Gynecologic Oncologist Urges Screenings for Early Detection
By BECKY GILLETTE
Randall D. Hightower, MD, authors study showing older/younger women benefit equally from treatments for ovarian cancer
FAYETTEVILLE--As the staff gynecologic oncologist at Washington Regional Medical Center, Randall D. Hightower, MD, sees firsthand the consequences of failure to screen for gynecologic cancers.
"For sure, preventive screening is very important for our patients, especially for the diagnosis of a preinvasive process and catching it prior to the development of a gynecologic cancer," Hightower said. "An example would be a Pap smear being performed for the prevention of cervical cancer. Often in patients with cervical cancer, we may see that her last Pap smear was performed after the delivery of her last child 20 years earlier. Having more frequent Pap smears could diagnose a precancer with corresponding treatment given to address it, thus, preventing cervical cancer."
As a gynecologic oncologist, Hightower not only treats gynecologic cancers, but also preinvasive diseases of these organs such as cervical, vaginal and vulvar dysplasias, as well as endometrial hyperplasia. The evaluation may include colposcopy, and treatment of preinvasive diseases may include CO2 laser, local excision, Loop Electrical Excision Procedure or cold knife conization.
"These preinvasive procedures are very much the treatment of choice and can cure patients of these processes that may lead to cancer," said Hightower, who has a clinic, Gynecologic Oncology, across from Washington Regional Medical Center. "That is the idea, to catch it early."
Hightower, who has practiced at Washington Regional since 2001, was the first in Northwest Arkansas to provide gynecologic oncology care.
He grew up in Russellville and became interested in medicine by watching the role that many doctors played in the care of his mother, who had cardiovascular disease.
"It required many medical and surgical interventions on behalf of my mother," Hightower said. "I admired them and appreciated the care and compassion they showed. I witnessed what a role they provided in improving the quality of life for my mother. Those influences shaped my life and guided me toward becoming a physician."
He was attracted to the specialty of gynecologic oncology because of the challenges of working in a field where you take care of potentially very sick people with life-threatening diseases such as ovarian, endometrial, or cervical cancer.
"These people represent daughters, sisters, mothers, wives and grandmothers who play a very important part in our lives," Hightower said. "These are the people we work with, play sports with and attend church with. To be able to participate in their care with surgery or chemotherapy and possibly improve their quality of life was a goal I wanted to achieve. My life has been made better for this endeavor. I am lucky to be able to take care of these wonderful people."
Hightower gets high satisfaction marks from patients who say he makes them feel very comfortable while also being professional, positive and encouraging. "Almost a year since this journey in my life began with ovarian cancer," one patient wrote to him recently. "So thankful to have you as a surgeon and also trust my health will stay. May God richly bless you in your work as you do for others."
"Comments like that make it all worthwhile," Hightower said.
Since February 2012, Washington Regional has had a da Vinci® Surgical System and currently has the newest version, the Xi. Hightower said using robotic surgery allows doctors to perform many types of procedures that in the past had been difficult or impossible to perform.
"We see many advantages for our patients using robotic surgery, including shorter hospital stays, reduced blood loss, reduced pain and faster recovery times - all with the use of small incisions compared to traditional open surgery," Hightower said. "Mainly I use it for cervical cancer and endometrial cancers. I also use it for the patient who may have certain physical conditions, such as obesity, where smaller incisions are beneficial and alleviate additional complications."
Hightower has had national influence with research he published in Cancer in 1994, titled "National Survey of Ovarian Carcinoma IV: Patterns of Care and Related Survival for Older Patients," that showed older women benefited as much as younger women from surgery and chemotherapy for ovarian cancer.
"The conclusion from this study was that it appeared conservative treatment contributed to the decreased survival of older ovarian cancer patients," Hightower said. "Some physicians tend to think older individuals would be unable to tolerate chemotherapy or surgery and do not offer that type of treatment to the patient. However, they can usually tolerate it just as well as younger women. I've treated individuals up to 100 years old without problems. Of the 12,316 patients evaluated in the study, 1,115 were 80 years of age or older. There was no increase in anesthesia problems or other complications in the different age groups."
Hightower received his medical degree from the University of Arkansas for Medical Sciences and did his residency at the Naval Medical Center in Portsmouth, Va. He completed his fellowship at the University of Miami/Jackson Memorial Hospital, Miami, Fla. Hightower's professional recognitions include an award for Outstanding Achievement in Cancer Research by Upjohn, named one of "The Best Doctors in America," and one of "America's Top Oncologists."
Hightower has been married to his wife Amy for 38 years and they have three children, Nathan, 36, Ashley, 33, and Kelli, 28, and three grandchildren. In his leisure time, Hightower enjoys fly fishing on the White River and local ponds in the area and likes to work in his yard. The Hightowers have raised German Shepherds since 1993. "They are like part of the family," Hightower said.