Because of you, we can dare to imagine a world where cancer is preventable, detectable and beatable for all.
Awesome Games Done Quick is an annual live-streamed video game marathon organized by Games Done Quick to raise funds for the Prevent Cancer Foundation®. Hundreds of all-star gamers from around the world meet to speedrun—play as fast as possible—their favorite games. People around the globe tune in online to watch the “best of the best” take on the most popular games.
My training in human nutrition has always made a point of focusing on prevention in addition to supporting treatment. The recent identification of clonal hematopoiesis as a condition that can assign cancer development risk in otherwise healthy people provided me a promising avenue to apply my nutritional science background to cancer prevention.
The past successes of nutritional interventions in preventing disease such as the fortification of flour products with folic acid to prevent neural tube defects is remarkable and inspiring. As our understanding of how specific cancers initiate, it evolves the opportunity to develop prophylactic nutritional interventions and becomes excitingly more plausible.
Aging is a major risk factor for the development of blood cancer, such as leukemia, due to an increase in the dominance of ineffective blood stem cells. Blood stem cells are necessary for hematopoiesis. (The process of creating all the cells that constitute the blood system.)
Over 6% of all individuals 60 years of age and older who are otherwise free of blood disorders have clonal hematopoiesis. Clonal hematopoiesis is the dominance of ineffective blood stem cells that results in an increased propensity for blood cancer development and poor outcomes once cancer develops. This can be detected from a minimally invasive blood draw; therefore, it presents a truly pre-cancerous state that is easily detectable and in adequate time for intervention. Because the timeline from clonal hematopoiesis detection to disease is unknown, traditional therapies that have side effects, especially when taken for long periods— such as drugs—are not feasible.
I propose the use of dietary interventions as a sustainable and effective cancer preventative strategy to prophylactically treat people with clonal hematopoiesis. Using the zebrafish model—which shares many of the biological features that define the human blood system and allows for high throughput screening of treatments in a whole-body context—I will test dietary interventions to evaluate their influence on slowing clonal hematopoiesis.
I will also combine genome editing techniques to model clonal hematopoiesis along with cutting edge genetic and color cellular barcoding approaches to track the dynamics of individual blood stem cells in response to dietary interventions in real time.
Funding gives me the financial freedom to focus on my cancer prevention research full time in a mentored setting. During this valuable time, I will develop into an independent cancer prevention scientist prepared to train the next generation.
The goal of my work is to develop nutrition-based preventive treatments to be used after an individual is found to have a genetic predictor of cancer. The appeal of nutrition-based interventions is that they typically have less side-effects than traditional drugs and can be safely taken for long durations.
As a physician scientist, I conduct research to understand how leukemias develop from pre-leukemic precursor conditions to develop better preventive interventions. My interest in cancer research stems from my experience in medical school, closely working with blood cancer patients and my mother’s breast cancer diagnosis. I moved to the U.S. to receive training in a cancer research lab and developed myself as a physician scientist. I feel fulfilled when I develop new therapies in the lab and work hard to translate them into clinical studies in the hopes of improving the care of our future patients.
Acute leukemia is an aggressive cancer with significant morbidity and mortality rates. Most patients are transfusion dependent, requiring visits to hospital at least once a week. While our current therapies can cure a fraction of these patients, most patients have high-risk leukemias that can be fatal. In the past 10 years, we have learned a great deal about the pre-leukemic precursor conditions in the blood system which can be detected years before leukemia arises. The goal of my laboratory is to understand the mechanisms driving the progression of precursor lesions into leukemia and develop new approaches to halt this progression.
Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) are aggressive blood cancers that are among the top ten causes of cancer deaths in the U.S. Clonal hematopoiesis (CH) is a well-known precursor lesion to AML and is defined by the presence of genetic abnormalities (i.e., mutations) in the blood cells of an individual, years before they get a clinical diagnosis of blood cancer. Individuals with CH are at 11-times higher risk to develop AML.
Our research has shown that a third of adult patients with ALL also harbor CH-type mutations in their leukemias. We were also able to demonstrate that mutations can exist in blood cells of ALL patients many years before they are diagnosed with leukemia. Since CH can predict the risk of leukemia for both AML and ALL patients, we may have a window of opportunity to implement risk-reduction strategies in high-risk individuals to halt the progression of CH to fatal acute leukemias.
The aim of this project is to have a detailed genetic characterization of CH evolution to help understand the critical pathways driving leukemias, which can then be targeted to prevent leukemia before it happens.
We will explore:
These studies will help us discover the pathways driving leukemias in adults. This will allow us to use risk reduction strategies to prevent leukemia in high-risk patients.
Mechanisms responsible for development of leukemias from precursor lesions, characterized by blood count abnormalities, are currently unknown. Funding from the Prevent Cancer Foundation will allow us to discover the unknown as we perform a large-scale genomic analysis of samples to identify drivers of leukemia progression.
Our goal is to identify new biomarkers and mechanisms responsible for leukemic transformation so that we can develop better models of risk assessment and discover new therapies that focus on prevention through precision medicine. We hope to bring new insights into leukemia prevention and inform physicians taking care of patients who are at high risk for leukemias.
Hispanics/Latinos are disproportionately burdened by cancer. Cancer is among the top two leading causes of death in the U.S. Latino population, accounting for about 2 out of 5 deaths. This population has lower cancer screening rates than any other race or ethnicity. This disparity is exacerbated with a lower overall health care utilization among Hispanics/Latinos. There is an urgent need to address this modifiable factor of low screening rates among this population and reduce cancer-related mortality.
My immediate goal is to identify strategies that will help this target population increase cancer knowledge and screenings. My long-term goal is to make an impact in this community by reducing early mortality rates from cancer. I have conducted several qualitative studies and observed that a large part of this community is disconnected from the U.S. health care system; therefore, they do not use many of the resources available to them.
Hispanics/Latinos are disproportionately burdened by cancer and experience structural racism (macro-level conditions that restrict opportunities and resources) as a barrier to cancer prevention and screening.
We want to adapt the successful Project HEAL (Health through Early Awareness and Learning) program for the immigrant Hispanic/Latino community. Project HEAL is an evidence-based intervention in African American faith-based organizations that we developed with support from the National Cancer Institute and the American Cancer Society. The program trained African American leaders as lay Community Health Advisors (CHAs) to conduct group educational workshops in churches to increase knowledge and screening for breast, prostate and colorectal cancers. It was effective in increasing cancer knowledge overall, as well as colonoscopy, fecal occult blood test and digital rectal exams over 24 months in Black communities.
This project will measure the effectiveness of Project HEAL to increase cancer knowledge and screenings with Hispanic/Latino immigrants. There is a critical need to adapt and determine the effects of Project HEAL on cancer knowledge and screening outcomes among this population.
With the Prevent Cancer Foundation’s funding, we will culturally adapt and implement Project HEAL with Hispanic/Latino immigrants with the goal to address low screening rates among this population and reduce cancer-related mortality. This project will pilot test the effectiveness among this population and will be followed by a larger trial with a larger number of participants.
My hope is that we will observe an increase in cancer knowledge and use of cancer screenings during the pilot test. I hope our evaluation indicates that the intervention is feasible and has efficacy, utility and impact. I hope results from this project will allow for the proposal of a larger trial to achieve a higher impact in a larger population of immigrant Hispanics/Latinos.
Cervical cancer is the leading cause of cancer-related death in Haiti, yet sufficient screening is not widely available. This project will provide 34,000 free cervical and breast cancer screenings, organize bi-annual education campaigns and train 35 nurses and 45 community health workers to reduce mortality and morbidity rates.
Organization: KILELE Health Association
Title: Thamani Yetu – Engaging Communities to Improve Cervical Cancer Prevention and Early Detection in Mbeere North Sub County, Embu County, Kenya
Location of Project: Kenya
Award: $150,000 for two years
This project aims to reach 40,000 Kenyans by engaging with the community and providing human papillomavirus (HPV) vaccinations, cervical cancer screenings and treatment. The program will also address myths and misconceptions and work with cancer survivors. These cervical cancer initiatives are intended to be replicated in other countries with hard-to-reach regions.