Episode 14: Cancer Prevention Fellowship Program

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Jessica Faupel-Badger, Ph.D., M.P.H.

Dr. Faupel-Badger is serving as the Acting Director for the Cancer Prevention Fellowship Program and is the Planning Officer for the Division of Cancer Prevention (DCP). In the Planning Officer capacity, she oversees strategic planning, reporting, and analysis of DCP-led initiatives. She also seeks to develop collaborations that leverage DCP research activities and advance the development of the DCP-supported research workforce.

Prior to joining DCP, Dr. Faupel-Badger led the Education Branch at the National Center for Advancing Translational Sciences (NCATS), where she collaborated with NCATS staff to develop new tools and education activities to improve understanding of translational science and the translational science spectrum. Dr. Faupel-Badger has extensive experience leading education and training programs, including serving as the director of training and education in Division of Pre-Clinical Innovation (DPI) at NCATS; directing the Postdoctoral Research Associate (PRAT) program at the National Institute of General Medical Sciences (NIGMS); and serving as the deputy director of the Cancer Prevention Fellowship Program (CPFP) at the National Cancer Institute (NCI).

Dr. Faupel-Badger received her Ph.D. in tumor biology from Mayo Graduate School/Mayo Clinic College of Medicine. She then joined the NCI Cancer Prevention Fellowship Program for her postdoctoral training and received her M.P.H. from The George Washington University.

Lymarie Maldonado-Báez, Ph.D., M.S.

Dr. Maldonado-Báez serves as the Deputy Director of the Cancer Prevention Fellowship Program in the National Cancer Institute’s (NCI’s) Division of Cancer Prevention. Prior to joining NCI, Dr. Maldonado-Báez served as a regulatory scientist in the Office of Biotechnology Products of the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration (FDA) with expertise in the regulation of biological treatments for cancer and immunological disorders.

Dr. Maldonado-Báez holds a Ph.D. in cell biology from Johns Hopkins University and received an M.S. in biochemistry and B.S. in industrial microbiology, both from the University of Puerto Rico. While a graduate student, she was awarded a MIRT Fellowship from the Fogarty International Center to conduct biomedical research in Grand Canary Island, Spain. Dr. Maldonado-Báez completed postdoctoral training and conducted independent research at the NIH, where she made significant contributions to the fields of membrane trafficking, cell-cell communication, cell migration, metastasis, and cell metabolism. During her tenure at NIH, she mentored a diverse cohort of postdoctoral fellows, graduate, undergraduate, and high school students focused on biomedical research careers. She is a fellow of the Ford Foundation of the National Academies of Sciences, Engineering, and Medicine and an active member of the Society for the Advancement of Chicanos and Native Americans in Science (SACNAS). Dr. Maldonado-Báez is actively engaged in developing outreach and training initiatives to promote diversity, equity, and inclusion in biomedical research and training programs inside and outside the NCI.

Leticia Nogueira, Ph.D., M.P.H.

Leticia Nogueira, PhD, MPH, is the scientific director of health services research in the Surveillance & Health Equity Science department at the American Cancer Society (ACS). Her research focuses on determinants of health disparities in the cancer care continuum that can be addressed by policy changes. Dr. Nogueira was a Cancer Prevention Postdoctoral fellow at the National Cancer Institute, where she worked with cancer health disparities at the Division of Cancer Epidemiology and Genetics (DCEG).

 

 

Keith M. Bellizzi, Ph.D. M.P.H.

Dr. Keith Bellizzi is a Professor of Gerontology in Human Development and Family Sciences. Trained in gerontology, behavioral medicine, and public health, he has spent the last two decades studying resilience, cancer survivorship, healthy aging, and behavioral change. Prior to joining UConn in 2008, he was a Program Officer and Health Scientist in the Division of Cancer Control and Population Sciences at the National Cancer Institute (NCI) and graduate of the preeminent Cancer Prevention Fellowship Program at the NCI.

 

 

Show Notes

Dr. Jessica Faupel-Badger
Dr. Lymarie Maldonado-Baez
Cancer Prevention Fellowship Program (CPFP)
NCI Division of Cancer Prevention
NCI Division of Cancer Control and Population Sciences
Cancer Prevention Clinical Trials Network (CP-CTNet)
Master of Public Health Program
Food and Drug Administration

Ad: NCI Future Fellows Application System

Dr. Leticia Nogueira
Dr. Keith Bellizzi
American Cancer Society
NCI Office of Cancer Survivorship (OCS)

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Episode Transcript

[UPBEAT MUSIC] 

OLIVER BOGLER: Hello, and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host, Oliver Bogler. I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways that people join the fight against disease and hear their stories. Today we're talking about a great program at the NCI, the Cancer Prevention Fellowship Program. First, we're joined by two leaders of this program. And then, after the break, we will speak to two alums who have gone on to very interesting work and will tell us how the CPFP helped them. Stay until the end to hear what our guests have to recommend and to learn how you can take your turn to recommend something to our listeners as well. 

OLIVER: It's often said that an ounce of prevention is worth a pound of cure, and that is certainly true about cancer. Here with us today are two NCI colleagues who work in our Division of Cancer Prevention. Dr. Jessica Faupel-Badger, the Planning Officer for the Division of Cancer Prevention and Acting Branch Chief of the Cancer Prevention Fellowship is here. Welcome. 

JESSICA FAUPEL-BADGER: Thank you, Oliver. Delighted to be here. 

OLIVER: Also here is Dr. Lymarie Maldonado-Baez, the Interim Director of the Cancer Prevention Fellowship Program. Welcome. 

LYMARIE MALDONADO-BAEZ: Thank you, Oliver. It's a pleasure to be here. 

OLIVER: So let me start by asking you, Jessica, what is cancer prevention? 

FAUPEL-BADGER: Okay, so Cancer prevention is a very broad area, but I think we can peel this back to two fundamental questions, and one is, how does a normal cell transform into a cancer cell, and how can we intervene on that process? And cancer prevention is the translational piece that bridges these two questions. It requires understanding the underlying molecular processes, including how behavioral, lifestyle, and environmental factors influence these processes to develop strategies to prevent cancer, and the strategies to prevent, or sometimes we say "intercept," "cancer interception" is a term we use, so strategies to prevent or intercept cancer at the earliest point possible, could be screening and early detection, could be clinical or molecular cancer prevention strategies, including areas like immunoprevention or behavioral interventions. So just coming full circle, it's a very broad area that's multidisciplinary and it requires this translational and public health mindset aimed at ultimately decreasing cancer incidence at the population level. 

OLIVER: And we've been watching, at least for many cancers, or some cancers, the incidence decline and the mortality rate decline over the last couple of decades, I guess it's fair to say. What role has cancer prevention played in that? 

FAUPEL-BADGER: Well, I think there's a variety of different roles. Some of that is developing new strategies for early detection and screening, new opportunities for this molecular clinical cancer prevention strategies. We know that immunotherapy is a huge area in the treatment space. It's also a growing and important area in the prevention space. But then I would also say some of this is, you know, encouraging more people to follow through with the cancer screening recommendations, communicating more about what we know about behavioral and lifestyle risk factors at the population level. So it's a multipronged, multifaceted approach. 

OLIVER: But I think it's fair to say that prevention has had a significant impact in this positive change that we've seen. 

FAUPEL-BADGER: Oh, absolutely. 

OLIVER: So the Division of Cancer Prevention is what we call an "extramural division," which means that its primary focus is the funding of research outside of the NCI across the country. Can you tell us a little bit about the division's portfolio and what that looks like? 

FAUPEL-BADGER: Yeah, so we support a wide variety of different research programs. We have, you know, networks for different research areas, such as the Cancer Prevention Clinical Trials Network. We have different consortia related to early detection within either specific types of cancer or different strategies for early detection, like liquid biopsies. We also have investigators that come in through the research program grant, so the regular R01s proposing projects in cancer prevention, and then we support cancer prevention clinical trials, from small clinical trials up through large Phase 3 screening studies. 

OLIVER: So I think most people can probably imagine that, for example, scientists, investigators interested in behavioral strategies like to get people to stop smoking, exercise more, these kinds of things. Those kinds of scientists fit very well within your portfolio, but it sounds like it's much broader than that. 

FAUPEL-BADGER: The National Cancer Institute is a big place. Lots of different places are contributing to cancer prevention research. I think the Division of Cancer Prevention works very closely with the Division of Cancer Control and Population Sciences, and so that division, DCCPS, would be the one where you would see a lot of this research, for example, on tobacco and some of the lifestyle factors. But yeah, cancer prevention both within the Division of Cancer Prevention and more broadly across NCI is a very broad waterfront. 

OLIVER: Got it. I mean, to our listeners who might be trying to imagine themselves as engaging in cancer prevention research, can you give us sort of an overview? I mean, you could be a wet laboratory scientist and do cancer prevention research, right? You could be interested in cell signaling or cell genetics, all kinds of different things, right? 

FAUPEL-BADGER: Yeah, so it does span all disciplines. So working at the lab understanding molecular processes and pathways and designing interventions, physicians who'd like to explore these interventions in the clinic, epidemiology, understanding the cancer etiology and risk factors at a population level, the social and behavioral sciences, biostatistics, lots of creative clinical trial designs, not just in the treatment space but in the prevention space and making sure that we have -- we're getting results that we can interpret. So yeah, there's a lot of different disciplines that contribute, and also, if you're in one of those disciplines, needing to be conversant with the other disciplines, right, because as I mentioned early on, we're ultimately trying to influence the public health outcome. We're trying to decrease cancer incidence. So there has to be this multidisciplinary translational perspective. The work that you're doing now, who do you hand that off to? Where does that go next to have this public health intervention? 

OLIVER: So understanding the continuum of discovery, implementation, and impact, and measuring all that, and then being able to work in large teams, so -- 

FAUPEL-BADGER: Exactly. 

OLIVER: So, Lymarie, looks like we need people with all kinds of skill sets and interests in this field of cancer prevention. You are involved with the Cancer Prevention Fellowship Program, which is, I think, one of the marquee programs in this area in the country. Tell us about it. 

MALDONADO-BAEZ: Well, sure. The Cancer Prevention Fellowship Program aligns perfectly with what Jessica just described as the goal of cancer prevention research. So our program is a multidisciplinary postdoctoral training program and it's housed in the Division of Cancer Prevention at the National Cancer Institute, and our main goal right now is to train emerging researchers and leaders in cancer prevention and control through independent research. We also offer career development training, leadership opportunities, and we do that also in a -- by providing also a collaborative environment. It's very important, as Jessica said, that in order to move the field of cancer prevention forward, investigators and all involved need to be able to collaborate and be able to integrate their science into other fields - learn how everything connects. So just to give you a little bit of history, since 1987, the CPFP, or the Cancer Prevention Fellowship Program, has trained outstanding early career scientists that have gone on to prominent careers as researchers and leaders in this field. So we have former Cancer Prevention Fellows in academia, in government agencies such as the National Cancer Institute, the NIH as a whole, the Food and Drug Administration, and even at the U.S. Department of Agriculture, among many others. Our fellows are also leading initiatives in other types of research institutions, including NCI-designated cancer centers across the country, and others have joined groups that are very dedicated to promote cancer prevention in our country through nonprofit organizations and also industry. And so when we think about our program, we have designed our training with an understanding that cancer prevention covers all aspects of preventing the occurrence or the recurrence of cancer and also preventing suffering and death from this disease. That's why our approach is multidisciplinary. That's the principle that has guided the CPFP training program. So our fellows come from diverse academic backgrounds. Currently, we have around 50 different scientific disciplines represented in our program, including nursing, rehabilitation science, oncology, and surgery. We also have represented the field of behavioral sciences, pharmacology, mathematics, biostatistics, and even environmental health sciences, and more. And as Jessica was saying before, it is important. So our program not only brings people from different disciplines, but give them the opportunity to work together and learn early on in their careers to communicate to each other and design initiatives that are basically attacking this issue, this challenge from different angles, and this is very important. 

OLIVER: It sounds like you've got people coming from all kinds of different areas to work together. I know that one of the things that your program does is it helps them get a Master's in Public Health, right? An MPH. So that seems to be also a foundational training element. Can you tell us more about the MPH, please? 

MALDONADO-BAEZ: Right, so the reason why we offer that benefit of completing a Master's in Public Health to our fellows is because we strongly believe that training in public health is instrumental to moving the science of cancer prevention forward in all directions because it provides the ability to work in concert with multiple disciplines and understand also the impact that the work will have in the different communities we serve. And I always go back to a paper that I read that is very old. It was published in the 1920s with a professor at the Yale School of Medicine said that, you know, public health's long-lasting mission has been to prevent disease, prolong life, and promote health, but that has to be done through organized efforts across societies and organizations. And if you think about it, if you are a Ph.D. student and you're working at the bench conducting basic research, it's hard sometimes to see how what you're doing at the bench has a connection with the community. How do you translate that from the bench to a treatment strategy or a screening initiative? So public health, a Master's in Public Health do provide that. So we offer that benefit to those fellows that don't have formal training in public health, and they will go -- during their first year, they will join a one-year accelerated MPH program at the university of their choice, and then once they finish that MPH, they'll join the NCI to initiate the research. Whereas, fellows that do have formal training in public health, they can join right away. So every year we welcome a cohort of fellows, and in that cohort, we have two pools, the ones that will go to complete their MPH and those that can join the NCI right away. 

OLIVER: How big are your cohorts? 

MALDONADO-BAEZ: So traditionally, our cohorts are between 10 and 14 fellows, depending on the year. This year, we are very fortunate to -- we're going to be welcoming, in about less than a week, actually, 11 fellows, so we're very excited about that. 

OLIVER: I should mention we are recording this at the end of May. So tell me, Lymarie, how competitive is this? Hard to get into this program? 

MALDONADO-BAEZ: Well, it is highly competitive because it's one of those training -- postdoctoral training programs that in addition to offering the benefit for the MPH working at the NCI, it also provides a very unique training curriculum. Our fellows also will receive training in leadership, grant writing, and grantsmanship. They also participate of a whole suite of communication training, all the way of how to learn to communicate your science to scientific communities, but also to the public. So we make sure that's important. And also, if you think about it, all the people in this nation that will be interested in conducting cancer prevention, when it comes to the number of individuals that we can accept at any given moment, it's 10 to 14 people, so it becomes very competitive, and if you add to that the multidisciplinary aspect of the program where we have people from different disciplines applying to the fellowship. 

OLIVER: And then the folks are in the program for how long, typically? 

MALDONADO-BAEZ: So this program, we support funding -- we provide funding for up to four years, and again, it depends also, if they go to complete their MPH, that means that they have three years to do the research at the NCI. And another unique character or aspect of our program is that we provide the stipend or the financial support to our fellows, so that provides them with the freedom to select the research home, so their funds are not attached to a specific principal investigator or project or division, giving them the freedom to join a group that will provide the resources and the expertise to conduct their unique and innovative research, and that allows them also to collaborate with multiple groups inside the NCI and outside the NCI as well. 

OLIVER: Jessica, you've been observing cancer prevention for a while. I wonder if you could tell us a little bit about the changes you've seen, even since the late '80s, when, I guess, the CPFP was initiated. 

FAUPEL-BADGER: I do think that there's a broader array of disciplines contributing to cancer prevention research. You know, I think another area, and I was just thinking about this in response to some things I said earlier in the podcast, but one of the areas that's really been growing and is important is thinking about health disparities and how we enable more people to get access to cancer screening and early detection and prevention measures. So, you know, I think that area has grown and needs to continue to grow for us to make more progress in the cancer prevention space. So, you know, as Lymarie mentioned, the Cancer Prevention Fellowship Program brings in people from a variety of different disciplines, and we should do the analysis, but I'm going to guess that the -- that group of disciplines has only broadened over time, and people who you may think would have a minimal connection to cancer prevention have brought -- they may not have a cancer prevention training before they join the fellowship program, but they have skills that are relevant and then become cancer prevention scientists through the training in the program. So, you know, I think that's, you know, just a bigger home for lots of people to contribute. 

OLIVER: Thank you. And I wonder, Lymarie, if you could tell us, has the CPFP itself then evolved in the course of these changes that Jessica just outlined since its inception? Has it changed? 

MALDONADO-BAEZ: Yeah, definitely. Over the years, we have seen how the program evolves, and I will say that our program is constantly evolving. That's one of, I would say, challenges sometimes of working with the program, the Cancer Prevention Fellowship Program, because we try to keep up with all the challenges and the demands of the area. One big area of growth recently has been the interest in global oncology and global prevention. We have seen now there's more interest in our fellows to connect their work at the global level and learn more from low, middle-income countries and design initiatives that can be implemented and sustained on those countries and how what they have learned from those activities can help design better activities and better initiatives here to help underserved communities in the U.S., and it's fascinating what those fellows are doing in that space. We are also seeing an increased interest in the impact of climate change in cancer prevention and survivorship and it's something that we are trying to expand because now our fellows are combining what Jessica said, you know, health disparities is really important, and they are taking that even further, looking at the environment of those groups and also economical factors. So it's interesting to see that molecular prevention is taking a turn to incorporate more of the health disparity science, and that's evolving also, learning more, integrating environmental sciences into the equation. So those areas have definitely been growing in recent years and it's something that we look forward to expanding in the future through not only the work that we do in the division but through establishing new collaborations with other research groups at the NCI. 

OLIVER: Thanks for mentioning that. Later in our podcast, one of our guests is actually very interested in the impact of climate change on cancer in the prevention setting. So thanks for that sneak preview. So I wonder, then, Jessica, maybe I'll ask you first, can you tell us a little bit about your journey? How did you get interested in science in the first place? How did you become interested in cancer and then prevention itself? I know you are an alum of the CPFP, right? 

FAUPEL-BADGER: Yes, I am, and, you know, my journey could take a while, but let's -- I'll just say that, you know, I grew up in a rural area of the country and I didn't even know that you could do a Ph.D. or what a Ph.D. was until I was in college. So, you know, these journeys take some amazing twists and turns. But I had the opportunity, when I was in college, to do a small project, basically maintaining cancer cells in culture, and I just became fascinated with, you know, how these cells would take over their cell culture dish and how much time we had to put in to splitting them and taking care of them, and that led me to pursue a Ph.D. focused on tumor biology. And then I was one of the people working in the lab, and the lab I was in sort of had two different areas of focus. One was very basic research, which is the area that I was in, studying cancer cell signaling, and the other was looking to develop an early detection test for ovarian cancer, and I sort of became captivated by what the other group was doing and how do you, you know, how do you have this impact at the population level, and that led me to find the Cancer Prevention Fellowship Program where I could take my basic science background and get a Master's of Public Health and then focus on this at the population level, and long story short, became a big fan of the Cancer Prevention Fellowship Program and multidisciplinary training, and, you know, as we talk about new research directions, one of the things that I think about is, well, who's going to do that work? Where is the workforce to support that? And so my path has taken me more into biomedical research workforce development. 

OLIVER: Thanks. Your title is Planning Officer for the Division of Cancer Prevention, right? 

FAUPEL-BADGER: Yes. 

OLIVER: So tell us, just give us a quick sketch of, what does the Planning Officer do? 

FAUPEL-BADGER: So it's a variety of different things. I would say the main thing is helping the leadership of the division with their priorities and, you know, making sure that we prioritize our work going forward to maximize our impact, but it's also collaborating with other individuals across NCI on initiatives that span the whole institute where all the divisions and centers are contributing, contributing to some of the reporting that we need to do to Congress and, you know, contributing to the President's budgets, so being part of all of those pieces as well. So it's, you know, kind of helping to manage things within the division but also paying attention to what's going on one or two levels ahead of us. 

OLIVER: Sounds fascinating. Lymarie, please tell us, how did you come to be a scientist and a cancer prevention person? 

MALDONADO-BAEZ: So I didn't follow a very straight path. I had many turns and stops in the way, but I would say that I -- very early in my life, I was very fascinated by the fact that the body had this surveillance system that protected us from getting sick. Like, my friends were not sick all the time, so to me, it was like, oh, my God, this is so great, there must be something. But it wasn't then until I was in third grade that my cousin was diagnosed with leukemia, and then in sixth grade, my older sister was diagnosed with ovarian cancer, and it got me thinking, okay, yeah, we have this system, but it's not perfect, right? Why is this happening to them? They are so young. It shouldn't be happening. And that's how everything started in my head. You know, I grew up in Puerto Rico, we didn't have a lot of resources, but I was very fortunate to be able to participate of science summer programs on the island, actually supported by the NIH, some of them, and that allowed me to go to the university where I completed an undergraduate degree in microbiology because I wanted to understand how things infected cells and how the cells were interacting with the environment. Then from that, I decided to learn more about the signaling mechanisms that were involved in transforming cells from being healthy and happy in your body to become cancer cells and develop into a tumor. So I did my Ph.D. in Cell Biology and I focused more in an area that is called "membrane trafficking" that allowed me to study and identify the pathways that were used by cancer cells to metastasize, and I followed that path when I went to the NIH to do my postdoc and become a research fellow as well, and at some point I decided that I needed to see the impact of the research that we were doing in a more direct way and that's when I decided to join the Food and Drug Administration, and I became an evaluator and an assessor for biological treatments for cancer and immunological disorders, and that was a great experience because I was able to work together with a multidisciplinary team of people from different disciplines, it was just incredible, and see how the science that we were conducting at the bench was translated into treatment and then clinical trials and then see the benefit that had in a patient's life when we heard the stories from the patients and how that was impacting their lives. So I've been very fortunate to have been part of the different, I don't know, stations, if we want to call it that way, and now I'm very grateful to have the opportunity to work with the fellows and help develop the new generation of researchers in this area and being part of that legacy, because I think that is just amazing when you look at their projects and their ideas and their connection with the field. 

OLIVER: Thank you very much. Lymarie, to close. I wonder if you could give us your advice or the advice that you might give to our listeners who might be thinking about a future in cancer prevention for their own careers. 

MALDONADO-BAEZ: First of all, it's just -- it's very rewarding to witness the impact that your research have in the life of people, not only the patients that are suffering diseases but also their families, and being part of the mission, that you can prevent people from dying or even suffering from this disease, is very rewarding. But my advice would be, if you're interested in this field, just take time and, you know, reflect on your field, what are the -- what are the needs in the cancer prevention field and what can you bring to the table, and think outside the box because that's what will be driving innovation and that's what we need. We need new strategies. We need to learn from our mistakes and also learn from our successes. So I will definitely advise anyone interested in this field to be bold. Think about how their expertise can contribute to move forward the cancer prevention field and to connect with us, with the NCI and the other organizations that are conducting cancer prevention research to learn more about opportunities. There's plenty of things. We want them. Please come, because I think that the more disciplines come into this field, we'll be able to move the science far more faster. 

OLIVER: And we'll put some links in the show notes so people can connect and learn more. Jessica, final word to you. Same question. What advice to our listeners? 

FAUPEL-BADGER: Well, I would say that, you know, scientific areas become more specialized and you certainly need to have a depth of expertise in your specialization, but I would also look for those opportunities to communicate -- to collaborate and communicate with people outside of your discipline and, you know, again, think about this work just doesn't live in a journal article. You know, what else needs to happen to actually put this into practice and move it forward. So it's one thing to be deep in your area but also trying to have that broader view of things. 

OLIVER: Fantastic. Thank you both for sharing your insights and advice. Really appreciate it. 

MALDONADO-BAEZ: Thank you. 

FAUPEL-BADGER: Thank you. 

OLIVER: All right, stick around. After the break, we will be talking to two alums of the Cancer Prevention Fellowship Program who are going to tell us about how it impacted their careers. 

[UPBEAT MUSIC] 

OLIVER: The NCI is the US federal government's principal agency for cancer research and training and conducts a broad range of research in its Intramural Research Program. If you are interested in gaining research experience and training at NCI there is a great first step, you can take. Here with me to tell you about that is Chanelle Case Borden, Associate Director of Training Programs in our Office of Training and Education.   

CHANELLE: Thanks Oliver! We are talking about a webpage called Future Fellows where you can submit your CV or resume if you are interested in a postdoctoral, doctoral, or postbaccalaureate fellowship at NCI, and that is both at the master-level and post-college level. We will put the link in the show notes, but you can find the webpage by searching for “future fellows NCI.” At the site, you can tell us about your research interests and also indicate a division or center that you would like to work in. 

  

OLIVER: What happens once an applicant has submitted their material at the site, Chanelle?  

CHANELLE: Once you are in the database, any research team leader at NCI can see your application for the next six months. If they have an open position that fits your indicated interests, they will contact you directly to arrange an interview.  

A question we commonly get is when are positions typically available. Generally, most postbac and postdoc positions are available on a rolling basis, however the fall/winter is generally a time where we see a lot of postbac hiring to begin the following summer. Internally, we are always promoting the use of Future Fellows to our investigators and staff to fill their open positions. So, if you are considering completing training at the NCI, I encourage you to submit your information. 

OLIVER: Great, thanks Chanelle. So that’s Future Fellows on the NCI’s cancer.gov website – check it out and submit your info today. You never know where it might lead.   

[UPBEAT MUSIC] 

OLIVER: And we're back. In this segment, we're speaking to two alums of the Cancer Prevention Fellowship program. It's a pleasure to welcome Dr. Leticia Nogueira, scientific director of health services research at the American Cancer Society. Welcome. 

LETICIA NOGUEIRA: Hi. Thank you for having me. 

OLIVER: Also with is Dr. Keith Bellizzi. He is the professor of gerontology at the University of Connecticut. Welcome. 

KEITH BELLIZZI: Thank you for having me, Oliver. It's great to be here today. 

OLIVER: So in the first segment, we talked about the field of cancer prevention generally. That's where we started, and I'm interested in what specific part of that field you work in at the moment, what your focus is. Let start with you, Dr. Nogueira. 

NOGUEIRA: So as a researcher at the American Cancer Society, we get to work with cancer prevention, primary prevention, and secondary prevention, throughout the cancer continuum. 

OLIVER: Can you define those for us, please? 

NOGUEIRA: Yes. Primary prevention really is about the exposures that contribute to cancer risk. Secondary prevention is once you've been diagnosed with cancer, access to care, the exposure can then lead to different outcomes is the secondary prevention. So you have better survival and you don't get secondary cancers after the first diagnosis. And we get to work with the entire cancer care continuum, and my research focuses mainly on structural racism and climate change as determinants of health especially from a policy perspective. 

OLIVER: So help us connect those two. I don't think people often think of climate change a contributing factor to cancer, necessarily. 

NOGUEIRA: Yes, there's several different ways that climate change impacts, again, every step of the cancer care continuum. So one of the ways is through disruptions in access to care because climate-driven disasters behave differently, so it makes it harder for communities to prepare and respond. Then it disrupts access that the patients need to have to complete cancer treatment and survivorship cancer. And also, there are several environmental exposures associated with climate-driven disasters and other types of climate hazards such as increased heat or flooding events that cancer patients are most vulnerable to such as infections during flood events or chemotherapy and thermal regulation being impaired and then during heat waves and also exposure to carcinogens during climate-driven disasters, such as what we saw with Hurricane Harvey and the Houston ship channel that has a lot of extra chemical infrastructure that ended up contaminating the entire area. 

OLIVER: And health services research, you're studying how care is delivered and how screening is delivered? 

NOGUEIRA: Yes. Both screening, treatment, and survivorship care, all of those steps of the process are part of our research. 

OLIVER: Dr. Bellizzi, you work in gerontology. How does that connect to cancer prevention? 

BELLIZZI: I do. So in general my research focuses on the latter part of the cancer control continuum. So cancer survivorship. And we've made great strides in treatment, in early screening. People are living longer with cancer, but we also know that cancer treatment is not benign. So what are some of the late health effects that folks are dealing with, how are they living with cancer? And that's the area of research that I've been involved in for the past couple of decades. And the connection with gerontology is that for the most part I look at older adults who've been diagnosed and are now living with cancer, and I have two different lines of research that I'm currently working on. The first is funded by the NCI. It's a U grant award, and we're examining mechanisms and outcomes of resilience trajectories in adult survivors of breast, prostrate, and colorectal cancer, and we're currently conducting prospective trajectory analyses following newly diagnosed patients over a 12-month period. And the goal is to identify the biological, physiological, and psychosocial factors that are associated with each trajectory. So that is, who's doing well and what are some of the characteristics of people who seem to be doing well, and who may be struggling and what are some of the characteristics of those folks. And obviously, this information will ultimately be used to inform intervention targets. That's one line of research, and if I may, the second line of research I'm working on is the role of social determinants of health on accelerated aging in older adults with cancer. And we're collaborating with colleagues at Yale examining epigenetic age clocks, which is a really novel measure of biological age. And the goal here is to identify which social determinants of health, so, for example, housing, food insecurity, discrimination. So which of those factors might be associated with accelerated aging. So again, we can intervene and potentially mitigate these negative effects in a population that as we know is already at risk for accelerated aging due to cancer treatment. 

OLIVER: That's interesting. Both of you seem to be working in areas where there's increasing need for your work. Dr. Bellizzi, the population is aging, I think, in most countries. Dr. Nogueira, obviously climate change is with us, but it's becoming more acute. I wonder if you could both comment sort of on your perspective of the last decade or so and where we're going. Where does the future lie? Are we going to be able to stem some of these effect of these macro changes in our world? Dr. Nogueira, please. 

NOGUEIRA: Yes. I think it's becoming increasingly recognized and people are more frequently aware that climate change is the greatest threat to human health of our time and impacts every health outcome, and every step of the cancer continuum is also impacted. And I think that our ability to really ameliorate this comes to those three choices that we have with climate change, right. Mitigation, adaptation, and suffering. The more mitigation we do, the less adaptation will be necessary, the less suffering there will be. So trying to identify and better understand how each one of those is interconnected can help us identify solutions at the overlap of all of these. So I think that a lot of research on the impact that climate change has on health risks and health outcomes, the suffering bucket, turning that into a solution, the more awareness, the more evidence base that we have there, the easier it is, for example, to make decisions on whether to support development of new fossil fuel infrastructure in the area and how that might impact the health of residents. Adaptation is going to be necessary no matter what because climate change, as you said, is ongoing, so enhancing emergency preparedness and other climate adaptation efforts so that we can better protect the health and safety of vulnerable populations. Cancer patients are a vulnerable population, as Dr. Bellizzi was saying, some social determinants of health also increased vulnerability to climate hazards. And then mitigation really is the most important one. So trying to evaluate how our own professional activities are contributing to the problem. How can we decrease emissions from our own professional activities. Traveling to attend conferences is one of the easiest ones, offering a virtual option, but also emissions from the healthcare system, which is the second-most energy intensive industry in the United States. What type of research can be done to help us diminish the emissions so that we stop contributing to the problem at the same time we're trying to solve it. 

OLIVER: Interesting. Dr. Bellizzi. 

BELLIZZI: Yes, thank you so much for that question. You know, when you asked that question, I think about the burden of disease in the older population, and you mentioned some of the macro concerns, and some of those have to do with the aging of the U.S. population and aging more globally. So we have a significant increase in older adults all over the world, especially in industrialized societies. We know that the number one risk factor for cancer is age. So if you look at the incidence and prevalence of cancer, it occurs more frequently in older adults. We also know that there is a shortage of geriatric oncologists. So there are not enough geriatric oncologists to provide cancer care to older adults, and there's a pending wave of retirements that are expected. So it is a really important question that you ask, and it's a problem that we haven't yet figured out. Who is going to be providing care to the older population of cancer patients and cancer survivors? Is it the primary care physicians? Are we going to train more folks in geriatric oncology? Again, these are really good questions, and we still don't have the answer to those questions, but it's important that we start thinking about those questions now. 

OLIVER: So you're in -- the two of you are in quite different vantage points, I guess. Dr. Bellizzi, you're in an academic setting. Dr. Nogueira, you are at the American Cancer Society. I'm curious, you're developing knowledge. You're advancing the science of your fields. But how do you hope that that knowledge will actually impact it and what roles do you think you can play from your respective vantage points. Maybe Dr. Bellizzi, tell us first, please. 

BELLIZZI: So I think quite a lot about that question. So you know, obviously, we're engaged in research. You know, we work on, you know, writing up our research to publish, you know, but the sad reality is very few folks that we're actually trying to help will ever read these peer-reviewed publications. Other scientists may, but not many scientists actually read our research unless it's something that's published in JAMA or JNCI and gets media attention. So I think a lot about community engagement. You know, how do we take the research that we do and disseminate it to the people that we're actually trying to help. And I have found a few different outlets for that. There is a nonprofit news organization called The Conversation, and they take academic research articles, and they work with the researcher to write it up in such a way that the lay public could understand. And I think having those connections, making those connections with community partners is extremely important. I think that's an important strategy to help disseminate our work, again, to the people that we're really trying to help. 

OLIVER: Dr. Nogueira, we had your CEO, Dr. Knudsen, on the show a few weeks ago. So we have a little bit of an idea of what the American Cancer Society is, but how does your work fit into it, and then how do you bring it to the American people and beyond? 

NOGUEIRA: Yes. That's a really good question, and also one I think about daily. So we are at least being trained to or we used to think in this linear way. You know, I'm a researcher. I will do my research. I'll do a hypothesis, data, write it up, and then somebody else is going to read it, and it's going to make a difference. And I think that we're starting to realize that this type of linear thinking is not enough, that we need to do more to communicate our findings. And, as you know, the American Cancer Society already does a lot in DC in advocating for policies there relevant to cancer patients, survivors, caregivers, and so that is already a part of our work. And also, it comes from communicating our research findings, identifying research projects that are relevant to policy makers and also looking at our own, especially when it comes to climate change, the field that I work in, how can we lead by example and do our own part and try to identify smaller and big changes that really set the tone of the direction we should be going. It's hard to be the change you want to see in the world. So that is easier, I think, working at American Cancer Society, which is committed to improving the health of and quality of life of cancer patients, caregivers, and the entire community. So it's a little bit of going beyond just the research and communicating and also evaluating our own activities and how we can do better and lead by example. 

OLIVER: Thank you very much. I mean if I'm allowed a personal note, I find a connection with both of your areas of research. I'm a cancer survivor myself now in my 11th year post diagnosis. So I guess I'm a survivor, and I think, Dr. Nogueira, we both had time in Houston. I lived there for over 10 years and experienced a few hurricanes, so I share that. But I'd like to pivot now and ask you both a little bit about how you got into this science. So, you know, I'm curious, always, how do people initially become interested in science, and then how does that develop into an interest in cancer. And of course, today, cancer prevention. Dr. Nogueira, maybe we'll start with you. How did that happen for you? 

NOGUEIRA: Yeah. I think that I was always interested in science and from an early age had -- I think we've been touched by cancer, either personally or a loved one. We all understand how painful cancer diagnosis can be for the entire family. So it has always been a topic that I was committed to working on. And I actually started on the molecular biology side of research, then due to the Cancer Prevention Fellowship Program was able to gain more expertise and able to talk more about it. On the epidemiology part, when they offered us to get the master of public health, and then had an even more awakening experience on the whole ‘your zip code is more important than your genetic code’ when it comes to determining your health outcomes, and then access to care, which led to the health services part of my career, which is what I'm working on right now. So I think that the science and the cancer were always there, but there's so many different aspects and perspective that one can work on while committed to those two, that it can really take you places you never imagined you would end up working at. 

OLIVER: Let me just follow up though. I mean -- so I used to do research myself, don't anymore but was drawn into it because of the fascination of molecular biology and that revolution. But you at some point then decided to at least look at and then join the Cancer Prevention Fellowship Program. That was not a random event, right. So what made you think, you know, I love this molecular biology I'm doing, but I want to see what cancer prevention is all about, what was that cause? 

NOGUEIRA: Yes. So I was presenting the results of this study that I was doing with obesity, diet, and exercise at a conference and got a question about when would this molecular aspect that I was studying be available to people. And I just had this moment of like, oh, that's going to take a lot. And I still read a lot of publications on the molecular side. I still think it's fascinating and can solve so many things. And I, in part, miss how things make sense when you're working on a molecular part and you look at the pathway and it's there. But for my personality, I think working on something that was closer to being able to measure an impact on the population was a better match, and that's how I did apply for the fellowship and getting to know more about epidemiology. 

OLIVER: Dr. Bellizzi, how did you get started in science and cancer? 

BELLIZZI: Yeah. Thank you so much for question, and I don't know necessarily think my trajectory was a normal trajectory. So, and I have to go back a couple of decades to answer your question. 

OLIVER: Okay. 

BELLIZZI: So I was in my early 20s, shortly out of business school. So I graduated with an undergraduate degree in business. So 24 years old, just graduated. I was out working in the business world and an accident sent me to doctor's. And that experience really changed my life forever. I was diagnosed with metastatic testicular cancer. 

OLIVER: Oh. 

BELLIZZI: And was given a 50% chance of survival and no chance of having children because of the fertility harming treatment. And believe it or not, a few months later after a follow up CAT scan for the testicular cancer, I was told that they found a mass, a golf ball sized mass in my left kidney, which turned out to be renal cell carcinoma, which as we know is kidney cancer. And as you can imagine, you know, my career and life plans came to an abrupt halt, and I was forced to navigate this whole new world. And while my friends were kind of moving forward in their careers, getting married, buying their first home, and having children, I was living in the hospital. I was undergoing several surgeries and aggressive inpatient chemotherapy. In my time in the hospital, you know, interacting with healthcare providers was really a pivotal moment in my life. I had witnessed first-hand how our current healthcare system works and in some cases doesn't work. You know, I recognized through that experience some critical gaps in cancer care delivery and importantly, the lack of psychosocial support that existed for young adult cancer survivors. So I do remember one afternoon I was sitting in the hospital in my hospital bed surrounded by my family and a nurse who just was incredible during my experience, and I made a promise. I made a vow. I said, if I survive, I'm going to quit my job and dedicate my life to cancer research. So obviously, I made good on my promise. I'm talking with the both of you today. 

OLIVER: Yes. 

BELLIZZI: And at the age of 26, I quit my job in business. I went to back to school, earning three graduate degrees including a PhD, and that actually led me to the NCI post-doc fellowship in cancer prevention and control. 

OLIVER: So tell us a little more about that. Your first experience with cancer was very much the treatment side of it. Did you then think about how perhaps it could have been prevented in the first place, your diagnosis? 

BELLIZZI: So the cancer prevention and fellowship program not only focuses on primary prevention but also secondary prevention. So my interest always was in what happens after someone is diagnosed with cancer? How could we support those folks? I mean I mentioned before that we know, you know, cancer and it's treatment. It's not benign. It leaves folks with possible late health effects, physical late health effects, psychological late health effects. That was the area of my research, and it was kind of interesting. I was at a conference, very similar story to what we just heard, I was at a conference in Washington, DC, presenting some of my work as a grad student, and at the end of my talk a woman approached me. Here name was Dianna Jeffries. She was a program officer in the office of cancer survivorship, working in DCCPS, and she was really interested in what I was doing. She wanted to know what my plans were after graduate school, and I told her, I'm getting on a train and heading home tonight. And she said, before you leave, I'm going to set you up to talk with Julia Roland, who was the director of the office of cancer survivorship. So she put me on the Metro, sent me up north to Bethesda. I met with Julia for about 30 minutes. I turned around. I got back on a train to head home. And that's when I got introduced to the Cancer Prevention Fellowship Program. And I know right then and there that's exactly what I wanted to do for a post-doc. I applied. I was very fortunate to get accepted. And it was one of the most incredible experiences of my career. 

OLIVER: So thanks for clarifying that. That makes sense. You found yourself a cancer survivor, and that sparked your interest in the journey that you were going to be on for the rest of your life. Fascinating. 

BELLIZZI: Correct. 

OLIVER: So you mentioned it was a great experience, Dr. Bellizzi. Tell us more. It's a cohort program. It's a small program. 

BELLIZZI: Yeah. 

OLIVER: What other things do you think helped guide you on your way? 

BELLIZZI: Yeah. So I think one of the reasons why I found it to be so appealing was because of the diversity of disciplines that were represented in my cohort. You know, I was trained in the behavioral sciences, so most of my interactions during graduate school was limited to other behavioral scientists. And what the fellowship did, the fellowship program really opened my eyes and introduced other important disciplines, like biologists, immunologists, you know, medical doctors, and the cool thing is, you know, we all shared the same goal of making the impact in cancer prevention and control. We just came at it from different perspectives. So that program made me realize the importance of team science and kind of stepping out of your discipline silo that we all tend to live within to attack a problem in a new multidisciplinary way. So that was one of the -- when people ask me about the cancer prevention fellowship program, that was one of the strengths of the program. 

OLIVER: Dr. Nogueira, how about you? What was your experience in the program. 

NOGUEIRA: Exactly. I couldn't agree more. I think that nowadays we hear a lot about the importance of diversity, right, and the cancer prevention fellowship program for many, many, many years now has been bringing people with diverse perspectives, diverse experiences, diverse areas of expertise together, and they do this in a way that builds community, that incentivizes us to interact and share our knowledge and experience in our points of view. And I just learned so much just from interacting with the other follows. And then they also provide a common language because they provided training, the MPH, to all of these researchers coming from communication, business, all of these different backgrounds, and now we have a language to communicate in. And as Dr. Bellizzi said, we have a shared goal. And so at every interaction, every time we presented our research, every networking event, we were learning from each other in addition to learning from our mentors and the structured education that we were offered. So it was -- this diversity of thinking in perspective and expertise was so important early in our training, right, to recognize that a team when everybody is agreeing is not doing much. It's a team where every person is bringing a different perspective and opening your eyes to a different point of view. That's really when you see progress being made. 

OLIVER: You mentioned networking, and we heard in the first segment of the show about the fact that the CPFP in addition to providing lots of information about cancer prevention also provides some career development opportunities for the fellows. Can you tell us a little bit about how that was, Dr. Nogueira. 

NOGUEIRA: Yes, of course. So they had really amazing training that went from how to have difficult conversations about authorship to how to schedule informal interviews, to how to write grants. It was all different types of these skills that go beyond the methodology of your research, how to communicate your research findings, and then they had the actual meetings and social events that facilitated a communication in a more informal way in which we could get to know each other and then build, like, well, I tried that one strategy we learned, and that didn't work well. This worked this way instead. So we were building this background knowledge and expertise together as well. And I think that it's still ongoing. When I was a fellow, we started having CPFP alumni meetings at different conferences that most of us attend, and that connection and that networking event keeps going even after you're out of the program. And it was so helpful to hear from different people from different backgrounds how each one of the strategies and techniques we were learning were being applied in different ways. 

OLIVER: Dr. Bellizzi, what was your impression of that? I can't believe that networking wasn't helpful. 

BELLIZZI: Yeah. Absolutely. And that's something that I try to stress to all of my graduate students, the importance of networking. But a couple of the training opportunities that I found to be particularly useful, one, which was already mentioned, grant writing workshops. So actually, writing a grant and going through a mock review, which was quite useful with respect to getting feedback, again, from different disciplines, which kind of opened your eyes to some of the potential flaws in your research design. You know, other opportunities that were provided, which I found to be useful was presenting our research, you know, presenting our individual findings to our cohort, the cohort of fellows and preceptors and getting feedback, again, from a multidisciplinary perspective. But networking is probably the most important thing a graduate student can do, a post-doc could do, and it comes easy to some people, not so easy to others, but it's a skill that I think is really important to work on because at the NCI, you're networking with some of the most amazing minds in the cancer world. So, you know, being able to walk down the hall and knock on the door and have a conversation with an epidemiologist or go down the hall and have a conversation with a biostatistician or someone who's in policy, it just it opens up so many other possibilities that perhaps you wouldn't have been aware of if you did not knock on that door. 

OLIVER: Lastly, then, Dr. Bellizzi, we'll start with you. What's your advice to someone who's listening who's interested in STEM or health. Why should they consider cancer or specific cancer prevention as a field in which to build their career? 

BELLIZZI:  Yeah, that's a great question. So, you know, my advice, I think, would be for us to, you know, recognize that we are all life-long learners, right. And regardless of the field that you go into, try to find a post-doctoral opportunity that will allow you to grow, will give you space to grow. Look for opportunities to help you kind of think outside of the box with respect to your current research interests. Ask yourself critical questions. What are the gaps in science, and how will this post-doctoral fellowship help me get answers to some of those gaps. And then, importantly, how might we think about or how might you think about and incorporate health inequities in all of the work that we do, from the beginning. Not as an afterthought, but from the beginning. And then, most importantly, you know, I would say never lose sight of the human element of the work that they do. You know, eventually, if they go into academia, they'll eventually find their academic home, and they'll likely feel immense pressure to write grants and to publish. And as you navigate these pressures and stressors, try to remember, you know, why you're doing the work that you're doing and how it will ultimately help others. 

OLIVER: Thank you very much. Dr. Nogueira, what advice might you share with someone listening? 

NOGUEIRA: I think don't be afraid of change. Throughout our careers, we might hear it several times. Find your niche, right. And that can be very intimidating, especially early career. You put four or five, sometimes more, years, into this very specific research area during your PhD, and now you have to make a choice for your post-doc, and you'll continue to make choices, right. And it can feel very scary to suddenly switch your area of expertise from molecular to epi or communications or whichever one it is. And you might feel like you're wasting all that knowledge you gained by switching. And change is always scary, and I think that trying to understand that your niche doesn't exist yet. When you try to look around, you're going to see all the niches that already exist, and that can feel very intimidating, right. There's no space for me. So connect with what you're interested in, as Dr. Bellizzi was saying, what is your goal? What drives you? And the questions are everywhere. So trying to connect the dots that nobody else has seen, that you're the only one that can really contribute there. Don't be afraid to suddenly change from this field to that field to this class, you know, obesity to climate change whichever one it is. I think that being open to change and knowing that your expertise is needed and you are the only one who is going to see this. If there is a hard tug towards a certain topic or a certain issue or an opportunity, listen to it, and the knowledge that you gained up to this point is yours, and it's going to continue to be applied as you move forward. Don't be afraid of change. 

OLIVER: That's great advice. Thank you very much. Well, thank you, both, for sharing your work and your journeys and your insights. Thank you so much. 

NOGUEIRA: Thank you. 

BELLIZZI: Thank you so much, Oliver. 

[UPBEAT MUSIC] 

 OLIVER: Now it's time for a segment we call "Your Turn" because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk that you found inspirational, or amusing, or interesting. You can send these to us at NCIICC @nih.gov. Record a voice memo and send it along. We may just play it on an upcoming episode. Now, I'd like to invite our guests to take their turn. Lymarie. 

MALDONADO-BAEZ: So I have two book recommendations, and it might not be the traditional ones. But one of them is this novel called "Eva Luna", E-V-A L-U-N-A. It was written by Isabel Allende in 1987, the same year that our program, the Cancer Prevention Policy program was founded. And it's magical realism. So, you'll see elements of real worlds but also combined with mystical elements. And it gets, it's developed or it takes place in South America. And it's a great novel, written by a great artist. And my second book, it's called "The Art of Communicating", and it's a book written by a Zen master. And it teaches how to communicate confidentially and mindfully, first with yourself, and then with those around you. And we love this book. And we have shared this book with the fellows that are part of our peer mentoring program. So, I will definitely recommend it to all people, to all your listeners. 

OLIVER: Thank you. Those sounds great. Jessica. 

FAUPEL-BADGER: So, mine might be a little different. One of, there's this movie that I've watched multiple times. And I just watched it again recently. And I just continue to be captivated by it. And so, it's called "Thirteen Lives". And it's the story of the Thai soccer team that was caught in the cave that flooded. And so, I was captivated by that when it happened. They were in this cave for almost three weeks. And I, you know, I think I'm just amazed by it when they show how many people contributed to getting the team out of the cave. So, you have people who are diverting the water. You have, of course, the rescue divers who go in. They have to come up with a way of taking these children out who I think were as young as 11. You know, young teenagers. They have to sedate them to take them out of the cave. So, just the innovation. And then, you know, so you see all of the rescue crew. You see people cooking food for the people who are there to help. So, I think there must be some metaphor, some comparison here to team science or cancer prevention research because you just see all of the ways the community comes together. And, in the end, they're all rescued. So, again, true story. So, I shouldn't, that shouldn't be a spoiler. But it's a story of hope and innovation, and amazing teamwork. 

OLIVER: That's fantastic. I haven't seen that one. I'm going to go watch it. Thank you. Thank you for that recommendation. 

Dr. Nogueira, your recommendation, please. 

NOGUEIRA: I would like to recommend this book called All We Can Save: Truth, Courage and Solutions For the Climate Crisis. It really does get at this intersection of different issues and how you can contribute to find solutions. 

OLIVER: Thank you very much. Dr. Bellizzi. 

BELLIZZI:  So recently I've -- I've been reading a book by Daniel Goleman, and it's on the topic of emotional intelligence. So why -- Why Emotional Intelligence Matters More Than IQ. And, you know, I just think, as a society, you know, we're currently sifting through this complex maze of misinformation and disinformation and emotionally charged issues. You know, we see it on the news, politicians and social media influencers. They know how to manipulate the emotions of others for their own gain. So I've been recommending this book on emotional intelligence to many of my friends to help them be more informed about how their emotions are being impacted by the behavior and actions of others. 

OLIVER: Thank you. That sounds like a fascinating read as well. Much appreciated. And I'd like to make a recommendation as well. It's a book published almost 20 years ago, but I read it only recently, The Year of Magical Thinking by Joan Didion. It describes a period starting at the end of 2003 when Didion's daughter falls severely ill, and her husband dies at the dinner table from a heart attack. It's a powerful book in which the author works to make sense of these events and takes the reader along on her journey. Now, a caution, not everyone likes this book. And Didion writes from her specific vantage, which is one of privilege. But setting that aside, the tragedy she experiences is a great leveler, and it's apparent that the forces Didion experiences exceed her ability to change their course. And I found that learning how she navigated this time in her life moving and instructive. 

[UPBEAT MUSIC] 

OLIVER: That’s all we have time for on today’s episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.  

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at NCIICC@nih.gov.  

Inside Cancer Careers is a collaboration between NCI’s Office of Communications and Public Liaison and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar. 

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won’t miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.  

If you have questions about cancer or comments about this podcast, email us at NCIinfo@nih.gov or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query. 

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening. 

  

  

 

 

 

 

 

 

all we have time for on today’s episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.    

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at NCIICC@nih.gov.    

Inside Cancer Careers is a collaboration between NCI’s Office of Communications and Public Liaison and the Center for Cancer Training.    

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.   

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.   

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won’t miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.    

If you have questions about cancer or comments about this podcast, email us at NCIinfo@nih.gov or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.   

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.