Key molecular regulator of uterine fibroids

Uterine leiomyomas, also called uterine fibroids, are benign tumors that originate from the smooth muscle of the uterus. Fibroids are the most common non-cancerous tumor of the female genital tract, affecting 80% of all women during their lifetime. More than half of women develop fibroids during their reproductive years, often complicating pregnancy. Fibroids are a major source of heavy uterine bleeding, pain, and reduced fertility, resulting in reduced quality of life and significant stress for many women. 

Treatments for fibroids consist of surgery, including hysterectomy or myomectomy, hormonal modulators, such as gonadotropin-releasing hormone agonists, and uterine arterial embolization (UAE), which blocks the blood supply to the tumor. The only true cure is surgical resection, with hormonal approaches and UAE estimated to shrink tumors by 30-40%. Bleeding and pain can also be significantly reduced by these treatments. However, results vary, and many women do not derive benefit from available procedures. Progress in designing new treatments has been slow, largely because we have a poor understanding of the biology of fibroids.

A new study recently identified a molecule that is expressed at abnormally high levels in fibroids. The molecule, H19, belongs to a class of molecules called long noncoding RNAs. H19 was found at increased levels in fibroid tissues from 30 women, including 20 premenopausal, compared with normal uterine myometrium tissues from the same women. High expression of H19 caused fibroid cells to double in number faster, whereas getting rid of H19 actually slowed down growth. Importantly, H19 also drove expression of molecular profiles that have previously been linked to fibroid development and growth. Thus, H19 may function upstream as a key regulator of fibroids. Estrogen and progesterone are thought to influence fibroid growth. This new study showed that combined exposure to estrogen and progesterone increased H19 expression and other fibroid-promoting genes. When H19 was eliminated, the effects of estrogen and progesterone were abolished. 

Although these results are preliminary, they are exciting for several reasons. We know so little about fibroids, and options for women who suffer from this debilitating chronic medical condition are limited. Fibroids receive little attention from the research community. The few studies that have been published in recent years are mostly preclinical in animal models and do not generally include patient samples. This new study used matched human fibroid and normal myometrium tissue from the same patients. This study also explored molecular mechanisms and biology, demonstrating cause and effect and not purely correlative findings.

Further studies are urgently needed to confirm the role of H19 and to identify other major mechanisms promoting fibroids. Identification of key regulators of fibroid development and growth moves us one step closer to understanding this disease and improving therapeutic options for women.

Reference: Cao T et al. Oncogene 2019 May 15

Five ways to improve your health writing skills

Health writing is a broad field, filled with a number of smaller niches. You may be focused on fitness, nutrition, women’s health, or cancer, just to name a few. Whatever your specific interest or specialty is, getting started as a writer can be intimidating. Here are a few simple strategies that can help improve your writing.

Read content from other health writers. Writing styles differ according to author, niche, and audience. Read a variety of content from health writers. Identify articles written for the same types of audiences you want to target. Note the structure and tone of the writing. Break the article down by paragraph, and decide what purpose each paragraph fills in the article. Effective nonfiction writing is usually centered on key messages, as explained here. Identify the main teaching points in the article you are reading. What is the overall take-home message? How does the author organize these objectives and messages to create a clear, concise story? Take note of research that is cited to understand the types and numbers of sources you may need as supporting evidence to write a piece of similar length or style. The tone and voice will vary more than structure when you start comparing articles; that’s what makes each author unique. Still, there are some patterns to notice. For example, if a piece is written for a patient, how does the writer maintain a positive, helpful message, even when discussing a serious condition? What reading level does the piece appear to target, and how does that affect word choice? If a piece is written primarily for healthcare professionals or researchers, how does the author make the article interesting and engaging, rather than purely academic? Annotate each article as you go through this exercise. You’ll begin spotting patterns in health writing articles that are targeted to similar audiences. You can apply these general patterns in structure and voice to your own outlines as you build your health writing practice.

Keep up with news from your niche. This is critical. Health research moves at a ridiculously rapid pace. Understand what constitutes a credible source in your field, and read these sources regularly. For example, if your focus is oncology, read abstracts from the top-tier oncology journals on PubMed each week to identify new articles. You can set up automatic alerts based on keyword searches. Follow blogs from the major oncology associations and reputable oncology news websites daily. Many of these sources offer e-mail newsletters that can automatically be sent to you. Also, mine abstract databases from major annual oncology conferences to stay in touch with breaking news. Health writers must stay up-to-date, or their content risks becoming obsolete and irrelevant, and possibly filled with errors if something new has been learned.

Write regularly and listen to feedback. Write as many different types of content targeted to your primary audience as you can. As long as you practice consistently, you will improve. Seek feedback from clients, colleagues, mentors, and writing groups. Feedback is most effective when it highlights your strengths and weaknesses, so you know exactly what’s working, and what needs to be improved. Don’t be afraid to try new types of deliverables. There are so many possibilities in health writing; articles, blogs, book chapters, abstracts, news summaries, and medical needs assessments are just a few examples. Research and read other writers’ work. Then, try writing something new, and ask for feedback; it’s the only way to learn and become a strong health writer capable of writing diverse types of content.

Join classes and professional organizations. Formal courses, online writing programs, and professional organizations often provide resources to help improve health writing skills. Identify health writing groups or classes online or in your area, and see if they offer feedback, specialized teaching, books, or certifications that will help you grow as a writer. In addition to medical and science writing associations, there are freelance health writers who offer online courses. Check out this link for additional advice.

Write for your audience. Health writers are educators. Your content is designed to teach an audience something new about a specific health topic. Keeping your reader in mind as you write will automatically focus your attention and improve your writing. Imagine your audience as you write. What concerns do they have? As you practice writing for the same general audience a few times, you’ll learn how to address their major needs and anxieties. Targeting your writing to help your audience is one of the most effective ways to improve the tone, clarity, and quality of your health writing.

These are just a handful of easy tips to help you on your way to becoming a strong, impactful health writer. It’s a continuous process, and regardless of how senior a writer is, there is always something new to learn. Be kind to yourself, and approach writing with a growth mindset, so that you are open to learning and evolving even when new challenges present themselves.

Communicating research to a broader audience

Research is all about increasing knowledge. Everyone should have access to that education. Unfortunately, research findings often remain trapped for years in academic circles. Science graduate programs train students to speak to other scientists, with manuscripts and talks usually targeted to professional audiences. Although this is critical for driving research programs forward, it does not allow the general public to access new research information. One reason for the breakdown in communication from academic science to the public is the lack of training in effective public engagement. During the past decade, scientific writing and presentation courses have been added to graduate curricula. Equal attention should be paid to fostering communication outside of academic circles. Most science training programs do not include opportunities for public engagement. Only with practice can scientists actually learn how to convey their research in a meaningful, interesting, clear and concise manner that is relevant to a general audience.

In the absence of established activities, students can work with their advisors to seek out opportunities to write for public audiences. This could include sharing research through school newsletters, blog posts, or social media. Professors can also integrate lessons focused on speaking or writing for the public into existing courses and seminars. Simple assignments could include writing lay abstracts and general research summaries or presenting brief public seminars about a specific research project. Students can work with mentors to develop a 1-minute elevator pitch of their research to clearly articulate the intention or impact of their work. Remember that storytelling and analogies are highly effective ways to communicate complex information. Keeping the message simple with 1-3 main teaching points will reduce the chances of getting lost behind your words. Colleagues from writing and communications departments can be invited to review and critique students’ written summaries or public presentations. Outreach activities will also provide students with unique opportunities to speak at middle schools or community events, which will improve skills in public communication.

Bridging this gap in communication positively impacts academia and the public. Educating a wider audience imparts deeper meaning and purpose to the everyday work of scientists and graduate students. Most importantly, improved access to research findings empowers the public to advocate for their needs. As an example, patients should be privy to research news that may help clarify treatment decisions. Receiving a medical diagnosis is frightening and confusing, often because of the unknowns. Education is one of the biggest weapons we have to combat those fears, ask informed questions, and be proactive about our own healthcare. The academic community has a responsibility to disseminate research to the public in a timely manner. Science graduate programs should prioritize building skills in public communication and engagement to facilitate broader access to research advances and education.