Nationally recognized gynecologic oncologist Thomas J. Rutherford, MD, PhD, an expert in ovarian cancer treatment and research, recently joined the University of South Florida to lead the Gynecologic Oncology Division at the USF Health Morsani College of Medicine Department of Obstetrics and Gynecology. He will also direct the medical school’s gynecologic oncology fellowship program, and surgical quality at the Tampa General Hospital Cancer Center.
Dr. Rutherford came to USF from Western Connecticut Health Network (WCHN), where he was network physician director of cancer services since 2015. Prior to that he was professor and division director of gynecologic oncology and director of the gynecologic oncology fellowship at Yale University School of Medicine in New Haven, Conn.
Charles J. Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine, went on several yearly medical mission trips to Jamaica with Dr. Rutherford when both worked at Yale, with their surgical team completing more than 60 major procedures a week on patients who often traveled long distances to receive care.
“Tom is the finest gynecological surgeon I’ve ever operated with,” Dr. Lockwood said. “With his leadership and outstanding national reputation, USF Health will build a world-class gynecologic oncology service and innovative research program.”
Building a new model of cancer care delivery
“We are excited to have Dr. Rutherford join us to help grow our gynecologic oncology team and the services we offer,” said Jerome Yankowitz, MD, professor and chair of the USF Health Department of Obstetrics and Gynecology. “His consummate surgical skills and compassionate approach to providing the latest evidence-based care will be a great addition to patients in the Tampa Bay community and Florida.”
At WCHN, Dr. Rutherford expanded cancer services at the network’s hospitals and helped create a new model of cancer care delivery that built upon the strengths of existing programs to enhance accessible, integrated and high-quality care provided to patients and their families. Under his guidance, surgical subspecialists and patient volume increased, with the number of gynecologic oncology cases growing to more than 700 a year.
Dr. Rutherford describes his philosophy of total cancer care as encompassing prevention, high-risk genetic screening, education and research, individualized treatment, survivorship and end-of-life care. “Anytime you take care of cancer patients, you take care of the entire family,” he said.
Over the next two years, he will work toward building a community outreach program, whereby the top USF-TGH team developed for gynecological cancer surgery would work closely with referring community obstetricians and gynecologists in the Tampa Bay area to provide treatment closer to home for patients, when appropriate. Patients requiring routine surgeries could be operated on in their community hospitals by the USF-TGH gynecologists and remain there for post-surgical care, he explained, while more complex cases requiring multispecialty teams for advanced patient support would be sent to Tampa General.
Such an outreach model makes sense in a health care system moving to provide optimal outcomes at reduced cost, Dr. Rutherford said.
“We can operate on a patient with a typical endometrial (uterine) cancer at almost any facility, so it benefits that patient to stay closer to their home and the referring doctor with whom they’ve developed a rapport. They really do not need the same intensity of gyn-oncology services as, say, an ovarian cancer patient requires after surgery,” he said. “It saves the system money, it keeps the family together, and the patient gets the proper care in their hometown.”
Progress identifying younger women at high genetic risk
Dr. Rutherford will also play a leadership role in advancing the research of the USF gynecologic oncology division, including basic science, translational and clinical research.
His own research has focused on isolating and characterizing the stem cell associated with ovarian cancer, the leading cause of gynecologic cancer deaths in the United States. The stem cell cannot be eliminated by standard chemotherapy, so Dr. Rutherford and others continue to explore novel therapies to destroy or control it.
Ovarian cancer is known as the “silent killer,” because it is not usually diagnosed until its advanced stages when the prognosis is poor. For women diagnosed when disease is confined to the ovary, survival rates are much higher.
While early detection remains difficult, Dr. Rutherford said, progress has been made in identifying younger women at high genetic risk for ovarian cancer and studying whether prophylactic surgery may prevent ovarian cancer as they age.
“Through knowing a patient’s genetics and family history, we can identify women at high risk who may benefit, in the long run, by removal of their fallopian tubes, or possibly their tubes and ovaries, so they do not develop the disease” later in life, he said.
Patients with the best outcomes tend to be those whose ovarian cancer has not spread to lymph nodes outside the abdominal cavity and for whom all tumors are removed during surgery, Dr. Rutherford said. Such patients, may be candidates for hyperthermic intraperitoneal chemotherapy, or HIPEC, a highly concentrated, heated chemotherapy treatment delivered directly to the abdomen following surgical removal of all visible tumors; the operating room procedure requires a highly skilled multidisciplinary surgical, medical and nursing team. Heating the chemotherapy solution and circulating it in the abdomen for about 90 minutes produces an inflammatory response that may help destroy any remaining cancer cells, said Dr. Rutherford, who implemented HIPEC to treat peritoneal cancers at WCHN.
“Our goal at the time of surgery is to get the patient to a state of no residual cancer – no visible sign of disease,” Dr. Rutherford said. “The problem with that is we realize there may still be microscopic traces of the disease we cannot see.”
Exploring new, more targeted therapies for ovarian cancer
That is why Dr. Rutherford and other researchers are exploring nanotechnology as a more targeted approach to seek and destroy difficult-to-treat ovarian cancer. Using a mouse model, Dr. Rutherford has been working with a research group to test whether an innovative “nanosphere” delivery system can bind strongly to integrins, molecules produced on the surface of blood vessels that feed tumors, and then attach to that nanocarrier a site-specific drug or other therapy to kill the ovarian cancer cells not eliminated by surgery and resistant to chemotherapy.
“We have a host of studies looking at applying nanosphere technology to either identify these malignancies as microscopic disease, or perhaps enhance the effectiveness of some of our existing radiological techniques,” Dr. Rutherford said.
A board-certified gynecological oncologist, Dr. Rutherford has authored more than 100 scientific journal articles on the prevention, early detection and treatment of ovarian, cervical and other gynecological cancers. He has led several clinical trials investigating new treatment options for patients with recurring ovarian epithelial, fallopian tube and primary peritoneal cancers resistant to chemotherapy.
He earned both his PhD degree in molecular biology and MD degree from the Medical College of Ohio at Toledo. He completed a residency in obstetrics and gynecology at Robert Wood Johnson Medical School in Camden, NJ, a Galloway Fellowship at Memorial Sloan Kettering Hospital in New York City, and a gynecologic oncology fellowship at Yale University Medical School.
Photos by Eric Younghans, USF Health Communications