In December, Dr. Teri Brentnall, UW associate professor of medicine, published a landmark paper on her discovery of a gene that, when mutated, is linked to familial pancreatic cancer. The gene may also figure prominently in the more common sporadic pancreatic cancer.
Brentnall’s work sheds new light on how this devastating and almost always fatal disease may be avoided or cured in the future. I talked to Brentnall about her work and what keeps her focused and balanced.
Q. You are a famous lady. You just did something pretty incredible — you discovered a particular gene that, when mutated, is linked to familial pancreatic cancer. How cool is that?
A: I work on scientific questions all the time. Most of the time, there isn’t much to write home about! Scientific discovery takes a long time and this work gives all of us a new way to think about pancreatic cancer.
The best part of science is the ‘eureka!’ moment when you unravel the puzzle.
Q: What motivated you to look at this particular disease?
A: When I started in gastroenterology, I was not really interested in pancreatic cancer. Then one day, a man came to my clinic and told me he was worried about developing pancreatic cancer. I thought that (his concern) was unusual, so I queried him. His father, grandfather and three uncles had all died from pancreatic cancer.
The cry for help from this one individual is what has kept me going on this quest to find out what caused this disease in his family. One clinic patient changed my life. He needed help with this incredibly lethal disease. My GI colleagues at the UW and I began an endoscopic ultrasound surveillance program and we have been pretty successful. The program that began with one patient has now tracked over 60 families and over 100 patients.
Then we asked why. What could have caused this lethal disease in this family? It was Palladin — this gene produces a protein that makes cells move and gives them shape. Our discovery was that the mutated protein allows cells to move 50 percent faster and that’s a feature of cancer. Carol Otey at UNC (University of North Carolina) discovered Palladin five years ago. I told her I thought that Palladin may be causing the cancer in at least one family and I asked her to join forces with me.
Q: How long ago did you meet family X?
A: Ten years ago. It has been a decade. A decade of hard work. A decade of fun and exciting work.
Q: Tell me about being a scientist.
A: To be a scientist you have to pick what questions you are going to spend your time trying to answer. You only have a limited amount of time in life and I can only answer just one or two questions. The questions I chose have kept us busy: How can we better diagnose pancreatic pre-cancer? Can we discover the gene that causes pancreatic cancer? It took me a decade to get here and we are not done yet. I have another question: Can we use this information to better diagnose pancreatic cancer and treat it earlier? Choose your questions well — it may be a lifetime commitment!
Q: Who are the ‘we’? I have heard that the team that made this discovery is made up primarily of women researchers.
A: I am fortunate to work with brilliant people.
The early detection program was built by a number of physicians here in the Digestive Disease Center, including Drs. Mike Kimmey and Mike Saunders. They did the hands-on evaluation of patients. Then there are the dedicated surgeons, such as Dr. David Byrd, who take care of the patients and give them the option of having their pancreas removed. The diabetologist who specializes in diabetes to help the patient once they become diabetic when the pancreas is removed. My clinic coordinator, Josephine Maurer. Our pathologist, Mary Bronner, has been very instrumental. She is the go-to girl.
The scientific team that helped make this gene discovery is international and they are all women.
Q: Are you a scientist or a clinician?
A: I am an M.D. I don’t have much training in genetics or molecular biology — and I am not overly intelligent. I just use common sense. That has stood me in good stead. Common sense to manage patients and common sense working on the science.
Q: You have a very busy life. You travel internationally — how do you find balance?
A: It is hard to find balance. I keep a picture of my kids on my desk. That is the impetus for me to say no. Because when someone asks me to write a paper or review a book chapter, I realize that that will be less time to spend with them. I have learned to stay focused. I try to support and care for my scientists but try not to take on extra work unless it is goal-oriented.
Q: You went back to New York to announce your discovery. Your name was up in lights on the marquee of Radio City Music Hall. What are you going to do for an encore? What is the next big thing that you will be looking for?
A: It’s nice to make this milestone. I feel like we really got some excellent new information. I keep thinking, how can we capitalize on this new knowledge? As I drift off to sleep at night, I think about everything that we have done and learned and when I wake up in the morning, I can’t wait to get to work. I am an incredibly lucky girl.
Over her 10 years of work on pancreatic cancer, Brentnall has come close to shutting down her research for lack of resources. She wishes to extend a big thank you to the Lustgarten Foundation for Pancreatic Cancer Research, the Canary Foundation and the Walters family for their financial support for this research.