Update – AACR and Compusystems Makes it Right

March 3, 2020 / D.B. Sieders / Leave a comment

Update on previous post: Hubby replied to Dave’s email. He’s awesome, is (once again) Captain of Team D Beats C, and I hope he writes about his experiences as a caregiver and spouse of someone living with cancer someday. I also called AACR and spoke to Josh, a very nice and caring human being who agreed that the response I first received was not appropriate or kind. He asked that I forward my correspondence to him so that he could look into it.

He also expressed heartfelt wishes for me as I deal with another round of breast cancer.

Later, I received a call from Sheraine, Customer Service Team Lead from Compusystems. She offered an apology and heartfelt wishes for a speedy recovery. She assured me that there are scripted responses that are available and appropriate for cases of illness and they would make sure those responses are used in the future.

A little kindness goes a long way. I’m pleased with the outcome.

Nice Going, AACR (Salt on the Wound)

March 1, 2020March 2, 2020 / D.B. Sieders / 4 Comments

I didn’t plan on writing two blog posts in one day, but here we are. Because of my second diagnosis with breast cancer, I have to adjust my life and schedule to accommodate surgery, reconstruction, and other treatments. I had planned to attend the annual American Association for Cancer Research Annual Meeting in April so I could present my research on molecular regulation of breast cancer bone metastasis, network with colleagues, patients, survivors, and policy makers, and learn about the latest advances in the field.

Cancer has robbed me of that opportunity.

Since I’d already registered, I contacted AACR to let them know what was going on and to cancel my registration. Here’s what I wrote:

Short, sweet, to the point. I didn’t expect a reply until next week, but, to my surprise (and based on the tone of the reply, horror), I received a reply within a few hours:

So, after writing the American Association for CANCER Research to let them know that I cannot attend the meeting because I have CANCER, that’s the stone cold, insensitive, shitty reply I received. I could’ve let it slide, but, as I note in my response, I’m soooooooo done with bullshit at this point.

Here’s my reply (copied and pasted since it’s too long for a screenshot):

Dear David,

Wow. Just wow.

Two years ago, I would have just let this slide, been “nice” and “quiet” without causing trouble, like all women are taught to do. But two years ago, I was diagnosed with breast cancer. And, as of last week, my breast cancer is back. As such, I have neither the time nor the energy for bovine fecal material. That the current bovine fecal material is coming from the American Association for Cancer Research, an organization I’ve supported since my days as a graduate student (member 1998-present), just after a second diagnosis with breast cancer, makes it all the more horrible.

As I noted in my request, I have cancer. I will likely be undergoing surgery for the third time during the annual conference, which means cancer has cheated me of the opportunity to present my own research findings on breast cancer metastasis to my peers. Cancer will also steal time from my research, my family, my friends, and my life.
So, in response to, “Please let us know if you still wish to cancel your registration,” um, yeah. Did you think I’d suddenly change my mind, or that my cancer would suddenly be all better so I can totally go to the meeting – my bad? What kind of stupid, insensitive question is that? Seriously, I have people who despise me who wouldn’t be that stone cold. Do you need proof of my diagnosis? I have CDs full of scans from my six biopsies and two lumpectomies. Do I need a doctor’s note? You can check out my blog where I’ve been documenting my story in an effort to let patients going through the same struggles that (a) they’re not alone, (b) knowledge is power so here are accessible data you can use to make informed healthcare decisions, and (c) to be a liaison between research and patients/survivors so the public understands how important our work is and so they’ll engage to help us better meet their needs. www.talkingtatas.com.

You’d best believe I’ll be blogging about the AACR responding to the news that I have cancer and cannot attend the annual meeting with it’ll cost you $125. No “I’m so sorry for what you’re going through.” No, “What can the AACR do to support you during this difficult time.” Just, “We can understand your concern.”

You can understand my concern, you say. With all due respect, no, unless you’ve had cancer, you absolutely, positively cannot understand even a fraction of my concerns. Unless you’ve been hit by the sledgehammer of shock upon hearing those three horrible words, you have cancer, unless you’ve had to tell your spouse, your children, and your mother that you’ve been diagnosed with a deadly disease, unless you’ve endured the pain of surgery and recovery, the burns and fatigue induced by radiation, the indignity of estrogen suppression therapies that forever change you and your relationship to your body, unless you’ve endured sleepless nights wondering if you’ll live for another 5 years, 10 years, 15 years, and if/when cancer might come back and kill you, you have NO IDEA about my concerns. That’s completely insensitive, condescending, and wrong on so many levels.

But please, by all means, take the $125. You certainly need it more than I do. I don’t need to think about insurance deductibles, medication, bills to support myself and my family.

And one last thing – you don’t get to call me “Dana” in a response like the one you offered. It’s Dr. Brantley-Sieders to you.

A little consideration, human decency, and kindness can go a long way. Coldness, disregard, and insensitivity can, too. Badly done, AACR. Badly done.

DIY Therapy for A Geek

March 1, 2020 / D.B. Sieders / Leave a comment

I’ve come to terms with the fact that I’m not done with breast cancer yet. But I don’t have to like it, and I don’t have to pretend that I’m entirely okay. I need help. Still in therapy, meeting with my care team on Thursday to come up with a game plan to get rid of this stupid little 6 mm bastard of a tumor, and then meeting with the plastic surgeon the following Monday to discuss Tits 3.0.

It’s a lot. What’s keeping me sane right now, aside from my family, Netflix Comedy Specials, and cat videos on Facebook, is my work. Y’all, I get to kill breast cancer cells ALL THE TIME in the lab. It’s so cathartic and gratifying. I wish with all my heart it was as easy to kill cancer cells in patients as it is in little plastic dishes. It’s not, but what we discover in little plastic dishes could eventually lead to the next cancer therapy.

The message is clear – DIE BITCH ASS CANCER CELLS!

My amazing student, who’s working with cancer cells that are similar to mine (hormone receptor positive), saved a plate for me. Not only did she save a plate, she decorated it with an adorkable “destroy me” tag that made me giggle snort.

I adore her.

Naturally, we decided to video me killing cancer cells.

Videography credit Kalin Wilson

As noted in the video, please for the love of your health, do NOT drink hydrogen peroxide to kill you tumor. It’s #toxic and not in a way that will target your cancer. But, as you can (hopefully) see, it stresses out the cells in the dish, overwhelming their defenses against oxidative stress to the point of death.

But, having the power to kill tumor cells that are similar to those growing in my body helped me on a psychological level. And if any patients or survivors want me to kill cancer cells like yours in the lab, I’m down! Hit me up. I can use chemo drugs, approved and experimental cancer drugs, peroxide, detergents, soda (it totally works), you name it. Let’s get creative!

And The Bottom Drops Out…

February 25, 2020 / D.B. Sieders / 3 Comments

It’s been one of those days.

Last week, I had my 6th biopsy. I actually blogged (read: bitched) about it in a previous post. CNN version: when I went in for my routine mammogram, which turned into four separate boob squishes and an ultrasound, a spot showed up in my left boob – the one that had already developed two tumors (surgically removed) and had been irradiated. It was likely nothing, but since it was in the cancer boob, we went ahead and biopsied it.

It wasn’t nothing.

Bad grammar aside, once again (and near what was supposed to be my 2 year cancerversary), I got the call we all dread. It’s cancer. 6 mm invasive ductal carcinoma, ER+/PR+ (probably) HER2-, in the same breast that had been irradiated, and in the same body that’s been on estrogen blockers for nearly 2 years.

Once again, I’m numb, angry, scared, and filled with uncertainty. Invasive. How far has it spread? I should get a PET scan – what if it has metastasized? I’ll likely have a mastectomy at this point, one or both breasts, but what else? Will I need chemo? More radiation? A new drug cocktail?

Will I be alive next year? In two years? The statistics say yes, but what about five to ten years down the road?

Once again, I had to call family and friends with bad news, had to fall apart in my husband’s arms, had to tell my daughter. I still have to tell my son. I feel like I’ve failed. I’ve let them down. Should I have toughed it out with the aromatase inhibitors that made me so sore and achy that I could barely get out of my car, out of a chair, out of bed? Should I have gone for chemo in spite of my Oncotype DX results? Should I have just lopped off both breasts to begin with?

Rationally and objectively, no, I didn’t fail. Cancer is insidious, sly, and unpredictable. No one has a crystal ball. Based on the information we had at the time, breast conserving surgery made sense. I stand by that decision. I stand by my Oncotype DX results and decision to forgo chemo and opt for medically induced menopause and tamoxifen – because in order to live life, I needed to be able to get out of my car, out of chairs, and out of bed.

Here’s what I know: My odds are still good for survival. Losing one or both breasts is going to be painful, heartbreaking, and sad, but those are the cards I’ve been dealt and I will play them. I’ve been through this before, and years from now, I may go through it again, but I’m here now. I want to live. I want to watch my children grow and be there for them as they transition from incredible teens into amazing adults. I don’t want to miss a minute. I want more long days and loving nights with my husband. I want to laugh, travel, work, play, and not let cancer rob me of my life.

I don’t know how to get there yet, but I will get there. I will face what’s to come and I will keep fighting in the lab, as an advocate, and as a survivor. Cancer will not defeat my spirit. It will not rob me of joy for however long I may yet live. Strong, weak, confident, scared, sure, uncertain, and everything in between, I will face this.

Advocacy 101 – What I Learned from Training

February 19, 2020 / D.B. Sieders / 2 Comments

I learned so many new things today at Patient Advocacy Orientation! My best days are when I’m learning new things. It’s one of the things I love best about being a scientist, and it’s a great foundation upon which to build for my new work as a Patient Advocate.

What exactly are advocates and what do they do? In terms of Research Advocacy Programs, advocates are disease survivors (cancer survivors in my case), caregivers, and members of the community who provide the patient perspective to researchers to help shape the nature and direction of cancer research and patient care. Their role is critical, as they serve as a voice for patients, helping investigators tailor their research with patients concerns in mind – not just in terms of outcomes and sound science, but also in terms patient comfort, respect for patient rights and dignity, and beneficence. This means making sure the goals of research are focused on and aligned with serving patient needs and improving outcomes and quality of life.

This seems pretty intuitive, and I believe most investigators are truly committed and passionate about doing research that will make a difference, be it developing new treatments, better diagnostic tools, reducing side effects of existing treatments, and improving survival and quality of life for patients. I certainly was and am. But most investigators don’t experience what patients do – except in cases like mine where researchers become patients and survivors. My experience certainly changed my perspective, which is why I want to share what I’ve learned with both the research and survivor communities.

That mission became more urgent for me today in the face of some jarring statistics. Tennessee and the surrounding regions have some of the highest cancer death rates in the United States.

Comparing the map above to the map below that shows new cancer cases diagnosed by state, incidence, the frequency with which cancer occurs, doesn’t fully explain higher death rates.

My heart sank when I saw these data, and really drove home my privilege. I am well-educated, have a high socioeconomic status, have access to insurance coverage and some of the best health care available in the United States, and I have inside information based on my work as a breast cancer researcher.

I’m lucky. Far too many of my fellow Tennesseans and Southerners are not. My Institution and Affiliated Cancer Center serve this region. I want to be a part of better serving patients in this region, which will be a HUGE focus of my advocacy work.

What will this work involve? One of the ways I think I can be of use is by helping recruit patients for clinical trials. According to what I learned today, many promising new drugs do not make it through Phase III clinical trial testing* due to failure to accrue enough patients to sufficiently test their effectiveness. That’s such a shame and missed opportunity. Of course, there are many barriers for patient participation in clinical trials – fear/lack of understanding; lack of access due to barriers to travel/transportation, unmet childcare needs, inability to take time off work, etc.; disparities that make minority populations reluctant to participate**. While I am not in a position to combat access to trials, I am in a position to serve as a liaison between patients and clinical researchers accruing patients for trials. I can help educate potential trial participants in the process, assure them of their rights (including the ability to stop participating at any time), alleviate fears through helping patients understand the benefits and how they might be helping a great number of future cancer patients. I am also working with African American advocates and other advocates of color to understand and be sensitive to those communities, their histories, and their needs.

Those needs are great, particularly in terms of breast cancer outcomes. African American women diagnosed with breast cancer have lower overall survival rates compared to white women. Finding out why is crucial for closing the gap. Increasing African American participation in clinical trials is a key part of that process.

For more on cancer disparities across ethnic groups, click here.

Bottom line: I’ve got work to do, and I’m excited to work with my fellow survivors to help patients now and in the future. Interested in becoming an advocate? Here are some resources that can help! My Institution’s Advocacy Resources, How Patient Advocates Help Cancer Research: Expert Q&A, Why Patient Advocacy is Vital.

*I’ll cover clinical trials in more detail in a future post. Click here to learn more now. Phase III trials test drugs that have already been proven safe and promising in terms of effectiveness.

**African Americans remember the horrific abuses perpetrated by scientific investigators, including those in charge of Tuskegee Study of Syphilis – which resulted in hundreds of African Americans being denied treatment in order to study the long term effects of untreated syphilis

Scanxiety: My Left Boob Just Won’t *&^#ing Behave!

February 11, 2020March 23, 2020 / D.B. Sieders / 6 Comments

Warning: This post is full of swears. It’s been a total shit day.

Getting “normal” annual mammograms after breast cancer is nerve wracking. I get that. Literally. Today was my second routine mammogram after completing surgical and radiation treatments. What (I’d hoped) would be an hour long visit followed by an, “All clear! Go, and live happy,” turned into a 3 1/2 hour long ordeal that consisted of FOUR FUCKING IMAGING sessions, an ultrasound, and scheduling another biopsy.

This is fucking bullshit.

For those of you who’ve been there, done that, bought the T-shirt (that reads, “Of Course They’re Fake – The Real Ones Tried to Kill Me”), you get it. I’ve had several survivors in my circle offer support, well-wishes, and cat memes, and I’m grateful. For those of you who haven’t been there (and I hope you never are), let me give you some background. At the time of this blog post I’ve had:

Six biopsies (last time was a charm with the Big C)

Two lumpectomies (one to remove a benign papilloma and the other to remove cancer – followed by oncoplastic reconstruction involving a reduction and lift)

Implantation of TWO Savi Scout devices to mark my tumors (this was mammography assisted, meaning I was in fucking compression while two GINORMOUS needles the size of small screw drivers were stuck into my left boob and I actually saw the tip of one come out the other side)

Twenty-eight rounds of radiation on my left boob – crispy bacon, anyone?

And a partridge in a pear treeeeeeee!

You’d think that would be enough. Seriously. But, alas, not for me. Whenever I go in for routine checks, I get the extra imaging, the call backs, the ultrasounds, and the biopsies. My breast are pincushions. It’s not fun.

Today’s visit started out well enough. I went into the room with my lovely robe, wiped off the deodorant I’d put on (because I forgot that I wasn’t supposed to use any), flopped out one boob, then the other, let the nice nurse get to second base while positioning my boobs, had my (first) mammogram scans and returned to the waiting room. Aside from being a bit sore (the left boob, cancer boob, is harder than the right thanks to radiation and it’s pretty uncomfortable in the old squeezy squeezy machine), I was content. I texted the lab to tell them I hoped I’d be in soon and then enjoyed some Facebook and Twitter time while waiting. I also had in-room entertainment in the form of a brash and bawdy lady who was Skyping – loudly – and having the kind of inappropriate conversation that you kind of want to film because it’s disturbingly awesome and no one will believe you unless you record it. All in all, not too shabby.

Then, they called me back. Just need a few more images, they told me. Nothing to be concerned about. I groaned, but was still okay. Considering my normal experiences with mammograms, this was a drop in the boob bucket. I got squished, got sore, and was escorted back to the waiting room filled with other women in those high fashion robes you get when you have to get your boobies squished. My entertainment was gone, and I missed her terribly, but I was slightly more concerned with the passage of time.

I mean, I did have work to do.

They called me back again. This time, the nurse (BTW, they’re all wonderful and I don’t fault them for any of this) explained that they’d found a spot. It was of concern because they hadn’t seen it on my previous post-treatment scans. They hadn’t seen it, because apparently this time the nurse was so good that she got images closer to the chest wall and they were seeing new areas for the first time. On the one hand, go nurse! Great technique!

On the other hand, WTF is the spot? Is it something I should worry about? We don’t know how old/new it is because we haven’t seen it before. Seriously, I’m two years out. I shouldn’t have a recurrence.

They needed another set of scans to make sure it was real, especially since they’d seen it only in one image/plane. So, for the third time, back in the boob vise for a trip to fuck that hurts land.

I go back to the waiting room. And…I’m called back for – I shit you not – ANOTHER round of images. This time they let me stay in the room with the owie machine while I wait for the radiologist to have a peek. Shortly thereafter, they tell me, as I predicted by this point, it was ultrasound time!

I’ve had plenty of ultrasounds.

As is my standard practice, I asked if I could see the screen, explaining that I’m a breast cancer researcher. Yeah, I got breast cancer, too, the irony isn’t lost on me. Yes, I’ve become more passionate about my research and am getting into advocacy, too. Sure, I’d love to see the mammogram image of the spot in question. Interesting (i.e. I have no idea if what I’m seeing is bad or not – then again, neither does anyone else or I wouldn’t be here).

I flopped out my left boob, the one I’d called a pain in my ass during my 4th time in the booby squeeze machine (and made the nurse giggle snort), put my left hand over my head, got the ultrasound goo smeared over my bad boob, and then the nurse commenced with the scavenger hunt via wand. And she wanded. And she wanded. And she wanded.

My arm was getting a little numb, and I was a bit concerned that she wasn’t taking pictures, but I just chilled. Then, she told me she wasn’t sure anything she was seeing matched the spot on the mammogram. So she grabbed the radiologist, who came in, goo-ed me up, and wanded. And wanded. And wanded.

The radiologist laid it out for me. They’d seen this spot, which was uniform in shape, an oval, and was most likely nothing to be concerned about – fat necrosis, an artefact of scarring, or a benign lesion. Given that it was in my bad cancer boob, she recommended a biopsy. And since they couldn’t find it by ultrasound, I would need a mammogram guided biopsy.

That’s exactly as sucktastic as it sounds. I will be put in (terribly uncomfortable) mammogram compression and stay there while someone jabs a fucking biopsy needle into my boob. Yes, I’ll have lidocaine, but that’s not going to help with the squeezy squeezy or the HORROR!

And, while I wait 9 days for the biopsy and another 5-7 days for the results, I’ll be stressed out. This is the reality for survivors. We’re ALWAYS nervous with scans, and it’s compounded when extra examinations are needed. It’s terrifying. Yes, rationally I understand that the odds of finding another tumor are extremely low, but the fear is visceral and always there. I’m worried it always will be. Most days, I’m upbeat and snarkily positive, but not today.

Some days, the best you can do is just hope for better tomorrow.

Screw The Woo Woo: Essential Oils Won’t Cure Your Cancer

February 5, 2020March 23, 2020 / D.B. Sieders / Leave a comment

Essential oils. They’re EVERYWHERE! Articles and posts touting their alleged benefits are all over social media, some news media, and the Internet. A Google search I performed today yielded 1.7 billion results. 1.7 BILLION! Yup, there’s a LOT of buzz about the wonders and medicinal benefits of essential oils.

And almost all of it 100% certified Grade A Bullshit.

This post is dedicated to debunking one of my least favorite bullshit woo woo scams (second only to homeopathy). And I will do so with the power of science and snark, because that’s just who I am as a person.

So what are essential oils? They are oils purified from plants and carry the aroma of the source from which they are extracted. Their name comes from the fact that they are thought to contain the essence of their source, and they smell pretty good thanks to terpenoids, aromatic organic compounds produced by plants that often function as chemical protection against herbivores, insects, and microbes. They also serve as attractants for pollinators, seed dispersers, and in mediating plant–plant and plant–microbe communication. Humans enjoy them because they smell and in some cases taste really good. Sadly, allergies prevent me from enjoying the florals, but I enjoy herbals and fruit oils in a wide array of products – cosmetics, soaps, perfumes, lotions, bath products, and many food items. They’re just nice.

Fresh herbs and oils, wooden table background – we smell good and taste nice!

But do they have any medicinal value? What about medicinal value when it comes to cancer? Part of the issue with answering this question involves the (lack of) regulation when it comes to production and testing. The concentration of active chemicals in extracts can vary widely from plant to plant, which parts are processed (different concentrations in leaves, flowers, stems, and roots), which season the plants are harvested, which strains are sourced, etc. Without consistent batches subjected to quality control to assure consistent concentrations of active chemical components (like terpenoids), and without rigorous, scientific studies, we can only rely on anecdotal evidence and (often misleading) claims from suppliers. Some efforts are being made by the WHO for quality and safety evaluation of herbal products, including chemical fingerprint analysis*. Much like vitamins and supplements, which are not subject to the same rigorous FDA standards for safety and efficacy (how well it works) as drugs, essential oils fall under the category of “safe for their intended use,” which does not involve use as medical treatments. They’re considered safe until proven otherwise, a MUCH lower standard than FDA approved drugs.

More importantly, they are (by fairly low standards) rated for safety, but not for EFFICACY. That would require clinical trials and rigorous testing.

Should we be researching them? Sure! Some pre-clinical studies involving cultured cells (cells grow in a petri dish under laboratory conditions) and animal (primarily mouse) models have been published. A systematic review of the literature from 2014 to 2019 identified 79 studies that fit inclusion criteria – including studies investigating essential oils with anti-microbial and immunomodulatory (affects the host immune response) properties, nutrition studies, studies with controls and proper statistical analyses. Of those studies, many documented the anti-microbial (bacteria fighting) and anti-fungal (fungus fighting) properties, antioxidant properties that may help slow food spoilage, and anti-inflammatory properties in laboratory and agriculture models. And, in some preclinical studies, high doses of essential oils can kill cancer cells in culture in a laboratory setting. Does that mean they’ll do the same thing in humans? Not necessarily. See my post on turmeric.

Just for perspective, it’s pretty easy to kill cancer cells in culture in a laboratory setting. I once killed a dish by accidentally leaving the cells in phosphate buffered saline instead of growth media. Yes, salt water can kill cancer cells in culture. So can many drugs, but the majority of compounds with anti-cancer activity in cultured cancer cells and mouse models are not effective in human clinical trials. So, the jury is out on whether or not the active ingredients essential oils can help treat cancer. And inhaling the pleasing aromas produced by essential oils may effect mood, but it doesn’t do anything to thwart cancer growth, survival, or invasion.

These observations definitely warrant more laboratory investigation, but as of this post, there is no evidence that essential oils fights cancer when inhaled or ingested or delivered in any other way into the human body. Advertisements by scammers like the ones listed below are lies:

These are some of the top hits under a Google search for “treating cancer with essential oils.” As is my standard policy, I will not share links for woo woo. The misinformation and outright lies are not only infuriating, they can prove deadly for patients who skip standard therapies in favor of alternative “therapies.” The stats are heartbreaking. In a Yale School of Medicine study (link to original publication here*), “patients who used alternative medicine in place of standard evidence-based medicine had a death rate 2.5 times higher than patients who received standard evidenced-based therapies.”

Women with non-metastatic breast cancer who opted for alternative “medicine” were ~ 6 times more likely to die within 5 1/2 years compared to women who received standard of care therapy. This is a small study – 281 patients – and captures data from patients who disclosed their decision to follow alternatives versus standard of care. It doesn’t include patients who do not disclose or discuss this with their health care providers, so the numbers could actually be higher.

For more information on aromatherapy – separating fact from fiction – click here. Check out this article, too. Bottom line: much like cannabis, essential oils may offer relief from the side effects of standard of care treatments, but they cannot cure cancer nor should they be used as a substitute for standard of care. Complimentary alternative medicine is fine, as it compliments proven therapies, but not on their own.

*Access to this article is limited by a paywall. If you want to read it for yourself, hit me up and I’ll send the PDF.

Fixing Mistakes – Putting Action Behind My Big, Fat Mouth

January 31, 2020 / D.B. Sieders / Leave a comment

Yesterday, I wrote a post about scientific fact checkers and how scientists interact with them, using Dr. David Sabatini as an example. I did NOT expect the attention it garnered, but I do hope that Dr. Sabatini (if he read it) took it in the spirit in which it was intended. Like I noted in the original post, I’ve been following and admiring his work on mTOR for years. Thank in part to his efforts, mTOR inhibitors are in the clinic and are helping cancer patients fight their disease.

As a scientist, I find that very intellectually stimulating and gratifying. As a cancer survivor, I’m eternally grateful. Should my disease recur, torkinibs may be a part of my treatment plan, or perhaps third or fourth generation inhibitors. There are more options now thanks to the efforts of laboratory and clinical investigators around the world, and that gives us all so much hope!

At the end of the previous post, I noted that I, too, had been flagged on PubPeer for an error in a 2012 publication. What happened? In figure 4C, we inadvertently duplicated photomicrographs in the top panels:

Yup – the sharp-eyed PubPeer reviewer caught what the graduate student, collaborators, myself, my co-investigator, peer reviewers, and the journal production editors missed. The “Parental” and “Vector” images are identical. Not good. Now, this is a relatively minor error, but if left alone, it could lead to the perception that our laboratory group is sloppy and not as rigorous as we should be. In science, like many other fields, reputation is everything.

How does this happen? It’s a product of long hours poring over data, trying to select the best representations of experimental results, building figures and revising them…and revising them…and switching out panels and photos until the student or postdoc putting together the figures eyes are crossing. Many of them are sleep deprived, overloaded, and after a while, really numb to looking at the same data over and over again. Is that an excuse? No, it’s a reason, which is why study PIs, collaborators, reviewers, and the journal have a responsibility to double, triple, and quadruple check our papers before they’re sent out into the cyberverse for other scientists to read.

I take my part of the responsibility for this one. At the time, I was a Research Assistant Professor. While not on tenure-track, I was quite senior in the laboratory and had a duty to co-mentor and support the graduate students and fellows in the lab. My name was on the paper. I missed this and dropped the ball. That’s on me.

Fortunately, thanks to PubPeer, I have the opportunity to fix it!

After sorting through electronic files (thank GOODNESS our former lab members were organized), I was able to locate original images and generate correct (distinct) panels for Parental and Vector controls:

I contacted PLoS One today to request a correction. They may not re-issue the paper due to time and cost constraints, but I do hope they’ll add the corrected figure panels to an addendum. I’ll report back on this once I hear from them.

Bottom line: We ALL make mistakes from time to time. Yet, our culture discourages us from owning those mistakes, as if they’re a mark of shame or weakness. Certainly admitting mistakes has become uncomfortable and taboo. That is something that needs to change. Owning mistakes and fixing them are signs of integrity. When I’m entering into new collaborations, I pay attention to how my potential co-investigators and their team handle mistakes. Admission and ownership of mistakes and efforts to correct them are signs that new collaborators are trustworthy, rigorous, and have integrity, essential qualities in modern science. Very few scientific studies are performed by a single laboratory/person in that laboratory. Shared labor is the norm, so trust is key.

I WANT to be known as trustworthy, as someone with integrity whose work can be trusted and reproduced. As someone who recently withdrew a submitted manuscript when we (to our horror) found out that many of the data weren’t reproducible, I’ve become more vigilant. And I’m a better scientist for it. Science is better for vigilance. And that’s a good thing.

Being a Great Scientist – How to (and NOT to) Handle Mistakes

January 31, 2020 / D.B. Sieders / 1 Comment

In the age of the Internet, trolls and trollish behaviors have multiplied exponentially. Science is not immune. Many of us were late coming to social media, but more and more laboratories, institutions, programs, scientific organizations, conferences, professional organizations, and journals are engaging in Twitter and other outlets. Overall, this is a great thing! It is so satisfying to peruse science Twitter and catch up on all of the latest findings, hot new studies and publications, and enjoy a community of peers that extends beyond the halls of individual institutions.

But OF COURSE there are trolls and trollish folks in the Twitterverse. Smart people aren’t immune to this. It’s human nature. Not our best quality as a species, but it’s there nonetheless and it extends to people across professions, educational backgrounds, political and religious ideologies…you get the idea.

No matter where you go, there’s always one (or more) assholes. That’s a fact of life, like death, taxes, and motherfucking reviewer number two.

A positive side-effect of the Internet Age is the rise of transparency and fact-checking. This is important in every field (side-eyes the news media), but especially in science. Scientists pore over the literature and build upon previous studies to move the field forward. If a study contains errors, inconsistencies, or (in the worst cases), fabricated or altered data, it undermines the integrity of the field and the scientific endeavor. That’s why sites like PubPeer work to spot inconsistencies in published scientific literature. Now, no one likes to have their mistakes posted in big bold font on the Internet, but setting aside ego and emotion, it’s actually a GOOD thing! It helps us be vigilant about our work and the work of our colleagues who contribute data to shared publications, it allows the authors of the studies in question to go back and examine the data and correct mistakes in collaboration with the journal in question. It makes science more rigorous. All good things.

UNLESS…

The scientist in question decides to get his or her TROLL on!

When a mistake is pointed out on PubPeer, there are basically two ways to handle it. #1 – Thank the fact checkers for finding the error, dig through the data and fix the mistake, contact the journal in which the mistake was published and (if possible) update the data presented or add a note with the updated data as an addendum, and promise to be more rigorous in the future. This is the best way to handle it. It preserves your integrity as a scientist (and the integrity of the scientific process), it shows your commitment to ethics and responsible conduct of research, and it shows that you value your reputation and quality of your work enough to protect it. Basically, it makes you look good, honest, trustworthy – all qualities you want to have as a human being and a scientist.

Then, there’s the second way to handle it…#2 – Insult the PubPeer fact checker (petty, failed scientists), block “steaming turd,” (grudgingly) contact the journal to see what you should do. See this post from For Better Science for the run down. The first two items are childish, unnecessary, and, well, trollish. Mistakes happen, even to the great and mighty Dr. David Sabatini (whose work I actually follow and admire, since I’m working on mTOR signaling in breast cancer in my own lab). He’s a leader in the field, and he could have used this as an opportunity to set a great example for his peers and colleagues by handling this situation, which happens to plenty of scientists, with grace, dignity, and integrity. Someone with his reputation and in his position has a great deal of influence and sets the tone for scientists at all levels.

This is not a great tone. This is not a good look. I’m 95% certain that, had he not gone on Twitter and got his troll on, no one would be talking about the errors that have been found in multiple papers. He could have quietly fixed them and moved on.

Instead, EVERYONE is talking about this. This isn’t the kind of publicity you want as a scientist. Here are some Twitter replies:

There are even more replies to the first post, some showing sympathy and support – while gently pointing out the importance of the work PubPeer is doing – others (who tend to get blocked) calling out Dr. Sabatini on the insults borne of ego. It didn’t have to go down like this. It’s sad and unfortunate that it did. Hopefully, it will serve as an example of what NOT to do when confronted with evidence of error in published work.

For a GREAT example of what to do when confronted with evidence of mistakes in a publication, check out how Nobel Laureate Dr. Frances Arnold retracted a published study when she and her colleagues found the results were not reproducible missing data from a lab notebook. This is a fantastic example of integrity, honesty, and ethics.

*Note – you might be wondering if I’m just armchair quarterbacking, safe in the knowledge that I’m not the one being called out by PubPeer. I am not. In fact, when I joined PubPeer and did a search on my name, I found a post about an error in a 2012 PLoS One paper for which I was a co-author – we accidentally duplicated a photomicrograph. These things happen, but I’m GLAD the PubPeer fact checker spotted it so we have the opportunity to correct this. We are working on it NOW!

(And yes, I did thank the fact checker, because my mama raised me to have manners)

Do clams get cancer? Questions from High School Freshmen

January 25, 2020 / D.B. Sieders / Leave a comment

One of my favorite outreach activities is volunteering at public schools. Over the years, I’ve had the opportunity to speak to and work with elementary, middle, and high school students – doing everything from dry ice demonstrations, mini anatomy labs with fixed mouse organs, microscopy labs with tissue sections, and career talks. Most recently, I visited a local MNPS high school to talk about cancer biology (click here to see the slide show and an explanation).

It was AWESOME!

First of all, I was super impressed by how much these young people already knew! They’re studying cell biology and cell division right now, which worked well for my talk about how errors in DNA replication, mutations, and failed repair after damage leading to amplifications and deletions contribute to cancer. We used cell cycle regulation as an example, talking about oncogenes (drive cancer growth) and tumor suppressors (normal braking system for growth – lost in many cancers) that encode cell cycle regulators. They already knew much of the background, including how the cell cycle is controlled, the steps involved, and some of the proteins that regulate it. They also knew a lot about carcinogens (e.g. cigarette smoke, ultraviolet radiation from the sun, certain chemicals), treatments (chemotherapy and radiation), and certain types of cancer including breast, lung, and colon cancer.

Secondly, they were engaged and asked a LOT of questions. It made the presentation much more fun and interactive, and it gave me quite a bit to think about. There were, of course, questions I could not answer off the top of my head. But I promised the students I would look up answers to their questions and send the answers to their teacher. These are some of those questions:

1. What is the rarest form of cancer?

The latest statistics I could find from the American Cancer Society are from 2017. According to the data they gathered, the rarest cancers diagnosed in the adults (20+ years old) in the United States include cancers of the trachea, Kaposi sarcoma (this one is interesting because it led to the discovery of HIV – when more of these cancers cropped up in young gay men in the 1980s, it led investigators to start studying this population to identify the cause), lip, nose cavity and middle ear.

2. Can cancer in a transplanted organ spread to a new host?

This has actually happened! In 2018, it was reported that a 53 year old woman who died from a stroke and had no known medical conditions at the time of her death (including screens for cancer) had her organs transplanted into at least 5 recipients. The patient who received the heart died shortly after transplant from unrelated causes, but a year and a half later, the patient who received lungs from the donor became ill and was found to have breast cancer cells in her body with DNA that matched the original donor. She died shortly after. The patient who received the donor’s liver developed breast cancer in the transplanted organ in 2011, was treated, but died of a recurrence in 2014. The patient who received the donor’s left kidney developed and died from breast cancer in 2013 (six years after transplant), and the patient who received the donor’s right kidney was diagnosed with breast cancer in his kidney cells in 2011 – they were able to remove the tumor from the kidney, and after treatment the patient lived 10 years cancer free (at the time of reporting).

This phenomenon is very rare, however, and most of the time cancer in a potential donor can be detected by screening before organ harvest.

3. Do clams or reptiles get cancer?

Apparently, clams do get cancer. Even worse, for at least one type of cancer, the cancer cells from one clam can travel to another clam through water and grow in the new host. Yikes!

Cancers have been documented in reptiles, but they are much more under-studied than mammals and other animals. More research may be done to better study the link between cancer and metabolism, since metabolism is lower/slower in ectotherms (cold blooded creatures) than endotherms (warm blooded creatures).

Interestingly, elephants and naked mole rats rarely, if ever, get cancer, and ongoing studies into their physiology and genetics could help us figure out why and how we can use the knowledge to prevent cancer in humans.

4. Can babies be born with cancer?

It is rare, but it can happen. There have been reports of babies born with neuroblastoma, leukemia, and teratomas.

5. When did people start getting cancer?

(I actually knew part of the answer to this one, but it was fun to dig a little deeper)

The world’s oldest recorded case of cancer came from ancient Egypt in 1500 B.C., and it was recorded that there was no treatment for the cancer, only palliative treatment (relief of pain and suffering). Cancer has been with us much longer, though, given that bone cancer (osteosarcoma) has been detected in fossils from early hominids dated to 1.7 million years ago. Similar tumors have been found in fossils from dinosaurs and even from ancient turtles that lived 240 million years ago!

Got any questions for me? Send them! I’ll do my best to find the answers and more information. Knowledge is power! Hit me with your burning questions – the weirder the better!

Talking Tatas

Accessible Science For Breast Health and Breast Cancer