Tell us a little bit about yourself. When did you first become interested in science?
I am currently a 4th year medical student at Weill Cornell Medicine, finishing up my research fellowship year (between 3rd and 4th year) in the Department of Dermatology at Memorial Sloan Kettering Cancer Center (MSK). I graduated with highest honors (summa cum laude) from Georgia Institute of Technology with a BS in biomedical engineering. My route to medicine, and eventually to dermatology, was relatively unconventional—in college, I had initially planned to work in the biotech industry and had completed various internships in San Francisco Bay Area and Atlanta, including Abbott Laboratories and Varian Medical Systems, working with numerous different medical devices in R&D and product management. I had changed my career path during my fourth year of college when I had decided that my interests lie in the underlying biology of the medical conditions more so than the medical devices that were intended to treat and manage such conditions.
I first became interested in science in 7th grade biology class. My teacher was absolutely wonderful—I still remember using Jell-O and other treats to create a “cell” and reconstruct all the different cellular structures and functions within it. My 9th grade biology teacher also encouraged me to enter a math-science accelerated program in my high school, and it was during AP biology course in 10th grade that my interest in science solidified.
You are currently working as a fellow for the Memorial Sloan Kettering Cancer Center – can you tell us a little bit about what you are working on (in terms us non-scientists can understand)?
I work with Dr. Rotemberg MD Ph.D., the director of imaging informatics within the dermatology department, and Dr. Noor MD who specializes in cutaneous T-cell lymphomas. I work on various projects but mainly focus on projects that pertain to the clinical applications of novel imaging technology within dermatology, including reflectance confocal microscopy and 3D-total body photography. Reflectance confocal microscopy (RCM) is a hand-held, portable “mini” microscope that we can use to look through the skin and non-invasively visualize the cellular structures underneath the skin without a biopsy to cut and take out the skin tissue itself. For an easy comparison, you can think of RCM as an ultrasound, but instead of using sound waves, it is laser-based, allowing more precise visualization (the cellular structures) and higher resolution of the images produced. One of the research projects that I am working on focuses on “high-resolution image-guided micro-biopsy” where RCM is used to visualize melanomas (and other non-melanoma skin cancers) and precisely target a 1-mm area with a high degree of suspicion for micro-biopsy and downstream genetic analyses.
What excites you most about this research?
With experiences in biomedical engineering and biotechnology, I am excited to be at the forefront of technological innovations in medicine and actively work on their clinical applications. Novel imaging technology within dermatology as well as other specialties has the potential to completely change how we diagnose, monitor, and treat various diseases and directly impact a patient’s life.
What are the biggest challenges?
One of the biggest challenges for this project is patient recruitment for the study. The melanomas must be large enough for two 1-mm punch biopsies for our research, prior to complete surgical excisions. This is the case in order to eliminate any possibilities that could affect the standard of care. The current standard of care for surgical excisions of melanomas requires that we preserve all the margins (edges of melanomas) of the excised specimen for pathology. In order to do so, our research project requires large melanoma cases which are less frequently seen, in order to sample a 1-mm area without compromising the margins.
How do you see this research changing the way we detect skin cancer in the future?
RCM is already actively being used in clinical settings at MSK, especially for borderline cases or those in cosmetically sensitive areas, to determine whether a biopsy is warranted. Studies have shown that RCM reduces unnecessary biopsies, decreasing the rates of associated morbidities including scars or infections. With the continued evolution of various imaging technology including RCM, the possibilities are endless. In the short term, I believe that we will be able to non-invasively visualize the cellular structure underneath the skin and precisely target areas of interest for micro-biopsy to minimize scarring, bleeding, or infections. In the future, there are possibilities to use noninvasive imaging to not only visualize and precisely determine the types of skin cancers but also predict how the various skin cancers like melanomas are going to behave, based on their genetic makeup.
Do you think this technology will someday go beyond skin cancer detection and into treatment delivery?
Yes, of course. One of the ways that we see our research going forward is to use RCM-guided micro-biopsy to monitor the progression of skin cancers during treatment. The ability to visualize the underlying cellular structures enables us to see and target specific areas of interest for therapeutic delivery and treatment monitoring. With RCM, we are now able to see things that we were never able to see without excising the skin tissue for pathology. Where the limit of such technology lies is something that no one knows yet!
With early skin cancer detection being key for treatment, what impact do you think this technology will have in reducing the mortality rate for skin cancers and melanoma specifically?
With the ability to visualize the underlying skin structures without biopsies, this technology can aid in determining the degree of suspicion for borderline cases, those that are confusing even with dermoscopy, a magnifying glass that dermatologists use to look at skin lesions. This is also useful for lesions in cosmetically sensitive areas like the face where biopsies are unfavorable for borderline cases due to its sensitive location. There are also possibilities for amelanotic melanomas (those without color) and mucosal melanomas, which can be deadly. The application of RCM for mucosal melanomas has only been explored in smaller studies, but I believe it will expand as the technology continues to develop.
What should we be doing to reduce the risk of skin cancer in our day-to-day lives?
First and foremost is sun protection! I cannot emphasize the importance of sun protection in our daily lives, starting from childhood. Physical barriers are the best, like wide-brimmed hats, sunglasses, or sun-protective rash guards at the beach. For exposed areas, using water-resistant broad-spectrum sunscreens with at least SPF 30 or higher is the key. I personally use sunscreen daily, even when I am simply taking a walk around the block—we are exposed to the sun more often than we think!
Science is known for being a male-dominated field – do you have any advice for other girls who are looking to forge a career path in the industry?
Science is an incredibly fascinating field that is challenging but rewarding. It is constantly evolving with endless opportunities for growth—I promise it will never get boring. It has traditionally been a male-dominated field and still is, but the field is moving in the right direction with more women in science than ever before. I would say that finding the right mentor, whether it is someone just a few years ahead of you or actively working in the field is the key. I have had such incredible women mentors throughout my journey who I looked up to and made me realize that I, as a woman, can also pursue science too.
Is there anything else you would like to add?
I want to thank Dennis Gross Skincare for the incredible support to melanoma research and the field of dermatology, as well as my mentors and MSK leadership for their guidance and for the opportunity to research and grow at MSK.