Tag Archives: research

Research Advocacy: Try This at Home!

Posted on by
1

Here is an article I wrote for the Komen Advocates in Science bi-monthly newsletter. I hope you enjoy it.

Cómo crear una rutina si trabajas desde tu casa? | Moi
As someone living with metastatic breast cancer, I’ve been sheltering in place and avoiding physical contact with the outside world.
 
Since the COVID-19’s arrival, nearly all of the scientific meetings I’ve been scheduled to go to the first half of the year have either been canceled, postponed or changed to a web-based format. These meetings provided me with opportunities to connect with researchers and clinicians on research progress and priorities.  Also, to reconnect and meet my fellow research advocates, which is always a great source of inspiration and strategies to improve my advocacy efforts.
 
Right now, I’m concerned about a number of things related access to care.  We know access to care greatly impacts our quality and quantity of life.

Some important clinical trials are on hold and not enrolling new patients.Research dollars at the National Cancer Institute may be in jeopardy, as the government decides where to draw funds from to fight the pandemic.  Studies may be delayed or canceled.

There are researchers who have had to postpone their research due to campus closures.  Basic researchers and their research are being hit particularly hard by these closures.

Some patients are reluctant to go to clinics for tests, scans and/or regular visits.

Some cancer patients are unable to access pain medication because getting a refill requires a face-to-face visit.
Cancer patients undergoing procedures or needing to be in the hospital are unable to have someone with them. 

Hospitals and clinics are closing access to all except the patient making it difficult for cancer patients to receive the emotional support they need from friends and families during clinic visits and hospital stays.

Cancer patients, who have been laid off, have thought about rationing or stopping their medications or treatment because they can’t afford it.

A number of these things are not traditional “research advocacy” issues. But they play a vital part in our efforts to end this disease and its impact on patients.

What can we, as advocates, do?  After all, we’re also practicing physical distancing and not leaving our homes. For starters, we can:

Engage in social media, like Twitter, to learn what’s happening with other cancer patients, survivors and co-survivors. How are they coping…or not? How might these experiences and insights impact research?  What actions can we take to reduce this pandemic’s negative impact on our breast cancer community?

Call or email researchers we are working with or have worked with.  What is their situation?  How can we help?

Contact our legislators when critical legislation or policies are being considered.  Komen makes this easy to do.  If you’d like to be involved, sign up to receive emails on the latest policy issues and how you can help.

Contact people we know who live alone.  Even a five-minute check-in call can make a difference in their well-being!

Ask if canceled or postponed research-related meetings might be conducted online or as a series of webinars.  Maybe we can keep research efforts moving ahead as we move online with our advocacy.

Things we can do to keep our minds engaged in research:

Write a blog post about your experience as a research advocate.  Komen has a blog page where you can contribute your thoughts.

Watch recordings of scientific webinars and meetings you’ve been meaning to review.  Stay on top of what’s happening in the science of cancer.

– The Research Advocacy Network is known for its advocate-friendly educational resources.   

– For breaking news or discussions on recent issues, Check here.  

– SHARE also has a good video library.

– Check out Komen’s You Tube page for videos of interest to you.

Get involved in one of the Advocates in Science Committees.  The new fiscal year starts April 1.  We’ll be launching our new AIS goals and objectives. We need your brain, voice, and passionate heart!  Contact Liz Graves to let us know if you’re interested,  lgraves@komen.org

Whatever you choose to do, make sure you are practicing good self-care and compassion. This is a difficult time. Your health and well-being are priority #1!

 Author’s note:  Many thanks to Cheryl Jernigan for her thoughtful contributions to this article.

You Publish – We Perish

Posted on by
7

Stop the Madness

Sometimes I wonder whether the purpose of some cancer research is to beef up biosketches of investigators while contributing to the growth of the medical publishing industry.

Other times I am sure of it.

As a seasoned advocate reviewer for three different breast cancer funding organizations, I’m asked to review the overall impact I believe an application may have on achieving the goal of the particular funding program.  I assess this representing the breast cancer community in total, not my particular medical situation. 

As I read each proposal, I seek answers to questions like these: “So what if this is study funded?  What eventual difference might the research findings make in the lives of patients?”  Sometimes the answers are difficult to find in basic science proposals, but it’s not impossible. 

Each applicant writes what they believe the impact of their study will be if funded and if their hypothesis is correct.  The idea is to make a difference by moving the science ahead in order to one day reduce incidence, improve quality or quantity of live, and/or prevent deaths.  Each program announcement is very clear about the objectives of this section of the application. 

One investigator, who I will call Dr. Nyt (Naïve Yet Truthful), enthusiastically stated in his Impact Statement that if funded, his research would generate two, maybe three manuscripts which would impact his career prospects, and would also put him in a position to get additional funding so he could publish additional studies.

That was the essence of his idea about the overall impact of his work.  That he would publish more articles and further his career.

There is a lot of truth to Dr. Nyt’s comments. 

It’s what many may think, but never write.

If you don’t publish, you don’t keep your job, no less move up.  You don’t Pass Go.  Ever.

Another part of peer review for some funding programs for less experienced scientists, is to review the potential of each applicant to become an independent breast cancer researcher.  During peer review discussion, much energy is put toward questions like these:

For someone at that level, does the fact that they only have four published articles give them a lower rating? 

What if the applicant was first author on all four publications? 

What if the applicant has never been first author, but has been co-author of ten published articles? 

What if the ten articles were published in “low quality” journals?

What if the applicant has only published two articles and is working to get approval on five more? Does that mean they aren’t very productive? 

Little is said about the quality of the contributions the articles may have to scientific progress and how these published articles may eventually influence clinical practice.

The reward system favoring publishing over impact is fraught with long term issues, issues that may have decelerated progress. Focusing on publishable studies may have delayed the groundwork needed to develop new therapies that could extend lives, improve the quality of lives or reduce deaths from breast cancer. The extreme emphasis on publishing may also have discouraged many promising investigators from pursuing a career in the field.

Scientists know this.  In academic settings they play the game because they have to.  It’s the old “publish or perish” — you’re only as good as your last published article, only if it’s accepted by a high-quality journal.  And publishing in any journal is better than not publishing at all.

Over the past six weeks, eight fabulous breast cancer advocates – my friends – have died of metastatic breast cancer.

How many new journals have gone to print over those six weeks?

How many articles have been published? 

How many of those are the career-sustaining articles that will likely go nowhere, except for citations in the next round of articles? 

How many of them end with “in order to know for sure, we need more studies?” 

I fully realize I’m an outsider making observations based on what I see and what I learn about.  In school, I didn’t excel in biology and couldn’t stand following the scientific method.  I’m no expert.

Alone, I have very little power to change anything.  That frustrates me.  People are dying.

Many advocates believe that if we just spent a lot more money on research, we would be closer to ending the death spiral in metastatic breast cancer.  Maybe we could. I’m certainly not against more funding.

But I’m not convinced that by only increasing funding for breast cancer research, we will achieve better outcomes for patients.

There’s more to it than that.

Until we fully examine and change the reward systems for scientists, it will be more difficult to achieve the progress we all want in order to stop our friends and family from dying. 

Let’s stop the madness.

An Open Letter to Breast Cancer Researchers: Are You Building Stairways to Nowhere?

Posted on by
11

Are You Building Stairways to Nowhere?

Are You Building Stairways to Nowhere?

Dear Scientific Researcher,

What you do is extremely important and provides hope to those like me living with metastatic breast cancer.  The projects you choose, and the collaborations and advances you make, can be vital to ending the set of diseases known as breast cancer, thereby saving thousands of lives in the future.

I have met many of you on various review panels and have sat in the room with you, discussing the strengths and weaknesses of proposed breast cancer studies.  You bring in scientific viewpoints; I bring in the views of the community, particularly the views of the patient advocate.  Sometimes you get wrapped up in the elegance of a specific study and shift uneasily in your seats when I ask:  “So how does this study help us save lives or prevent the disease from happening in the first place?”

I realize how difficult it is to obtain funding for your labs and that some of you have had to dismiss some talented members of your teams due to lack of funding.  I have raised over $50,000 for breast cancer research and have lobbied dozens of times on Capitol Hill to secure your research dollars.   I feel your pain.

I have attended far too many funerals cloaked in pink ribbons.  Inspiring women, creative women, and yes, demanding women and men have suffered and died at the hands of this disease.  Each day, those who call themselves survivors, live with dark clouds over their heads housing thunderbolts of lingering fears that recurrence and death is in the forecast.

When I read funding proposals, it makes me aware how little you really know about curing breast cancer in humans.  You don’t know how many breast cancers start, how to accurately detect breast cancers, why mutations happen, why the immune system ignores these aberrant cells, how cancer cells can survive throughout the body and colonize in new locations, or how some cancer cells resist treatment.  Sure, you know some, but not enough.

We have spent billions of dollars on breast cancer research, from both the public and private sectors.  You have written thousands of peer-reviewed journal articles on the subject.  You have attended and presented at hundreds of breast cancer symposia, costing millions of dollars and thousands of hours.

Securing study funding, publishing papers and presenting findings seems to have become an end unto itself for some of you.  Finding real cures for real people appears to have been lost in the shuffle.

You study signaling pathways that end up worthless as targets for treatments due to the body’s ability to create redundant systems.  You study different dose levels of the same thirty-year-old chemotherapy treatments on lab mice and proudly boast that the new combination extends life a few months.  You repeat unsuccessful research studies because prior scientists failed to produce their findings.  You plunge into nanoparticle technology to find the right shape to fit into cell receptors in order to develop a toxic payload into cancer cells, and discover the keys can’t find the locks.  You study the neighborhood around cancer and try to figure out if that’s what fosters new cancer formation.  You spend years discovering new cellular mechanisms, write about them, and then look for your next project.

All of this:  Yet people keep dying.  At least one has died from breast cancer as you read this letter.

But are you building stairways to nowhere?

What happens after you publish your findings?  When you finish a project what happens next?  How are your results applied to get us any closer to actual treatments or prevention?  How do you hold yourselves accountable to clinicians, patients and the general public?  How can you make it less about “publish or perish” and more about saving lives?  How can you make sure you ask the right questions before starting any new project instead of building a stairway leading to nowhere?

Are you satisfied with your own progress?  How would you feel if someone undergoing treatment looks over your shoulder as you work?  Would you personally go to your friends and family, asking them to donate to the work you are doing right now?  If your own loved-one was diagnosed with breast cancer, what steps would you take to make sure they would not perish from the disease?

These are important things to think about.  I know you work hard.  I work hard at staying alive.  Both jobs are difficult.

What I’m asking you to do is to consider your role in the fight to end breast cancer.  Are you winning or losing?  What can you personally do to ask the right research questions that are not redundant or merely interesting, but are important to finally putting an end to breast cancer?  How can you make sure that your research makes a real difference and foster translation into the clinic?

I’m fighting the battle every day.  Please do what you can to fight with me.  Put an end to building stairways to nowhere.

Sincerely,

Sandra Spivey

Starting out

Posted on by
2

Since my retirement as a human resource professional in 2008, my life has been filled with cats and cancer. I have been lucky enough to be asked to mentor several people I’ve worked with in the past on career advice and sticky people issues. That has helped keep my mind active.

My grown daughter, Allison, and her tuxedo cat, Bickley, moved back home soon after I retired. Allison and I soon started volunteering at the local animal shelter, cleaning cat cages and playing with cats every Saturday morning.  We adopted cat #2, Tiny Baby Sweetheart Honey Cupcake Sugar Princess Yummy Gumdrop, who proved to be everything but Tiny. Soon after that, we decided to adopt our son’s three-legged cat, Buddy (who my husband Bill now calls Zoom-Zoom due to her adept running skills).  So our lives are filled with floating fur and hair balls. 

In 1995, I was diagnosed with breast cancer and expected to complete treatment and be done with it, as happened to my mom in 1980. My cancer had other ideas and infested my bones in 1998 at age 45. I read where 10% of those with the same disease lived past 3 years. I decided to sign up for that group and am happy to say that my membership application was accepted. 

I’ve had several cancer adventures, from 3 weeks in the hospital for a bone marrow transplant to sitting next to cancer researchers determining the strengths and weaknesses of various breast cancer research proposals.  

So my life is now filled with cats and cancer. The cats provide therapeutic value in dealing with cancer. It’s the perfect mix for a retiree like me.