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Doctor of Determination

By Reetika Khanna Email By Reetika Khanna
January 2020
Doctor of Determination

DR. VEENA RAO, who developed a passion for science in high school, was encouraged by her mother to read about the Nobel Laureate Marie Curie. Now a professor and co-director of the Cancer Biology Program, and Georgia Cancer Coalition Distinguished Cancer Scholar in the Department of OB/ GYN at Morehouse School of Medicine, Atlanta, she was recently awarded a $100,000 grant for her breast cancer research on early detection of Triple-Negative Breast Cancer (TNBC).

You were inspired by physicist and chemist Marie Curie, who is known for pioneering research in the field of radiology. Were there other motivating agencies that galvanized your interest in science?
When I was young, I wanted to be an Olympic athlete. I wanted to be a circus girl. Then I wanted to be an astronaut and travel to the moon! But reading about Madame Curie and being motivated by my father, who was a stellar electrical engineer, led me to become a scientist. My biology and chemistry teachers in high school also helped along the way by reinforcing my passion. As a teacher, I now encourage my students in the same way. I remind them that becoming a good scientist takes passion, honesty, and hard work.

Where did you further your education after Most Holy Rosary Convent in Hyderabad?
I completed my Ph.D. from Osmania University. I did my postdoctoral work at the University of California, Berkeley, and Yale University School of Medicine, where I was first exposed to the cancer field. I was also lucky enough to be sent by the Government of India to several prestigious universities like Max Planck Institute in Germany, University of Edinburgh, Scotland, and MIT, Boston.

What was most significant about your experience at Berkeley and Yale? Did your time at those venerated universities in any way inspire you to become a teacher?
The freedom of thought and long working hours I had at Yale and Berkeley were the two most important strengths I believe the schools possessed. The only weakness was that my mentor wanted everyone to be in the lab all the time. Being in the lab all the time doesn't mean you are productive. All these experiences made me passionate about pursuing a career as an academic cancer scientist.

What brought you to Georgia?
In 2002, I was recruited by the Morehouse School of Medicine to start a cancer research program at a minority medical school and train students in cancer research. The biggest attraction was that the then Governor of Georgia, Roy Barnes, gave a $1.5 million award as Georgia Cancer Coalition Distinguished Cancer Scholar for cancer research.

Tell us about Triple-Negative Breast Cancer (TNBC), and its relationship to the BRCA1 gene that you have been studying from the time it was positionally cloned in 1994.
TNBC is a type of breast cancer in which all receptor tests—hormone epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR)—come back negative. TNBCs are very aggressive, and they have a high rate of recurrence and distant metastasis, which accounts for the high mortality rates. BRCA1 belongs to a class of genes known as tumor suppressor gene that produces proteins to repair cell damage and keep cells growing normally. The mutation of the BRCA1 gene raises a woman's risk for developing TNBC, ovarian cancers, and lower risk— among both sexes—for pancreatic, colon, prostate, and peritoneal cancer.


What comes next?
My group has been working on the BRCA1 gene since 1994. We are planning in the future to screen biomarkers for early detection and targeted therapies for these aggressive cancers, thus reducing the mortality of these cancers. We are also working on the mechanism of chemoresistance and recurrence in TNBC.

Does race play a role in the incidence of TNBC?
It does. In the U.S., between one in 400 and one in 800 people has a BRCA1 mutation. However, prevalence varies by ethnic group. Among Ashkenazi Jewish, about one in 40 have a BRCA1 mutation. European/ Caucasian, about one in 250. According to a recent American Cancer Society (ACS) publication, breast cancer is the leading cause of cancer death for black women in six states, including Georgia. Another recent paper suggests Indian women also have a high incidence of TNBC based on data surveys from Google and PubMed (Thakur et al. 2017).

Breast cancer can also afflict men. How common is it? What kind of preventive screening is available to men?
Breast cancer in men is rare, occurring less often than breast cancer in women. Mammograms are not commonly offered to men due to the small amount of breast tissue. However, doctors may recommend mammography for men with a genetic mutation that increases the risk of developing breast cancer.

As in all cancers, early detection is crucial in improving the odds of survival. Screening saves lives. Who do you recommend should get genetic testing for BRAC1 mutations to assess cancer risks?
Women who have a family history of breast, ovarian, and other cancers or who have breast cancer should consider it.

What impact, if any, has Artificial Intelligence and Intelligence Augmentation had in your field? What discoveries, new tools, and techniques have surprised you the most?
I have not used AI in my research. I am aware that AI has impacted clinical research in the breast cancer field where AI software is being used in analyzing mammograms of breast cancer patients. The discovery and cloning of the BRCA1 gene was a significant milestone in the history of breast cancer research. I am excited about Precision/Personalized Medicine. It is a new concept and technology for disease treatment and prevention tailored to individual patients’ genetic/molecular profiles, environment, and lifestyle. In short, delivery of the right treatment to the right person at the right time, not a one-size-fits-all treatment.

So, one can expect personalized medicine as opposed to generalized, cookie-cutter therapeutics?
Yes, personalized medicine will take over in the future. TNBC, for example, is not a single disease— currently, it is divided into six categories, and each has its unique treatment. In the future, treatments will be based on the gene that is disrupted, not the organ of origin.

Scientific data aside, if you were to venture a guess, how long do you believe it takes for the salubrious impact of a groundbreaking discovery in the field of oncology to reach cancer patients?
A groundbreaking bench discovery in the field of cancer to reach the cancer patient’s bedside, I guess, can take anywhere from 10 to 20 years or more. It is all a team effort between basic and clinical scientists and clinicians.

How does the sugar and meat-heavy average American diet impact our well-being? In your opinion, what are the three most vital things one can do to stay healthy?
The ACS recommends eating mostly vegetables, fruits, whole grains, and less red meat and sugar. A healthy diet can reduce the risk of heart disease, diabetes, stroke, and some cancers.

The three most vital things one needs to do to stay healthy are eating a healthy diet, exercise to maintain a healthy weight, and to stop stressing out.

You have been living with hearing impairment for over twenty years. How has that affected your daily life?
The impairment has never stopped me from pursuing my passion and achieving my goals to find a cure for breast and ovarian cancers. Thanks to technology, hearing aids now connect directly to your iPhone. I tell my students my impairment is an advantage—if you don't want to hear someone upsetting you, you can turn the volume down!

How does being a researcher impact your teaching style?
Being a researcher, one has hands-on experience in bench research, which has an advantage in teaching and exciting the student's interest in research. One can also educate the students about where the future is leading with respect to technology.

What keeps you at the Morehouse School of Medicine?
My current role model is Helen Keller, who was the first deaf and blind person to earn a Bachelor of Arts degree. My favorite quote is: "When one door closes, another opens, but often we look so long at the closed door that we do not see the one which has opened for us." Because I saw the open door at Morehouse School of Medicine, I was able to make my best discoveries here. Even though I have been to several Ivy League schools, I tell my students my best research discoveries were at the MSM satellite site at Grady Memorial Hospital. After 16 years at Grady, my labs recently moved to the main campus of MSM.

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Author of Kismetwali & Other Stories, Reetika Khanna is an Atlanta-based freelance writer who likes to spotlight people with purpose. She has worked with ELLE as a senior features writer, and as an associate features editor with ELLE DÉCOR, Mumbai. For more, go to ReetikaKhanna.com

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