Many scientists who study pediatric cancer come to the field from the personal experience and pain of a relative or friend who suffered the illness. Not Michael Scheurer, Professor of Pediatrics at Baylor College of Medicine, who leads up TheReasonsWhy.Us epidemiological and clinical research study with The Oliver Foundation.
Dr Scheurer comes from a background in public health and infectious diseases. He saw a need for research into why cancer happens in some children and not others – and into ways to prevent it in the future.
Born and raised in Alabama in the Mobile area, as a child Dr Scheurer dreamed of being a physician in order to help people. No one in his family had ever worked in the medical profession, so he drew inspiration from TV shows such as ER. But in college taking anthropology classes, he came across a fascinating perspective: how different cultures approach sickness and health. “It was interesting to me to understand how different cultures define illness and how their perceptions of healing evolved to address disease.”
Dr Scheurer ended up pursuing a master’s degree in public health at the University of Alabama and then a doctorate in epidemiology at the University of Texas School of Public Health, where he developed an interest in research, especially in cancer. He is curious, for example, why some groups of children develop the disease or react well to specific treatments, while others do not.
Today, the 46-year-old is co-Leader of the Cancer Prevention and Population Sciences Program and Director of the Population Sciences Biorepository at Baylor, which is a private health sciences institute in Houston within the Texas Medical Center, the largest medical center in the world.
Dr Scheurer says scientists still do not fully understand why the incidence of pediatric cancer is rising – at least 45% since 1975 – but that at least two factors play a role.
“One: There are some increasing exposures to environmental agents. And two: for some types of cancer, there’s an increased ability to diagnose those diseases in children,” he says. “The types of cancers that occur in kids are often different than the types of cancer that occur in adults, so understanding over time how to better diagnose those diseases has probably led to a steady increase.”
For epidemiologists studying cancer in kids, research long has looked at risk factors for developing the disease – that is, how genetics or other physical traits make some children more vulnerable than others. But these days, the scope is broadening, examining factors in the continuum of the cancer experience including its development, treatment and life-long effects in survivors.
While five-year survival rates for pediatric cancer are now at over 80%, at age 45 years an estimated 95% suffer from cumulative prevalence of any chronic health condition. And in the case of acute lymphocytic leukemia, a 2015 study found that only 23% survive more than 20 years.
“We’re looking at the risk factors associated with better response to therapy, with severe toxicity in children who receive a certain type of therapy, with long-term survival, or with the development of chronic health effects from treatments we’ve given certain children,” says Dr Scheurer. Researchers are studying different groups of children and a range of biological, social and institutional factors, not only physical traits: “It’s an exciting time to be part of pediatric oncology and cancer epidemiology.”
That is where The Oliver Foundation comes in. While partnering with The Oliver Foundation, which recruits families for the study who have suffered pediatric cancer, Dr Scheurer’s team is simultaneously partnering with investigators at the Icahn School of Medicine at Mount Sinai, New York, led by a trained dentist. The dentist, Dr Manish Arora, Vice Chairman of the Department of Environmental Medicine and Public Health, has developed a way to analyze baby teeth not only to determine environmental exposures but also to pinpoint when they occurred, even before birth.
“That’s fantastic, because one of the key downfalls to this kind of research is not knowing when an exposure happens and when that exposure is more important and causes something bad to happen,” says Dr Scheurer. The work at Mount Sinai looks at the age of teeth, much like looking at rings on trees to determine their age, and identifies when and what exposures took place.
“Precise measurement of dates is transformational, because studies now rely mainly on information requested from parents, whose memories may be inaccurate or incomplete,” says Dr Scheurer.
So far, the teeth analyses have looked mainly at exposures to metals such as lead, zinc and arsenic, and to organic compounds such as pesticides, from local populations. “As we continue to ramp up our work with The Oliver Foundation, we will expand on that work to include children across the country and even internationally,” says Dr Scheurer.
Next, researchers can correlate the teeth studies with other research, such as genetics. “So, we can understand better, for instance, that this child not only was exposed to a high level of factor X at a certain age, but they may have some genetic variant that put them at increased susceptibility to that factor. Most likely, it’s the combination of exposure and genetic susceptibility that increases a child’s risk to develop cancer: Their body can’t deal with the exposure the same way another person can.”
While in the laboratory and outside, Scheurer enjoys listening to music to calm and refresh his mind and soul. He sometimes tunes into instrumental jazz or Mozart while doing data analysis or to classic rock while coding. He attends concerts in his free time too, including chamber and orchestral groups. Among favorite recording artists on his playlist: pianist-songwriters Tori Amos and Nina Simone.
Staying patient is important, because research can take years to show results. Dr Scheurer says he keeps motivated because of his scientific curiosity and his continuing passion to help others: “I’m hoping at some point soon, we’ll understand more about risk factors and prevent future kids from going through the cancer experience.”