Quick Questions with a Cancer Researcher: Using Genetics to Address Radiation Treatment Side Effects
Every day at Wilmot Cancer Institute, dozens of cancer researchers are asking questions to better understand cancer and to improve cancer treatments and quality of life for those living with cancer. What drives cancer researchers to this complex work and how do they make new discoveries happen? We’re asking some of our cancer researchers simple questions to learn more about their work, their background, their experiences and their goals moving forward.
Radiation treatment is recommended in many cases to help kill a patient’s cancer cells and move a patient closer to being cured. However, radiation treatment can come with both short-term and long-term side effects, ranging from skin irritation or fatigue to nausea, vomiting or incontinence – all aspects that impact a patient’s quality of life. Sarah Kerns, Ph.D., M.P.H., conducts research in a field known as radiogenomics. Through her work with others around the nation, she hopes to find ways to use genetic markers to identify early on which patients will be more likely to develop side effects and which won’t. She explains her work by answering five simple questions.
What research are you working on right now?
Right now, most of my research projects focus on identifying genetic and other biomarkers that could help arrange cancer patients into groups according to their predicted risk of developing side effects following radiation treatment.
We know that genetic background explains some of the variation between patients’ responses to radiation. Some people tolerate radiation treatment just fine, while others who receive the same radiation treatment might develop side effects months or even years after finishing radiation treatment. The side effects can be mild and bothersome or severe, requiring additional medical interventions. Experiencing radiation treatment side effects in the normal tissues surrounding the tumor limits radiation oncologists’ ability to give high enough radiation doses to ensure the tumor cells are killed. If we could identify people at high risk for such effects prior to treatment, they could be given a modified treatment plan or protective intervention prior to radiation treatment. Other patients at low risk could be treated with higher radiation doses and have a better chance of having their cancer cured.
What’s your proudest achievement so far as a researcher?
My collaborators and I recently published a study among patients with prostate cancer where we identified several genetic markers that are strongly associated with development of urinary and bowel effects up to five years after radiation treatment. This was a large study involving more than 3,800 prostate cancer patients from six different cohorts in which we tested more than 7 million individual genetic markers across the whole genome. It was an ambitious project involving about 40 investigators from around the world, so it was gratifying to be able to complete the project, and it was encouraging that we found some interesting results. We can now work to combine the genetic markers into risk models that can be tested in the clinic.
What’s the biggest challenge you’ve faced as a researcher and how did you work to overcome it?
The biggest challenge in these types of genomics projects is getting access to large enough groups of patients to have good statistical power to discover risk markers. While many genes are involved, each individual genetic variant has a relatively small effect on a patient's risk of developing radiation side effects. So, we need to measure this effect in large sample sizes to be confident we’ve identified a true positive association. In addition, success of the projects depends on different types of expertise, from radiation biology to statistics and genomics. My collaborators and I are part of a group called the Radiogenomics Consortium, which brings researchers together to share data and expertise. By coming together, we hope to overcome these challenges. I’m on the Steering Committee of the Radiogenomics Consortium, and this has made it much easier for me to complete projects successfully and help move the field closer to having an impact on the cancer patients we’re aiming to help.
What would you want everyone to know about your research or cancer research in general?
On an everyday basis, researchers often feel like they’re making very little progress, spending so much time troubleshooting technical hurdles and trying to make sense of the overwhelmingly complex nature of biology. To many people, it may seem like progress isn’t happening fast enough. But each new piece of information is a step closer to understanding a clinical problem or biologic process that can ultimately have a positive impact on care of cancer patients and quality of life for cancer survivors.
In your area of research, what keeps you going every day?
In the short term, the collaborative nature of my work keeps me going every day. I work with a team of other investigators — both locally in Rochester and around the world through the Radiogenomics Consortium — on all of my projects. This makes the work much more efficient, high-quality and enjoyable. Many of my collaborators have become my good friends, and working with them makes it possible to persevere in the face of challenges, accomplishing more together than any of us could on our own. In the long term, I’m driven by the translational nature of my work. The ultimate goal is to develop tools that can be used in the clinic to help radiation oncologists better tailor treatments to their patients’ individual risk profile to have the best chance of curing their cancer while protecting them from developing side effects later in life. This goal makes all the hard work seem worthwhile.
Learn more about Sarah and her work. Work like Sarah’s is possible only with support from our community. If you’d like to support cancer research happening in Rochester at Wilmot Cancer Institute, consider participating in the Wilmot Warrior Walk or giving a donation online.
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