Meeting the Minds: Dr. Kenneth Noller

His goal: Detect ovarian cancer earlier

Boston Globe, April 19, 2005

A longtime patient showed up in Dr. Kenneth Noller’s office one day very upset. She told Noller, an obstetrician-gynecologist, that she was afraid her husband was going to kill her.

A few minutes later, her husband tried to break into the examining room with a gun. Noller managed to called security officers, who arrived before the man could do any harm.

“They took him off to jail, and we got her into a shelter,” Noller said, describing his role in the case not as heroism but as a necessary part of an obstetrician’s job. “Several times through the years we snuck people out of the office into shelters.”

Most of Noller’s days are more mundane, but his everyday work will potentially benefit far more women.

Now the chairman of obstetrics and gynecoloy at Tufts-New England Medical Center, Noller, 60, is about to help launch a nationwide effort to find a better early-detection test for ovarian cancer. Because it is usually caught late, after the cancer has spread, ovarian cancer is often deadly; the best current test is so often wrong that it’s mainly used to detect recurrences. An estimated 22,220 new cases of ovarian cancer are expected this year, with 44 percent of those diagnosed surviving five or more years, according to the American Cancer Society.

A longtime advocate for women’s health, Noller’s path was by no means direct or obvious. He grew up in Topeka, Kansas, and before college worked for a while — successfully — as an electrician. The people he worked with encouraged him to go to college, arguing that “you’ll make all this money,” he said, smiling shyly.

He majored in history, then applied to Creighton University in Omaha to study medicine. After completing medical school and his internship, Noller became interested in research just beginning at the Mayo Clinic in Minnesota. He became part of the team that in 1972 studied women exposed to the DES hormone in pregnancy, whose daughters had developed vaginal or cervical cancer.

“Research satisfies the academician in him,” said his daughter, Lisa, an assistant US attorney in Chicago. “He likes a puzzle. He likes to see how things work, and to fix things.”

His drive to improve women’s health may also be what led him to the challenge of cancer research. “He’s an eternal optimist,” Lisa Noller said.

The senior Noller said what drives him is the desire to make healthcare better for women. “We can’t keep doing what we’re doing today 30 years from now. We have to keep getting better at research and inquiry.”

Noller’s research

Noller is heading the Boston arm of a new national research effort to find a good early-detection screen for ovarian cancer.

Ovarian cancer is very hard to detect early because symptoms rarely appear until the cancer is fairly advanced. In general, the earlier a cancer is detected, the more success doctors will have treating it.

The best current test, known as CA-125, yields too many false positives, Noller said.

“It’s a useful test if someone has already had ovarian cancer,” he said, “but the average woman walking down the street, if a woman has a cold, her period, gall bladder disease,” the screen might suggest she has ovarian cancer.

The new five-year study, one of the largest ever undertaken for ovarian cancer, will follow 3,400 women who are at risk for ovarian cancer because of family history, certain genetic mutations, advanced age and other factors.

The women will be divided into two groups based on their own preference. One group will choose to have surgery to see how much removing their ovaries and Fallopian tubes reduces their risk of developing the disease. The other group will undergo a new screening technique that involves frequent blood tests.

“The nice thing about this study,” Noller said, “is that the woman decides up front, on her own, whether she wants to be followed with frequent testing, or whether she chooses to have her ovaries taken out.”

The Ovarian Cancer Prevention and Early Detection Study is funded by the National Cancer Institute in collaboration with the Gynecologic Oncology Group, a 35-year-old, nationwide organization of gynecologists, scientists and related institutions.

To find out more about participating in the trial, call Susan Turner at 617-636-0186 from 10 a.m. to 5 p.m weekdays.