterus — the endometrium — grows outside the uterus. The condition impacts about 10 percent of U.S. women of childbearing age.
The first grant, issued by the National Institute of Nursing Research, a branch of the National Institutes of Health, spans four years and totals $1.4 million. It will allow Harris to conduct a 12-week dietary intervention among women with endometriosis in hopes of decreasing their pain and improving their quality of life.
“Over 80 percent of women with endometriosis report chronic pelvic pain, and symptoms are often not sufficiently abated with hormonal suppression or surgery,” Harris said. “The identification of other evidenced-based, modifiable factors that improve pain and quality of life are critical to improving the lives of women with endometriosis.”
Harris said previous research on diet and endometriosis suggested that some dietary factors are more strongly associated with the type of endometriosis that’s commonly diagnosed because of pain symptoms. Many body functions that play a role in pain processes can be influenced by diet, including prostaglandin metabolism (lipid compounds that act like hormones in animals), alterations in levels of inflammatory markers and the ability of muscles to contract.
Harris’ study will include 100 participants, all of whom have had laparoscopically confirmed endometriosis, with a pain score of at least 7 out of 10 (10 being the worst). The women will be divided into two groups with one group receiving the 12-week dietary intervention. These participants will receive meal ingredients delivered to their homes during the first four weeks of the intervention, then will receive meal plans and recipes for the remaining eight weeks.
Pain, quality of life and inflammatory markers will be taken at weeks four, eight and at the end of the 12-week intervention. Follow-ups will be done at six months and one year.
The study is scheduled to start recruiting this fall. Email the research team for more information.
Exploring the link between endometriosis and ovarian cancer
The second grant, a Discovery Award from the Department of Defense Peer Reviewed Medical Research Program, provides $200,000 to examine how and why certain types of endometriosis transform into ovarian cancer.
“Currently, women with endometriosis and their clinicians have little evidence to guide treatment decisions and to assess an individual woman’s risk of ovarian cancer based on endometriosis characteristics,” Harris said. “Identifying women with endometriosis who are most likely to develop ovarian cancer is very important to lessen future risk and minimize potential harm to women with endometriosis who are unlikely to develop ovarian cancer.”
Previous research has offered limited information on the link between the two diseases. According to Harris, studies have shown endometriosis tissue close to ovarian cancer tumors will sometimes contain the same genetic mutations and that ovarian endometriomas — in which endometriosis develops deep within the ovaries — appears to be the most likely subtype to become ovarian cancer. When these types of lesions are removed, though, some women still develop ovarian cancer. In addition, a recent study found ovarian cancer-related mutations in a type of endometriosis not thought to transition to ovarian cancer.
“These observations taken together indicate that there is much we do not know about what causes endometriosis lesions to progress to ovarian cancer,” she said. “We hope to identify a subset of high-risk women based on endometriosis tissue and peritoneal fluid characteristics.”
Harris, who has a strong interest in women’s health issues, said endometriosis research has been historically underfunded.
“The amount of money that endometriosis gets in the context of other conditions is very small, considering how common it is and its large impact,” she said. “We’re thrilled to have received this funding.”
