Face to Face with Cancer

"I said ok Lord, this one's yours. Just give me peace. I do not want to live every day in fear of dying."

And for the past six years, Sharon Cunningham has been able to live her life fully despite a stage IV lung cancer diagnosis. Early in her treatment, Winship Deputy Director and lung cancer expert Suresh Ramalingam identified a mutation in her cancer that could be targeted by the drug erlotinib (trade name Tarceva). She has been on it ever since, and doing well.

Recently, Cunningham and Ramalingam shared her story with a class of students pursuing PhDs in the Cancer Biology Graduate Program in Emory's Laney Graduate School. The class, Cancer Clinical Colloquium, was started four years ago as a way of introducing budding cancer researchers to the "human side" of the disease. Class enrollment burgeoned, and what started as an elective is now a program requirement.

The class was designed by Winship hematologist and researcher Edmund K. Waller and is now co-directed by Waller and Taofeek Owonikoko, medical oncologist and researcher specializing in lung and aerodigestive cancers. Each week, a different Winship physician comes to class with a patient. Students prepare by studying the patient's particular cancer and are ready with questions.

"Do you have a family history of lung cancer?" (yes, her grandfather died of lung cancer)

"Were you nervous about telling us your story?" (no, she's told her story before)

"How important is your relationship with your doctor?" (very)

Cunningham told the class that picking the right doctor and trusting him has been of primary importance in her treatment, and that her faith has enabled her to go forward without fear. She comes in every three to four months for CT scans and Ramalingam reviews the results, which have been good. She told the class there was a moment when she asked him point blank, "What does that mean? What does the scan actually show? He said, the scan shows no cancer. But there could be invisible cancer cells. So that's why you keep taking the drug."

Students write weekly blogs in response to the doctor-patient presentations. This week's presentation piqued interest in the impact of cigarette marketing on lung cancer rates, the rise of lung cancer in people who have never smoked (like Cunningham), and dismay that lung cancer research is not as well funded as other cancer types. Emily Summerbell shared the story of her grandmother's battle with lung cancer. Amber Caldara wrote about her firsthand experience of the military's tobacco culture: "I don't think we were really educated on these statistics while I was in. We frequently take courses for gun safety and mental health...but nothing on lung cancer and tobacco use."

Many students commented that meeting Sharon Cunningham put a face on a disease they have learned about through "numbers and molecular pathways." Fadi Pulous found "moments of optimism" and inspiration in her story. Meaghan Griffin wrote, "When most people think about lung cancer patients, what comes to mind is the image of someone who is very fragile and terminally ill. Mrs. Cunningham blew those stereotypes out of the water."

These graduate students spend a lot of time in labs, working directly with Winship investigators to study how cancer cells behave at the molecular level and how to exploit the mechanisms of their behavior for cancer therapy. Former students say the Colloquium class connected them to patients who motivate their research. Hope Robinson, now a third-year student in the program and working in a pediatric cancer lab, took the course in 2015 and says it changed her perspective.

"As students of cancer biology, we spend most of our time thinking at the molecular level. We are concerned with what is happening inside the cell—what proteins are interacting? Are there changes at the genetic level? Is the DNA available for transcription or tightly wound? It could be easy to forget that on the other side of our research are human beings with histories, families, and plans for the future that cancer is jeopardizing. The Colloquium class is motivating in a way that nothing else can be. It helps us see our research in a different way."

Former student Christine Tallo says the experience translates directly into her current work as a Winship genetic counselor. "A fundamental tenet of genetic counseling is translating scientific concepts and research for patients to help them understand how genetics impact their treatment and their families. This class helped me realize how important this is."

For Sharon Cunningham, the class was also a great experience, and she feels she's played a role in guiding these young scientists: "It's the people they are helping
who will give them incentive to do this work."