Scale

When I give a talk about cancer research, I like to highlight both the diversity of cancer research and that it is a continuum. One way to do this is by showing a scale that, going from smallest to largest, includes cancer research focused at the level of molecules, cells, tissues, organs, patients, clinical trials, cohorts, and communities. Much cancer research spans various points on this scale. I can take any two points on this scale, and talk about an important research project at Holden based on those two points. For example, molecular epidemiology involves taking samples from a large number of individuals in a group of cancer patients and evaluating them at the molecular level in order to improve our ability to predict how specific changes in genes might impact an outcome. Identifying new cancer drugs requires we screen large numbers of compounds to see which have the most promising effects on cancer cells, then after appropriate testing in the laboratory, assess the effects of these new drugs on patients in a clinical trial.

In the research lab, we start on a small scale exploring cancer at the molecular level with the hope that, with persistence (and luck), such research will eventually have a major impact on a much bigger scale, namely on the health and well-being of our patients.

Trying to change public perception and public policy related to cancer also takes place on a broad range of scales, and extends from one-on-one conversations to broad efforts to change national policy. These also are all connected. The right conversation at the right time with a single individual might convince that person to become an advocate. They, in turn, might have a major impact on an influential policy maker.

Last week, I participated in a radio call in show on Iowa Public Radio hosted by Ben Kieffer.  The topic was “How is Iowa doing in the fight against cancer?” You can find the broadcast here.   During the radio broadcast, we talked about a broad range of topics including research progress, research funding and how individuals can reduce their own risk of getting cancer. It was an interesting experience – sitting in small room wearing a pair of headphones talking with one other person, yet knowing there were many others listening in.

The idea for this conversation came up during a casual one-on-one conversation I had with Ben while we were riding our bicycles across Iowa as members of the same RAGBRAI team. My conversation with a teammate on RAGBRAI led to a radio broadcast, and maybe that radio broadcast will result in getting someone engaged who eventually will make a really big difference in reducing the burden of cancer for our community.

Just like in the lab, start small – think big.