TheoryLab

“That’s the beautiful thing about diet. You don’t have to have health insurance to make these changes. You don’t need a physician to make these changes. You just need the right motivation and the long-term commitment.”

What you do need, though, is evidence. American Cancer Society grantees Carrie Daniel-MacDougall, PhD, MPH, of the University of Texas M.D. Anderson Cancer Center and Xuehong Zhang, MD, ScD, of Brigham and Women's Hospital, are working to provide evidence that could have huge implications for colorectal cancer research.

3:10 – Carrie Daniel-MacDougall on her ACS-funded research: “With the dawning of the gut microbiome era, knowing that dry beans have various prebiotic properties, I thought it was important to revisit this question again with these new technologies and also with this growing population of colorectal cancer survivors, particularly overweight and obese survivors, who may be at risk of recurring or developing another obesity-related cancer.”

5:40 – Xuehong Zhang describes his colorectal cancer studies: “The objective of this proposed research is to determine the association between yogurt intake and colorectal cancer risk and survival. We hypothesize that higher yogurt consumption can decrease the risk of developing adenomas—the precursor to colorectal cancer—as well as improve survival among patients with colorectal cancer.”

10:05 – On some of the challenges of recruiting colorectal cancer survivors, even at one of the largest cancer centers in the country: “We’ve also learned that some of them kind of have PTSD in terms of returning to the hospital for blood draws and participation in the study… Beyond all the science and the mechanism, there’s a behavioral aspect to working with people and working with patients that’s important to recognize.”

16:00 – Next steps for Dr. Daniel-MacDougall: “The next phase, if we find that this is promising, is to go multi-center, and that’s going to be a bigger, scarier, harder-to-get grant…We’re also always building up the next thing or how we’re going to get to the next step and that’s trying to do more dietary assessments and dietary-based research in cancer patients going on to active treatment.”

18:55 – New directions Dr. Zhang would like to take his study: “…Lactic acid is much (lower) in yogurt and is more palatable to individuals with lactose intolerance, so that motivates me to think more about how to expand the current research into other racial and ethnic groups, especially among the black population.”

21:35 – What can we tell patients about primary prevention of colorectal cancer? “The vast majority of colorectal cancer can be prevented by maintaining healthy weight, being physically active, and having a healthy diet… To me the healthy lifestyle is the key to colorectal cancer primary prevention. Clearly, screening and early detection is also important.”

“Because it’s so accessible, because everyone eats and everyone has fun tweaking their diets, sometimes people forget it’s science that we actually study quite intensely in school. And so you’ll give someone your take on something and they’re like, ‘Well, but you know I’ve heard this ketogenic diet is the thing I should be doing.’ Our challenge is to keep it scientific and evidence-based…it’s a huge challenge that not a lot of people face in other fields.”

For this conversation we brought together an MD, an MD/PhD, and a PhD working in a clinical department. Their research is all relevant to inflammation and is relevant to colorectal cancer, but they’re coming at it from different directions.

Ronen Sumagin, PhD, of Northwestern University, is interested in the immune system and inflammation.

Jason C. Mills, MD, PhD, of Washington University, St. Louis, is focused on the upper part of the GI tract and in how inflammation affects stem cells.

Iswar K. Hariharan, PhD, of the University of California, Berkeley, works on Drosophila and is interested in what regulates cell growth.

Highlights include:

7:30 – “We’re interested in the interactions between the cancer cells and their almost normal neighbors and trying to find ways in which we can perhaps empower the normal cells to kick the cancer cells out of the epithelium.”

9:25 – “In the pancreatic ductal adenocarcinoma field there’s a series of experiments that culminated in one that exemplified both the inflammatory aspect and developmental aspect of tumorigenesis…”

18:00 – “…but on the other hand, I do think that shutting off growth when a tissue reaches the right size has something to do with cancer.”

20:15 – “In the 1950s and 1960s a Swiss biologist…showed that injured Drosophila tissues could switch fates in a dramatic way…for instance a tissue that normally makes a leg, if you damage it enough, could end up making a wing. There was this plasticity that was induced by exposure to damage. We published a paper a year ago in eLife where we tried to dissect this phenomenon genetically…”

25:45 – “Our research is all about the interplay with the immune system and that cell autonomous decision to become a dangerous clone that no longer listens to cues about size or growth and that neighboring cells can’t control. But we’re all studying the same thing from slightly different perspectives.”

32:15 – “The way I view cancer is that it is basically a non-healing wound and we should treat it as such.”

For this conversation we brought together an MD, an MD/PhD, and a PhD working in a clinical department. Their research is all relevant to inflammation and is relevant to colorectal cancer, but they’re coming at it from different directions.

Ronen Sumagin, PhD, of Northwestern University, is interested in the immune system and inflammation.

Jason C. Mills, MD, PhD, of Washington University, St. Louis, is focused on the upper part of the GI tract and in how inflammation affects stem cells.

Iswar K. Hariharan, PhD, of the University of California, Berkeley, works on Drosophila and is interested in what regulates cell growth.

Highlights include:

7:30 – “We’re interested in the interactions between the cancer cells and their almost normal neighbors and trying to find ways in which we can perhaps empower the normal cells to kick the cancer cells out of the epithelium.”

9:25 – “In the pancreatic ductal adenocarcinoma field there’s a series of experiments that culminated in one that exemplified both the inflammatory aspect and developmental aspect of tumorigenesis…”

18:00 – “…but on the other hand, I do think that shutting off growth when a tissue reaches the right size has something to do with cancer.”

20:15 – “In the 1950s and 1960s a Swiss biologist…showed that injured Drosophila tissues could switch fates in a dramatic way…for instance a tissue that normally makes a leg, if you damage it enough, could end up making a wing. There was this plasticity that was induced by exposure to damage. We published a paper a year ago in eLife where we tried to dissect this phenomenon genetically…”

25:45 – “Our research is all about the interplay with the immune system and that cell autonomous decision to become a dangerous clone that no longer listens to cues about size or growth and that neighboring cells can’t control. But we’re all studying the same thing from slightly different perspectives.”

32:15 – “The way I view cancer is that it is basically a non-healing wound and we should treat it as such.”

The American Cancer Society not only funds cancer research, it also employs dozens of scientists who are among the leaders of their respective fields.

ACS researchers Stacey Fedewa, Pete Campbell, and Becky Siegel talk about the colorectal cancer research they're conducting related to risk factors, health equity issues, and the rise in early-onset colorectal cancer.

1:15 – On some of the most important unanswered questions in their field – “We know that no two tumors look alike on a molecular level. What are the causes and consequences of that tumor heterogeneity?”

4:50 – On how much we’ll able to learn from CPS-2 and CPS-3 – “In CPS-2 we just finished targeted sequencing of about 800 samples from people diagnosed with colon cancer. We just started looking at the data now. It’s literally hot off the presses…And CPS-3 is only going to be bigger…We’re able to measure things in the blood that happen prior to diagnosis, we have extensive survey information years before their diagnosis, and then we’ll have tumor samples from their colorectal surgery.”

6:30 – On the increase in colorectal cancer incidence in young adults – “Millennials now have twice the risk of colon cancer diagnosis compared to someone born in the 1950s at the same age. And for rectal cancer…it’s four times higher. And no one right now knows why this is happening.”

17:15 – The Medicare loophole and its implications – “Medicare will cover ‘screening colonoscopies,’ but the way (Medicare) defined screening colonoscopies is if there was no polyp found. So if somebody comes in for a screening colonoscopy and a polyp is found it will be deemed ‘diagnostic,’ and then they might be charged up to 20% for a colonoscopy…People are being asked to put a credit card down when they get a colonoscopy.”

22:00 – Why does their work matter to colorectal cancer patients – “Very, very few studies have data on patients before they became patients and after they were patients. CPS-2 has been going on since 1992, so with that amount of follow-up time, we’re able to follow people into their 80s and 90s and see what factors really influence that long-term survival.”

The American Cancer Society not only funds cancer research, it also employs dozens of scientists who are among the leaders of their respective fields.

ACS researchers Stacey Fedewa, Pete Campbell, and Becky Siegel talk about the colorectal cancer research they're conducting related to risk factors, health equity issues, and the rise in early-onset colorectal cancer.

1:15 – On some of the most important unanswered questions in their field – “We know that no two tumors look alike on a molecular level. What are the causes and consequences of that tumor heterogeneity?”

4:50 – On how much we’ll able to learn from CPS-2 and CPS-3 – “In CPS-2 we just finished targeted sequencing of about 800 samples from people diagnosed with colon cancer. We just started looking at the data now. It’s literally hot off the presses…And CPS-3 is only going to be bigger…We’re able to measure things in the blood that happen prior to diagnosis, we have extensive survey information years before their diagnosis, and then we’ll have tumor samples from their colorectal surgery.”

6:30 – On the increase in colorectal cancer incidence in young adults – “Millennials now have twice the risk of colon cancer diagnosis compared to someone born in the 1950s at the same age. And for rectal cancer…it’s four times higher. And no one right now knows why this is happening.”

17:15 – The Medicare loophole and its implications – “Medicare will cover ‘screening colonoscopies,’ but the way (Medicare) defined screening colonoscopies is if there was no polyp found. So if somebody comes in for a screening colonoscopy and a polyp is found it will be deemed ‘diagnostic,’ and then they might be charged up to 20% for a colonoscopy…People are being asked to put a credit card down when they get a colonoscopy.”

22:00 – Why does their work matter to colorectal cancer patients – “Very, very few studies have data on patients before they became patients and after they were patients. CPS-2 has been going on since 1992, so with that amount of follow-up time, we’re able to follow people into their 80s and 90s and see what factors really influence that long-term survival.”

In this episode Jason Locasale, PhD (Duke University), and Nan Gao, PhD (Rutgers, The State University), talk with the American Cancer Society about how metabolism is functioning in intestinal epithelial cells, and the difference between how normal epithelial cells and stem cells in the epithelium function. They also talk at length about the interesting role played by the microbiome.

In this episode Jason Locasale, PhD (Duke University), and Nan Gao, PhD (Rutgers, The State University), talk with the American Cancer Society about how metabolism is functioning in intestinal epithelial cells, and the difference between how normal epithelial cells and stem cells in the epithelium function. They also talk at length about the interesting role played by the microbiome.

This conversation with Dan Erkes, PhD, a postdoctoral fellow at Thomas Jefferson University, was interesting because he talked, not only about the challenges and opportunities around drug resistance for melanoma, but also about how rewarding it is to conduct research in a community that's actively supporting him.

2:00 – On his research into the mechanisms of drug resistance for melanoma – “There are a lot of new drugs coming out that really help patients in a lot of different ways, but most patients are still developing diseases that the drugs don’t do anything to anymore. We’re trying to figure out either new ways we can treat those tumors or ways in which those cancers have become resistant to those drugs.”

3:22 – What it was like to find out he got funded “I got two really great things from the phone call. First off, I got feedback from scientific reviewers, which was really helpful for my growing as a scientist. But also, just to know that the grant was funded and to know that, now I have job stability, our lab is now able to hire other people and we’re able to do this research more quickly and just that people I guess liked my ideas.

4:45 – Progress the lab has made since the grant was funded – “The thing that I’m most excited about is that we’re taking tumors that are resistant to these FDA-approved drugs and asking, can we use a BET inhibitor in that situation? If a patient were to fail a drug could they then get a BET inhibitor potentially as a salvage therapy to help them later down the treatment line?”

7:00 – On the community of support around him – “I grew up in Cheltenham, which is a suburb just north of Philadelphia and I’m a native Pennsylvanian. Just this idea that there is a group of people out there who have means and are able to give back to the community – it’s really amazing. I’m able to stay in the city I love and the community I love based on other people in my community.”

8:45 – On challenges publishing his work – “We haven’t necessarily gotten the feedback we were hoping for. Right now the main struggle has been what do we actually add to this project to finish it off, what are the specific things we need to do, because we kept doing a lot of different things that never seem to make the reviewers happy.”

This conversation with Dan Erkes, PhD, a postdoctoral fellow at Thomas Jefferson University, was interesting because he talked, not only about the challenges and opportunities around drug resistance for melanoma, but also about how rewarding it is to conduct research in a community that's actively supporting him.

2:00 – On his research into the mechanisms of drug resistance for melanoma – “There are a lot of new drugs coming out that really help patients in a lot of different ways, but most patients are still developing diseases that the drugs don’t do anything to anymore. We’re trying to figure out either new ways we can treat those tumors or ways in which those cancers have become resistant to those drugs.”

3:22 – What it was like to find out he got funded “I got two really great things from the phone call. First off, I got feedback from scientific reviewers, which was really helpful for my growing as a scientist. But also, just to know that the grant was funded and to know that, now I have job stability, our lab is now able to hire other people and we’re able to do this research more quickly and just that people I guess liked my ideas.

4:45 – Progress the lab has made since the grant was funded – “The thing that I’m most excited about is that we’re taking tumors that are resistant to these FDA-approved drugs and asking, can we use a BET inhibitor in that situation? If a patient were to fail a drug could they then get a BET inhibitor potentially as a salvage therapy to help them later down the treatment line?”

7:00 – On the community of support around him – “I grew up in Cheltenham, which is a suburb just north of Philadelphia and I’m a native Pennsylvanian. Just this idea that there is a group of people out there who have means and are able to give back to the community – it’s really amazing. I’m able to stay in the city I love and the community I love based on other people in my community.”

8:45 – On challenges publishing his work – “We haven’t necessarily gotten the feedback we were hoping for. Right now the main struggle has been what do we actually add to this project to finish it off, what are the specific things we need to do, because we kept doing a lot of different things that never seem to make the reviewers happy.”

Treating patients at the St. Louis Veterans Affairs Medical Center led Ken Carson, MD, PhD, to investigate questions about racial disparities in treatment of patients with Non-Hodgkin Lymphoma.

He still sees patients once a week, and his success as a researcher has led him to Flatiron Health, where he serves as senior medical director and focuses on real-world evidence generation.

1:15 – On his ACS-funded research on “racial disparities in outcomes among patients who have a common form of lymphoma”

4:50 – On transitioning to doing big data work and his work at Flatiron Health – “The ultimate objective is having every patient’s experience help inform the next patient’s experience.”

11:10 – Advice for his younger self – “You don’t have to follow the traditional academic mold”

13:20 – What he’s most excited about – “As we better understand how to capture adverse events and treatment toxicities with big data, we’ll be able to explore that further with the ultimate goal of improving—not just response, progression-free survival, and overall survival—but also patient quality of life during treatment.”