Royal Alexandra Hospital Foundation

The Lois Hole Hospital for Women – and its clinics, patient rooms and hallways – are where many of Alberta’s women experience the most difficult moments of their lives. But this is also a place of hope and change, where developments and commitments in research are improving maternal and women’s health in direct ways. Of these developments, none is more significant than the addition of three research chairs, led by three remarkable women who bring a revelatory focus to women’s health and set new best practices in the field, garnering national attention at the same time they are increasing the depth of local care.

Committed to advancing findings in women’s health, these researchers are Dr. Sue Ross, Dr. Lynne-Marie Postovit and Dr. Radha Chari. All three have all been working to bring about change in women’s medicine and how it is delivered to patients. In short: it’s all about making women feel better.

“The goal is to consider patient experience,” says Dr. Ross, chatting over tea at the kitchen table in her weekend home. All around her is a mess from a remodelling project that Ross is hoping to see the end of soon, but for now, it’s a work in progress. At work, it’s the tangible effects of research on the lives of women that matters most to Ross. “To me it doesn’t matter if you provide perfect clinical treatment, it doesn’t matter if it doesn’t help women to feel better in some way, shape or form.”

Dr. Ross made her way to Alberta and the Lois Hole Hospital for Women via her upbringing and education and in Scotland where she originally trained as a pharmacist. After earning her PhD in health services research, studying how patients access health care and how they respond to treatment, she began doing clinical trials in surgery and family medicine.  Since moving to Canada in 1999, her research has focused on obstetrics and gynecology. She now spends the majority of her working time in Edmonton, with three or four days a month in Calgary, maintaining research projects in both cities. “My goal is to lead Alberta- and Canada-wide research,” says Ross, adding that the Cavarzan Chair in Mature Women’s Health Research at the Lois Hole, “has been the most fantastic experience I could have imagined in many ways.” She was awarded the chair in 2012, and until then she had been balancing her time between research and teaching responsibilities. Her position at the hospital means she is able to focus on research and writing full-time.

“To me it doesn’t matter if you provide perfect clinical treatment, it doesn’t matter if it doesn’t help women to feel better in some way, shape or form.”

Dr. Sue Ross

Ross’s research aims to ensure that clinical treatments are safe and effective for problems that commonly affect mature women, such as pelvic floor disorders that including leaking urine and feces and pelvic organ prolapse (where the uterus or other pelvic organs bulge into the vagina), and problems associated with menopause. These disorders cause women significant distress and adversely affect quality of life. Ross’s goal is to help women and their doctors to make the best treatment decisions. 

Ross has led clinical trials, testing the efficacy and safety of new treatments for pelvic floor disorders, but her work is now taking a different approach “I want to look at the prevalence, cost and impact of pelvic floor disorders in Canada,” she says. “There are some vague numbers, but you cannot get an idea of how widespread pelvic floor disorders really are, and people feel stigmatized if their symptoms are severe.” This is also a work in progress for Ross. Recently, she and her multidisciplinary research team were given access to national data from family physician clinics across the country in regards to this research. “When you work at a hospital, you get the impression that it’s a really big deal, but of course the people who come in are only the tip of the iceberg,” she says. The study helps target treatments and provides estimates of increase to the clinical workload as the population ages and the number of women with these disorders increases.

Ross and her research team have been working with the multidisciplinary menopause clinics in Edmonton to introduce a quality of life measurement, adding this to existing symptom measurements. The added questionnaire will provide insight into if and how much menopause impacts a woman’s quality of life, and builds on the team’s other research to explore the best types of treatment for women with difficult menopause.

Dr. Ross currently has a number of papers in development with various other researchers and scholars across Canada, and she is designing studies and guiding them through to funding, research and publishing. “It’s the writing that takes the time,” she says, noting that she’s interested in learning more about communicating her work with the public. She says her time at the Lois Hole Hospital for Women has been eye-opening. “I get to work with lots of interesting people and learn new things every day,” she says. She makes sure that researchers ask questions that generate novel and useful answers. “It’s important that I’m present at the hospital interacting every day with clinicians and patients.”

While it might seem that Ross is stretched thin between projects, it’s this all-encompassing work ethic that makes her work stand out.  “Sticking to your passions against all the odds can really pay off,” she says.

Following your passions is a sentiment that everyone at the Lois Hole Hospital for Women can get behind. The foundation’s research chairs all conduct their work from the hospital, and they are all dedicated to women’s health, and bringing to the forefront a field that has been traditionally underfunded. Part of how they stick to their guns is through a commitment to community, and working together to create an atmosphere that embraces multi-disciplinary solutions.

“When We’re asking big questions, the only way we'll get answers is by working as a team and bringing all of our expertise into the fold,” say Dr. Lynne-Marie Postovit

Dr. Postovit has done groundbreaking research in the field of tumour progression, and has been the Sawin-Baldwin Chair in Ovarian Cancer at the Lois Hole Hospital for Women since taking up the post in 2013. She also holds positions at the University of Alberta, the Cancer Institute of Northern Alberta and is the Alberta Innovates-Health Solutions Translational Health Chair in Cancer. Postovit has a PhD in anatomy and cell biology, and has spent her time considering how the environment surrounding a tumour might promote its progression. “We’re trying to understand what causes that, so that we can get in there and prevent it,” she says. As her career progressed she moved her lab from London, Ontario to Edmonton, and started looking at how the stem cell system and cancer cells share similarities. “The focus of our entire program is understanding how an environment can push cancer progression,” she says. 

Postovit’s work focuses on ovarian and breast cancers because often they are the hardest to identify in time to treat them successfully.  In her ovarian cancer research, Postovit is hunting for a way to diagnose the disease earlier – most ovarian cancers go undetected until they are diagnosed in stage three or four, and that point they have a low cure rate. “So we need a way to be able to detect this earlier, at stage one, for example. One of the things we’re doing is trying to find biomarkers for ovarian cancer,” she says, noting that it’s a team of researchers working together on this work. “We’re doing this by looking at patient samples and using high-end techniques to try to discover what these cells might be secreting into their micro-environment so we might detect it as an early marker.” She also notes that, for now, there will always be women who have their cancers detected too late. “We’re trying to find targets that might prevent occurrence,” she says. 

“I want the work we’re doing to make a difference. That might mean finding a eureka moment, or it might mean slowly improving outcomes.” 

Dr. Lynne-Marie Postovit

It’s the teamwork that Dr. Postovit finds most imperative. “When you’re asking large questions, the only way to get answers is by working as a team and bringing our expertise into the fold,” she says. “This ranges from understanding the progression of the disease to surgically removing it to analyzing it and designing clinical trials.”

She is motivated by her patients, and she enjoys interacting with them through her findings. “It’s a reminder of how much needs to be done,” she says. “I want the work we’re doing to make a difference. That might mean finding a eureka moment, or it might mean slowly improving outcomes.”

Slowly improving outcomes seems to be the case. And because it’s the kind of work that takes a long-haul commitment, all of the researchers associated with the Lois Hole Hospital for Women need to be incredibly self-motivated, each of them wearing so many hats (or occupying so many positions, it seems) that it can be hard to keep them straight.

Dr. Radha Chari has taken on so many projects that she keeps them in a bullet point list. She is the head of the department of obstetrics and gynecology, University of Alberta, Faculty of Medicine and Dentistry, based at the at the Lois Hole Hospital for Women, a university associate professor and a zone clinical department head for women’s health for Alberta Health Services in Edmonton. Her work stretches across northern Alberta and into the Northwest Territories, and she has numerous research projects underway. 

A maternal-fetal medicine specialist for two decades, high-risk pregnancies are Dr. Chari’s realm, and she has worked to develop consultation programs in northern and central Alberta with cardiology, urology and neurology experts in pediatrics. “To me, it’s a real growing opportunity, also working with neonatologists and pediatricians in Edmonton and Calgary,” she says. 

 

Collaboration is key to Dr. Chari’s work. She recently began working with researchers from the University of Alberta’s physical education and recreation faculty, considering the effects of exercise on fetal growth. “This is beyond the faculty of medicine, which I am finding exciting,” she says. As a vice president for the Society of Obstetrics and Gynecology of Canada, Chari is helping to revamp the process the society follows when it comes to implementing guidelines for its ob-gyn members. She sees this as a way to contribute directly to women’s health, as it targets not only ob-gyns but also family physicians, midwives, nurses and administrators. “I have always had a real interest in women’s health, and am hoping to contribute to it,” she says. “I want to make a difference in improving how we do things.”

“I have always had a real interest in women’s health, and am hoping to contribute to it. I want to make a difference in improving how we do things.” 

Dr. Radha Chari

It’s this quest for new knowledge that she hopes to apply directly to advancements in patient care. Chari was involved in applying new technology to determine fetal prognosis, and was part of a team that developed MRI reference ranges to help predict newborn lung function. She has also been the lead researcher on a national trial looking at the management of preterm pre-labour rupture of the membranes (PPROM) in patients between 32 and 37 weeks’ gestation, and its impact on neonatal outcome. She currently works with basic scientists in pediatrics to evaluate perinatal management and pediatric health outcomes.

Working together at the Lois Hole Hospital for Women will give the research chairs an opportunity to strengthen their research and collaborate at the regional and provincial level. “We’re all different, we all have different areas of interest, which I think is a really great thing,” says Dr. Chari. “Obstetrics and gynecology is vast and covers a broad area. It’s becoming more important that we link our research to clinical practice.” She believes that when everyone works together, from basic scientists to clinicians, the findings are stronger and more relevant than research that exists in isolation. 

The goal is to apply their knowledge to patient care, improving the work that happens at the hospital. “There are things that are going to be relevant to clinical practice,” says Chari. Working that knowledge into practice is her goal. “It’s connecting across a continuum, taking research to the bedside.”

 

The support that an institution like the Lois Hole Hospital for Women can give to researchers like Drs. Ross, Chari and Postovit is invaluable. “We hope that we can be one of the leading centres nationally, and even internationally,” Postovit says. All three researchers are deepening the expertise of the institution and the field. Postovit says she was excited to come to community that demonstrates leadership in valuing women’s health.

They want to make a difference. “We’re representing early discovery all the way through to translation,” says Postovit. “We come up with a lot of great ideas and leads, but eventually we need to be able to help the patients.”