Our Roving Reporter Clare Watson chats to Lorraine Chantrill, Honorary Research Fellow, The Kinghorn Cancer Centre at the Garvan Institute of Medical Research, and Senior Staff Specialist Medical Oncology, Clinical Lead, Oncology Clinical Trials, St Vincent’s Hospital.
Clare: Lorraine, you’ve forged an exciting career in translational medical research and you are applying your oncology training to clinical trials. What is your current role and what does a normal day look like for you in this role?
Lorraine: My main job is as a practising medical oncologist but what I really love doing is trying to combine that with translational medicine and the best way I can do that currently is within clinical trials. Clinical trials in oncology are often testing new treatments but increasingly we are also collecting tumour specimens from patients and looking for biomarkers that might predict response to those treatments – that’s really exciting.
In terms of my average day, it’s quite variable because my clinical work is very different day-to-day to the translational work. As well as seeing patients in the hospital or in the clinic, I manage the clinical trials department [at St Vincent’s Hospital] to make sure all the trials are running properly. Often they need input from me with start-up visits for new trials, for example.
I also maintain a research interest in the Australian Pancreatic Cancer Genome Initiative. I meet with the group every fortnight to assist with ongoing action items and projects. I don’t at the moment do any bench work myself; it’s more about directing ideas on translational research into projects for the scientists I work alongside.
The part of my job that I enjoy the most is the research part – but it is also the part which can be the most frustrating in the sense that I actually feel like I fail most of the time. Doing research in cancer that translates into actionable changes and results in improvement in patient health is really challenging. But it has happened in other diseases and it is happening incrementally in pancreas cancer. I like to quote J.K Rowling about the fringe benefits of failure. As some people will know, we ran a clinical trial in pancreas cancer that didn’t work but I think it’s important to capitalise on the learnings from failing to do something properly.
Clare: You started your training with a science degree before you completed medicine. After this you spent several years working as a researcher between Oxford, UK, and Sydney, Australia. What were your motivations for completing your PhD after your medical training?
Lorraine: I would say that I have been very lucky to be in the right place at the right time along the course of my career. The first time was when molecular biology was evolving. PCR was first described in 1986 and in 1989 I started doing PCR in a laboratory in Oxford. We used very crude techniques, manual cycling samples between water baths set at different temperatures, and you can imagine the scale on which we could do things – tiny compared to what is possible now!
I was able to apply that experience in molecular biology to a project in Sydney on human papillomavirus in cervical cancer. In that job, I was exposed to the medical side of cancer. I would stand outside theatres obtaining specimens of cervical cancer but I decided that I would rather be treating patients. Around the same time, I had a personal connection with cancer when my mother died of cancer, so that really cemented my determination to do medical training.
As to why I did my PhD after a medical degree, that was because an opportunity presented itself with the Australian Pancreatic Cancer Genome Initiative after I had completed my oncology training. I was looking around for a research project and it was a fantastic opportunity to be involved in something from the beginning.
Clare: What has been a highlight for you in your research career?
Lorraine: I think that just being around when the concept emerged of analysing a tumour at the molecular level and then trying to design treatment based on that information – I think that is amazing. I think people who haven’t lived through [cancer genomics] not being available don’t really understand how powerful that knowledge is. We take it for granted now but imagine if you were trying to treat things like a black box. Being a part of the process to unravel [cancer genomics] has been a privilege.
Clare: Do you have any advice for a clinician who is interested in incorporating research into their career?
Lorraine: It is challenging because those two things, lab research and clinical practice, until recently, have moved in very separate circles and there has not been very much crossover, until now. I think the concept of a career as a clinical scientist is evolving in Australia and there are more people wanting to do that, and doing research quite successfully.
My advice to a clinician wanting to start at a grassroots level would be to just ask – to get involved, ask what is going on in your institution or the one next door, find out what people are doing and go and meet them. It is very powerful – the cross-fertilisation between those two domains – because it’s surprising how differently the clinicians and scientists think sometimes. We can help each other by making sure that assumptions that are perhaps made at the beginning of a hypothesis are not incorrect.
I think, as a clinician, you should also start out not expecting anything but just to contribute and participate. To expect tangible outcomes right at the beginning of a partnership is unrealistic. It actually takes a long time to demonstrate your commitment to a project and these should be long term partnerships. I participate in lab meetings occasionally, for example, and I flagged with lab group leaders that I am available to offer advice.
Clare: That’s a good point to make about clinicians being involved in that planning stage of a research project. As one of your professional aims is to enhance the culture of translational research, do you have any advice for a lab-based researcher wanting to develop a translational project in medical research?
Lorraine: I would say we have, as clinicians, been very slow to invite the scientists into our realm. One thing I initiated at The Kinghorn Cancer Centre is to ask scientists if they wanted to sit in on my clinic so that they could see the complexity of discussions that we have with patients. I think when scientists are doing experiments or preclinical research on certain medications they want to test it in a trial but what is hard to realise unless you experience it is the nuances of each person, their preferences and how sick they might be, which is hard to convey. I think for a scientist to observe patients and doctors in the clinic is a really useful exercise.
Clare: As you know, here at Franklin Women we aim to connect women working in diverse health and medical research careers to promote new professional relationships and opportunities. Is there a particular person that you have met over the course of your career who has been influential in you getting to where you are today?
Lorraine: In my research at Sydney University I did meet a woman who, like me, did a PhD at an older age. I think that is inspiring that there is no age limit. I was surprised, for example, when I applied for my Australian Postgraduate Award that there was nowhere in the application form where I had to declare how old I was and I think that is really good. I would encourage women to do research or a PhD if they want to – it is more about the passion for the subject than the place you are in your life – and remind them you don’t have to do things in a prescribed order so take opportunities when they arise.
Clare: Yes, you have shown with your career that you can integrate research at different points, whether that is as a primary focus, like a PhD, joining side projects or through ongoing conversations. Thank you, Lorraine!