#5. Black in cancer | Sigourney Bell
Hola amigos!
Well that was an eventful month, wasn’t it? Pride felt a little weird this year, but there were at least two bits of it that I’d like to bring up here - one, folks at the STEM Village have launched their new site and have published a series of beautiful letters by LGBTQ+ people in STEM. Here’s one. Also, our trans siblings in Spain will soon be able to change their name and gender in official registers without having to go through any diagnosis or surgery. About time, if you ask me. The fight is far from over, though (look at Hungary).
On a personal note, I - drums - submitted my PhD thesis just a few minutes ago! Yay! But worry not, I also carved out a little time for this project during the month and here’s Episode #5.
This time, I spoke with someone who works on a rare type of cancer that develops in children. She also co-founded Black in Cancer, an organisation that aims to empower and encourage future Black cancer leaders while reducing cancer disparities through education and advocacy. Oh, and she recently made it to the Forbes 30 under 30 list for her work. Her name is Sigourney Bell. Like I said to those of you that follow @HowToSci, I loved meeting her and I’m sure you will too.
This series is drawing to an end (I know, we’ve only just met!), so please please you tell your friends if you would like them to catch up before the final episode next month!
Once again, thank you all for being there! :)
Pablo
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Episode transcript
Baltimore, 1951. A black woman was admitted to hospital with what later turned out to be cervical cancer. A biopsy sample was taken from her to analyse her tumour. That didn’t stop there, however. Her doctor was shocked at how easily her cells propagated in a dish, and he was able to generate an immortal cell line. Normal cells can only propagate for a limited number of times, but these cells never died. To this day, many, many labs across the world have these very cells in their incubators. They have not just been used to help us understand cancer, but even to test the polio or the HPV vaccines, which have saved countless lives. Except, neither the patient nor her family gave permission to harvest the cells. Today, they’re just known as HeLa cells after the patient’s name, Henrieta Lacks.
Sadly, cervical cancer still kills people today. Yet, progress is being made. We’re now catching tumours earlier, so they’re smaller and easier to deal with. Prostate and skin cancers kill less and less people every year. Even with the more aggressive types, like lung or pancreatic cancer, survival rates are several times higher than they were only a few decades ago. And that’s not by chance, is it?
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Hello and welcome to How To Make A Scientist. My name is Pablo Izquierdo and today I’m joined by Sigourney Bell, who works at the Cancer Research UK Cambridge Institute and studies a rare pediatric cancer. On top of that, she also co-founded Black In Cancer, an organisation that aims to empower and encourage future Black cancer leaders whilst reducing cancer disparities through education and advocacy. Enjoy!
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Sigourney, you do research on cancer at the Cambridge Institute of the Cancer Research UK. What is cancer to start with?
Such a broad question. And so cancer is a wide array of diseases that are caused by a multitude of different things. So, I think so often people pin it down to being one disease, which, essentially, it is, in terms of it being a disease of cells becoming out of control, and proliferating way too much, but there are so many different causes. So essentially, cancer is a is a disease where cells get out of control, and divide more than they should. But depending on where they are in the body, and which stage they're at, they all behave very differently.
Okay, and do we know why certain, you know, alterations or mutations give us a specific type of cancer and not others, like, what's the difference across organs and cancers?
So all of our different cells use different molecular pathways to perform different tasks, whatever, whatever those are. So whether that's brain cells, liver, kidneys, heart, so it all depends on which genes are most important in different cell types. So we know that there might be genes that are super important, for example, in breast cancer, or just in maintaining cells within the breast, or within the liver, or the colon, that aren't required so much in other cell types, because obviously, all of these cells are performing different functions.
Okay. And all these mutations they accumulate over the years do they?
They can do, or, as I'm sure lots of people will know, some are passed on, that you have these mutations that give you higher susceptibility to certain types of cancer. That's where, you know, there are a lot of women who get tested for BRCA, for example, and end up having mastectomies so on and so forth, for preventative reasons. So they can develop over time, but they can also be within what's known as the germline, which is kind of passed on from generation to generation. So it really can depend.
But you do work on the type of cancer that occurs in children. So I was curious, because obviously, you know, we're used to the concept of cancer as something where damage sort of, you know, develops as you age. And so a lot of people get cancer when they're old. But how come children can get cancer too?
That's such an interesting question, and is something that a lot of people are trying to answer. And we think about cancer, as you know, this disease where we have changes in our DNA, known as mutations, and that's what tends to cause cancer. But the question that a lot of people are trying to answer is, why don't children actually get more cancer? So they're rapidly developing over a short period of time, all of their cells are dividing. And they're growing day by day, minute by minute. And so why aren't there more children's cancers than there actually are? So is there some form of protective mechanism involved, so on so forth? And a lot of children's cancers tend to be either change very early on that is so huge, that it causes this cancer, it doesn't tend to be the smaller mutations that build up over time tends to be more of a large scale change. So the reasons for children getting cancer and adults getting cancer are actually quite, can be quite different. Because you don't have this same buildup of environmental factors, so on so forth, that we do as adults, you know, things like smoking or drinking more obesity or whatever those factors are.
Right, but hang on. Are you saying, I might have got a completely wrong, but are you saying that cancers and children occur in children because they're aggressive enough that they don't need the accumulation?
Yeah, so yeah, they don't necessarily need the accumulation of as many changes, especially if these happen during developmental time points. So whilst an embryo was developing, while the fetus is developing that those changes can be so much more impactful at that point than they would in an adult.
Hmm, I' see. So what does he work come in? What do you work on specifically?
So I work on a rare type of children's brain tumor called supratentorial ependymoma. Sounds a little complex. But basically all that means is the brain is split into kind of two main regions. So the supratentorial region, which is the front two thirds of the brain, that's where the tumor that I work on occurs, so it occurs in the forebrain. And there's a little region in the center of the brain. And that's where we make cerebral spinal fluid or fluid that goes between our brain and spinal cord, and the cells that line that are known as ependymal cells. And it's a mutation in those specific cells, that that's where that tumor forms.
So what happens to you if you have those mutations?
So the specific type that I work on, so that it's known as that there's nine molecular subtypes, so a range of different mutations that can happen. So the type I work on, is caused by what's known as C11orf95-RELA fusions, which sounds very complicated, we're gonna break it down a little bit.
Alright.
So on chromosome 11, we code for lots and lots of different proteins. One of them is known as C11orf95. It's known as that because it has an unknown function. So in this specific region of DNA that we know forms a protein, but we don't know what the protein does.
Okay.
And basically, what happens is, at some point during development, the chromosome shatters, and it entirely rearranges itself. So imagine if you drop a glass on the floor, and you've got to somehow put that back together, and you're like, well, this bit mate might kind of fit here, and this bit might kind of fit here and bits fit together. And you end up with this rearranged chromosome. So these two genes that are 73 genes apart end up together.
And that happens on its own, does it?
Yeah.
Wow… okay.
So normally, when we have all of these genes on a chromosome, we have little sequences at the end of each gene that tell us, okay, this is the end of the protein. So this is one whole protein, and then we move on to the next one. In that rearranging process, the thing that helps the body to understand that this is the end of the protein disappears. So instead of it making two separate proteins, it makes one huge protein. And that's a fusion protein, because it fuses these two proteins, which should be separate, together. And this huge fusion protein then goes on to drive tumor formation. And that's how the cancer that I work in works.
And you’re trying to figure out how it does that?
Yeah, yeah. So our group recently published a paper that basically explains what starts to explain how that fusion protein binds to DNA, and then causes… that's part of what my project is around.
Right. And you do all this work at Cambridge University at the moment.
Yeah…
But you've also worked for Pfizer and AstraZeneca, two of the most spoken about companies these days.
Yeah.
So I thought I'd ask you what's similar, and what's different, I guess, between working or doing research at a university versus in in the pharma industry?
And so they're very, they're very different. So with my PhD, I totally guide my own project apart from, you know, input from postdocs in the lab and my boss, my supervisor. But on the whole, I figure out the question I want to answer. And if something isn't working, and, you know, doing more things to figure it out, or try to understand why it isn't working. And if there's a question, it's like, oh, that would be really cool to find out, I can pursue that I can be like, “Oh, that's interesting. Let's do an experiment to understand why that's like that”.
Whereas in pharma, it's a little bit different, you have a different end point that you're trying to reach. So you're not necessarily so interested in why something doesn't work. So so you're testing a new compound, you're like, “Oh, this isn't working.” That's your end point. It's like, it doesn't work. So let's just move on and try something different. And I mean, more recently, there's a bit more kind of academic work going on within pharma to understand some of those questions around it. It's not so much like “this doesn't work. Let's move on.” It's more of a kind of collaborative mindset. Certainly, with AstraZeneca there were lots of collaborations with academic groups.
Okay, so would you say the day to day is more repetitive as well in pharma than in academia?
It can be. I think, it also depends on the kind of area you're in.
Right.
So I worked on a number of different projects when I was in pharma. So although it was semi repetitive, there were lots of there was lots of different types of biology I was working on. So it means if if one isn't going so well, you've still got probably another three projects that you're working on that like, “Oh, yeah, this is progressing. And this is exciting” and you're not so kind of heartbroken if one isn't working. Well, the other three are doing great. So this is… this is fab, you don't want to put all your eggs in a basket to Absolutely.
Amanda Goleman, who is this poet from from America who I have to admit, I hadn't heard of her before and up until the inauguration of President Biden in January, and then I became obsessed with her. And I've read a lot of her poems, and I've listened to a few of her talks, and, and so on, so forth. And this two questions that she says are key to ask people and to ask ourselves, and so I thought to put them to you. One is, what do you stand for, but we'll get to that in a moment. But first, who shoulders do you stand on?
That's a, that's a tough one. So, so many people. If I'm going to go from a very personal aspect, very much my parents and my grandparents, my parents gave up a lot of opportunities so that I could have more opportunity and sacrificing in the schools I went to and how they supported my journey to today, but also very much my grandparents. My grandparents are Jamaican, came from Jamaica in the 60s, as part of the Windrush generation
Sorry to interrupt, what’s the Windrush generation for those of you listening at home who are not in the UK?
So basically, in the late 50s, and early 60s, a lot of Caribbean islands hadn't received independence. And basically, a range of adverts were put out from the UK, asking citizens of the Caribbean to come to the UK to basically help rebuild the motherland type of thing, after the wars, and really to help develop the country again. So my grandparents came over, and suffered a lot of racism during that time, persevered, worked, went through some really challenging times. But they are the reason that I'm here. They're the reason that I, you know, push the boundaries on what I'm doing and to work hard, and I'm incredibly proud of, of what they've done, the families they've raised, and just the opportunities that I have, because of them, and the doors that their generation opened for, you know, young Black students, or just young, Black people within the UK today. So yeah, yeah, yeah, absolutely.
What was your childhood like?
Oh, okay. So I will probably go with academic first. Usually, that's the easier thing to talk about. And so, my parents, were very much like, they wanted me to be able to get the best education possible, so that they knew that that would open more doors, and that nobody could ever take my education away from me. Yeah. And then that was kind of why I really developed my love of science. I mean, more during secondary school, in terms of understanding, you know, I didn't realize until more recently, how important visibility was for me, and how much that has an impact on what you then go on to do. So it was only when I was thinking about it the other day that I realized that actually, the only black teacher that I'd had during my schooling years was my biology teacher. And I don't think it's a coincidence that now I'm a biologist. So I think that that was a real kind of key part of what I was interested in, why I was interested in it. And she really pushed me and helped me to answer questions that I was having about, you know, whether that was biology or whatever. And helped me to become the best I could be. And that was... I had some, you know, some challenges in terms of, you know, a lot of the time being the only one in particular spaces.
And I think it really helped that I went to an all girls school and that I didn't see, there wasn't a lot of things coming at me telling me that I couldn't do science because it was a boy subject because it was just in a science lesson. And that was what we were doing. And I was interested in it. So there was no, this isn't for you type thing. And I think especially as a lot of my science teachers were female. I think that really helped in that I didn't have that kind of vision that I couldn't be a scientist, because there were a ton of female scientists that I'd seen.
That's really interesting. Because obviously, you can’t think of that if everyone around you in that classroom is a girl. Never thought of that!
Yeah. And it's really that you don't realize how important these things are until you speak to people who either haven't had that visibility or haven't had those experiences. And things that I look back on community, you know, conversations that I'd had with with my parents and stuff. And kind of a little anecdote I tell is that when I was young that my mom asked me like, also, what do you want to be? And I was like, I want to be an air hostess. She was like, right, okay, why do you want to be an artist? So I was like, “I wanna travel the world, blah, blah.” She wasn't so keen on that. So she was like, maybe you could do something else as well. And then that was kind of one. I was like, oh, maybe I could be a teacher or maybe doctor, whatever, and kind of ended up going more down that path. But actually, a couple months ago, I said to her, Well, when I said, “Oh, I wanted to be an air hostess,” I was like, Why didn't you tell if you knew that? That was because I want to travel the world? Why didn't you say like, “oh, why don't you be a pilot?” And she actually said, “I just I didn't think of it because I hadn't seen any black female pilots that I could be like, Oh, well, yeah, that's the thing you can do”. And you realize how important visibility is in the even if it's not in a conscious way, that somewhere in your subconscious, they're just things that you don't suggest, because you haven't seen it yourself. And I think people really underestimate how important and how impactful those things can be. I didn't meet a black man with a PhD until I started my PhD, having, you know, even done my undergrad and worked for at that point, three different pharmaceutical companies. And just how, how amazing it was when I did meet a black woman with a PhD. It was like, Okay, this is possible. Like, there's things I could do with this. And you know, it doesn't feel like an insurmountable hill anymore.
Right. So you could see people like you in the end.
Yeah.
It's funny, because like, Clarice Phelps, who was also on the show a few episodes ago, mentioned something very similar. She said of, you know, her feeling when she is usually the only woman or black woman in the room…
Yeah.
So in terms of visibility, together with Henry Henderson, you founded something called Black in cancer. Tell us a little bit about it. And you know, the sort of stuff that you do.
Sure. So we started Black in cancer in August of last year. And semi off the back of a lot of kind of, like in kind of STEM in Twitter movements, which all started with May of last year after the events of Christian Cooper in Central Park, which a lot of people may know about. So I was kind of looking for my own kind of Black female cancer community. So we kind of searched on Twitter trying to find people and there was this thread. And that was kind of when I saw Henry and kind of messaged him, I was like, “Oh, great, another person.” And, you know, we DM each other and start having a conversation about, you know, visibility, and all of those things.
But actually black in cancer research, it's a very unique space. And part of that is because, as well, as you know, the lack of visibility, and all of those things, there is an inherent distrust of the medical community by the black community because of a number of reasons. One of them being the Tuskegee syphilis study, which a lot of people may know about, amongst a range of other things. You know, we think about Henrietta Lacks, and the way that her cells were taken, and those stories and so many stories that go untold.
So we were talking about that and how that has led black cancer researchers becoming the font of knowledge for their own communities. So when it comes to, oh, you know, this person, this auntie, this uncle, this family friend, or whatever, has been diagnosed with cancer… you know, were asking you questions about it. And it's like, okay, as many people know within science, you can be an expert in one thing, and I won't even say I'm an expert in pediatric brain cancers, but that's my field. I don't know a lot about lung cancer, breast cancer, prostate, colorectal, and certainly not what standards of care are or like, is this the right treatment or so on so forth… but you realize that you become the font of knowledge, because it's like, well, you work in cancer, and you look like me, so I can ask you and I can trust you.
So what we wanted to do was to create a community where we could go to those people who were experts in those fields and ask those questions and have places that people could be redirected to. And that was really important to ask them to inform the community about cancer. So that was kind of why we developed what's known as one of our initiatives, which is the Cancer Awareness project, which is an aim to educate the black community about cancer. In a number of different ways in a way that is culturally competent, so that people can understand it so that it's pitched at the right level. And that people have the right information. We have this kind of phrase, within kind of that project that an informed community is an empowered community. And we want people to be informed so that they can be empowered about their healthcare decisions. And we thought, what better way to do that than to bring together all of the experts in all of those different fields, we gain information best from those who look like us. So bringing together a black community of cancer researchers, oncologists, advocates, to be able to speak to the community and so that they can do that if they go through that experience was really important to us. So that was kind of what we ended up building in terms of that.
But then on the other side, was, again, the visibility aspect and the aspirational aspect. So we worked towards building what's now known as the Black in cancer pipeline program. So we know that we have this leaky pipeline of black cancer researchers or black STEM professionals, that you might start off with a lot in undergrad, but as you go on through, you know, PhDs, postdocs, PIs, people in leadership within, you know, pharmaceutical companies, the numbers just dramatically drop off. So what we wanted to do was to make a real dent in increasing the numbers of black cancer researchers, you know, we have talks to encourage people and give them advice on applying for PhDs or postdocs or whatever that might be. We have the - for the first year this year is our our inaugural blacking cancer postdoc award. So that's in collaboration with the Emerald Foundation, which is a real active way and increasing the numbers of black cancer researchers that we can really push forward. So lots of kind of really exciting things that we're doing to do it in a very proactive way, and make sure that genuine things are happening. It isn't just a conversation, but real work on the ground.
Beautiful projects, and it's pretty young organization, is there anything in particular that triggered it? Like, Is there anything that made you think, you know, “okay, we got to do this now”?
And so I think part of that was a lot of conversations last year. And it was, it was a real significant change, we've had lots of events happen before, in terms of people realizing racial inequality, and so on, so forth. And that was really important. But those conversations never lasted very long. Whereas last year, because it was consistently on television, on social media, and the conversation kept happening, and people couldn't avoid it. And people took more steps to have those uncomfortable conversations. We knew that if it was ever going to be successful, it was going to be now when people were actively engaged in having those conversations. We knew that those conversations should be uncomfortable. But we're willing to have them anyway.
Okay. And so in another interview that he spoke about, not just the black community, but as a family as well. And, you know, that made me pause and think, to be honest, because you hear of the term community a lot. And certainly I hear the term LGBTQ+ community a lot, but not necessarily family. What’s the difference for you?
So I think a community has a shared investment in whatever that thing is, they have a shared experience. It's not always necessarily exactly the same experience, but certainly something that links them all together. So we talk about the black community, for example. But it's not a monolith. There are a range of different experiences just as in any community. But the family aspect that certainly I've experienced within what I now call our kind of Black in cancer family is, there's a different level of support, there's a cheering on. We have a Black in cancer slack and if I or anybody else posts any sort of achievement or award or you know, publication or whatever, that we are all there supporting each other encouraging each other cheering each other on will drop things for one another. You know, we've had a number of our committee who are doing their kind of final year vivas and passing their PhDs and stuff and, you know, we've been sat in their doctoral talks, cheering each other on and being like, this is amazing. Asking questions, and then celebrating together once they've achieved their PhD. So it's much more of a family than it is just a group of people who have a shared experience. It's genuine support for one another, genuine encouraging one another. Genuine… There's no, oh, well, you're going to be doing better than this. And there's no, there's a jealousy, there's just, you're doing really great. And how can I lift you up? And how can I pull you to where I am? And how can I give you advice and all of those things for us to all be better, and for us to all have the right information and for us all to be where we want to be? So I'd say that that's the difference between just a community where people have things in common, versus being a family.
Yeah, that's fantastic. That's really fantastic. Hm, I don't even know how to ask this. Do you ever feel like obviously, when you're doing all these things, especially in public, you are effectively representative of your community. Have you ever felt that you were being taken advantage of, and I'm speaking, you obviously, you know, as a white dude myself, I can't, you know, I’ve not experienced racism or things that you were exposed to in the BAME or POC communities, but I've listened and read to have a lot of people in your community said, you know, they're fed up, because they get rung up by institutions who surprise, surprise, they realize they're running an event, and all panel is white dudes and they need someone who’s not white. Have you ever encountered that? And, you know, how do you feel about that?
So, there have definitely been some times where things have been a challenge in terms of people asking, like, oh, could you come and do this? And I'm like, yep, that's no problem, you know, whether it's talking about Black in cancer, and so that they can support it, which is a brilliant thing. But when you also maybe ask me to come up with ideas that your institution can start to do to increase diversity, or to get more students, Black students or people of color or whatever. But you're asking me to do that, without any recompense… When if you were asking anybody else to consult on any other form of issue, you would pay them for their time and their expertise. That can be quite frustrating. And I think, at least this year, I've been taking more of a stand in being like, “you're asking me for this, which is no problem, I'm able to do that. But what I want to let you know is that I value, my own voice, and my own experiences. And if you're really trying to do this, you will understand that you need to value those too. Me sharing my lived experience, and my trauma, and the experiences I've been through aren't just for you to be able to say, “Oh, we had this talk wasn't that really great?” And that's something I'm working towards, and not just for myself, but for others that I've been speaking to who've been doing talks, etc, and being like, make sure that your voice is being valued, because unless we all do it, right, those burdens will then fall on the people who only do it for free. Because it's not about the money. It's about the value of my voice in my experience.
Yeah, well, this is important, right?
100%.
Like I said, we're all in for visibility and representation, but you can't, it's just not right for you to do the work that this institutions are doing or should be doing or are claiming in any way that they are doing it, right?
Yeah.
Let's just come back to your work before wrapping up, because time is flying. A lot of us know people with cancer or who have heart cancer, possibly ourselves. Can you give us any hope, any good news, anything that you think, you know, it's coming out, it's bound to come up in the next three, five years that, you know, you think, could improve how we understand or how we fight cancer?
So there is an incredible amount of work being done across a range of cancers. And I think one of the really good things that's happening is people being diagnosed earlier. So I think one thing that people are being made more aware of is understanding, you know, how to check yourselves for cancer, whether that's, you know, through advertisements or whatever, you know, are women checking yourself for breast cancer or men checking themselves for prostate cancer. “Do you know the symptoms of bowel cancer?” and those things are being put across more often. And with anything, the earlier the diagnosis, the more likely you are to survive. So I think that's something that's really great. And in terms of screening programs, and making those available to the communities is really fantastic. So, in any case, that's something that's helping.
In terms of kind of newer technologies and things, you know, the movement forward of like genomic sequencing and those things and those things becoming cheaper, meaning that people can find out more about their specific cancer type, we can trial, lots of different agents on their cells that come from that specific cancer, and then getting those back to the patient. There's a collaboration between Cancer Research UK, and the National Cancer Institute in the US. And they have these projects known as grand challenges. So they're trying to tackle really huge questions. So there's lots of work being done around understanding how we can work the immune system against cancer, and how we can really trigger those cells within our own bodies to harness them for cancer treatments and things. So that's really exciting. The immuno oncology space is really cool. And something that I'm kind of really looking forward to see how that works, moving forward and developing more treatments around that and, and things.
So there's lots of exciting things on the horizon. But as with any kind of science, sometimes it gets right to the point at which you're like, this is great. “This is working and everything”, and then it gets into the clinic, and you're like, “but why isn't it working in people?” So I'm always hesitant to be like, this is the next big thing. That certainly I think my biggest thing is to anybody listening, if you have screenings go to them, even if you're like, “Oh, I don't want to go for this, you know, smear test, or this Pap test or whatever.” There's a chance, that that might save your life. So whether that's a family member who's like, oh, I've been having this weird thing and just tell them to go and get it checked out. What's the worst that's going to happen is it's nothing. And the best it's going to happen is that they get an early diagnosis on something and go on to live a full life. Yeah.
Well, that could be a game changer. And like circling back to your workout, like in cancer, that's part of you of your advocacy work as well, right?
Yeah, absolutely. Absolutely. Because the earlier we get people diagnosed is, the more likely they are to live a full life. And honestly, and I said this since the beginning, if any one of the talks that we do, the work that we put into this, means that one person goes, “I went to the doctor alley because this and I got diagnosed, and they gave me this treatment and now my cancer is gone. And I can have the life that I want to lead. I can have kids, grandkids”, whatever, whatever that life's plans are... That they can go on to do that. That will be totally worth it.
Yeah, I can literally save lives.
Yeah.
Now, that's a silver lining. Sigourney Bell, it's been a pleasure to meet you. Thank you so much for for joining us.
It's been my pleasure. Thank you so much for having me.
Thank you.
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That was the second to last episode of this series, I really hope you enjoyed it. If you did, I would just suggest that you get your email onto the newsletter at howtosci.substack.com, or follow the show on Twitter at @HowToSci to make sure you don’t miss the final episode because it’s going to be great. And if you can make sure all your friends know about it too. The music was by Psychedelic Pedestrian and Vasily Novikov, my name is Pablo Izquierdo, and this is How To Make A Scientist.