Aya Hammad, a University of York Laidlaw Scholar, on understanding the origins of cancer, promoting equality in healthcare, and learning to be adaptable.
Research title: Understanding immune cell dysfunction in the Myeloproliferative Neoplasms
Cancer starts with one faulty cell. There are many ways in which cells can become faulty and those faults can lead to many problems, so I chose to investigate the cells involved in a specific group of those issues. My research is centred around a group of rare bone marrow disorders called Myeloproliferative Neoplasms (MPNs) which involve rapid and abnormal growth of blood cells (1). Patients with advanced forms of MPNs are at a much higher risk of developing life-threatening blood cancers (2). Haematopoietic stem cells (HSCs) give rise to the cells which make up our blood and immune system (3). MPNs and blood cancers can be caused by mutations in the ‘Ten-Eleven-Translocation 2 gene’ (TET2) in HSCs which changes their function. We know that HSCs initiate and drive MPNs, however, immune cells that are made from those faulty HSCs are also thought to play a role in those disease processes and how they progress (4). My research aims to define characteristics of immune cells called macrophages in mouse samples. I compare cells that are normal to those which have mutations in the TET2 gene. These cells contribute to the formation of MPNS and can cause patients to develop cancers.
In the wider context, my research project can facilitate an understanding of the processes leading to MPNs by looking at the immune mechanisms involved. Particularly within cancer research, understanding the impacts of certain mutations and how immune cells behave accordingly may guide further research towards understanding the underlying mechanisms of MPNs. A better understanding of the environment around a tumour is important as it may facilitate understanding of how to manipulate specific factors within the disease environment which can allow for advancements in management, and perhaps further treatments of MPNs as well as other immune and blood cancers.
Where did your passion for this research originate?
As a medical student, understanding the pathophysiology of disease has always been an interesting part of the course for me. Exploring the origin of a problem can help us understand how to fix it more efficiently. We are often taught more about how to identify and treat a disease than about how it comes about so for my research project the opportunity to explore the field of preclinical research was exhilarating.
I was born in Egypt, but my family immigrated when I was a toddler. Although I have not experienced living in Egypt I have seen the disparities in health and education through the eyes of my relatives there. I personally witnessed the impact of different cancers through the experience of members of my family back home. Their health outcomes were impacted by their geographical location and socioeconomic background more than their medical prognosis itself. Although I was not entirely sure what my research project should be about, furthering my understanding of cancer or its socioeconomic determinants were projects I considered early on.
Narrowing my project down further was not an easy task until I found Dr David Kent while looking for a mentor for my Laidlaw project. I was immediately fascinated by his lab’s work on the evolution of cancer cells which in essence meant he was looking into how cancer can come from a single faulty cell. Understanding cancer through looking at the cells which bring it to existence intrigued me, as did learning how our immune system can be the reason cancers are created or destroyed. This combined with Dr David Kent’s passion for his work and his continuous support in every aspect of my project made me have no doubts that this was the right project for me.
What is the most memorable moment from your Laidlaw experience?
I have made many memories as a Laidlaw scholar which I will cherish for years to come. One particularly memorable moment for me was when I had been working at the lab for 2 weeks and was tasked with giving a presentation to my supervisor to check my grasp of the content based on a literature review. I remember how apprehensive I was leading up to the presentation, It was a long process of reading research papers and often not fully grasping every concept. I will never forget the moment I was finished presenting my slides to my supervisor and how pleased she was with my depth of knowledge. Knowing I had a solid grasp of the concepts and was able to share them legibly with an expert gave me an unforgettable feeling. I felt immense gratitude that the hours of reading about immune cells, TET2 mutations and blood disorders paid off. At that moment, I realised that through persistence and revisiting concepts over time, everything does fall into place. I was amazed at how much I had learned during my short weeks in the lab. I learned that in reality, the most daunting part of learning something new is the apprehension around giving my best performance rather than doing the task itself. Taking on the challenge and leaving room for mistakes is the best thing I could do for myself.
What is the biggest challenge you came across, and what did you learn from it?
I think the biggest challenge for me has been dealing with uncertainty. During my first summer project, I experienced uncertainty regarding completing my experiments in the limited time we had and whether they were going to produce valid results. This research period highlighted the need for me to let go of solid plans and the comfort they may bring so that I can grow. The challenges I faced reiterated the notion that being a 'scientist' requires flexibility and openness to change no matter what the circumstances may be. Studying abroad during a global pandemic had not been an easy task. Tackling the uncertainties that come with this reality along with the challenges that come with learning new skills and working on an exciting yet demanding project taught me how to be resilient and adaptable.
Here are my key takeaways from my journey so far:
⚡ Learn to be Adaptable:Learn to let go and take things one step at a time. Trust the process because the greatest progress and achievements truly take time. Focus on what you can give and control instead of what you cannot and be patient with yourself. Things don’t always go according to plan and that is okay.
⚡ Accept Change: Learn to welcome change with open arms. Change is uncomfortable but it is going to challenge you all the right ways. It will push you to be adaptable and dynamic. Spontaneity can take you so far if you let it.
What does it mean for you to be a Laidlaw Scholar?
Being a Laidlaw scholar has been an honour. I have had the privilege of meeting incredible individuals who value ethical leadership and whose passion for their research and beliefs is unparalleled. The Laidlaw program fosters a community where being passive is not in our narrative. Instead, we choose to take action and pave the path for a better future. The program does not restrict us with a preset outline of what the competencies of ethical leadership are. As scholars we are encouraged to find our own paths to becoming ethical leaders and researchers, all while staying true to ourselves which I believe comes with great responsibility towards our communities to lead with integrity. Being a scholar has allowed me to envision the world I am striving towards. Through engaging with the Laidlaw program, I realized that I am interested in global health and understanding health issues that transcend national borders through merging population-based prevention with individual-level clinical care. To me, being a Laidlaw Scholar ultimately means being inspired to make positive change.
Which leaders inspire you and why?
Every time I have been asked which leaders inspire me I feel lost for words. This is down to the fact that to me inspiration comes in many forms and has many faces. Sometimes the biggest inspiration comes from ordinary people around me who display extraordinary acts of leadership. I am inspired when I see my parents consistently making sacrifices for a better future for me, or a friend gracefully overcoming a great deal of hardship, or an educator innovating to empower and enlist a love of learning in us.
If I had to choose someone who inspires me on a bigger scale right now it would be Melinda Gates because of the way she stands by her values and protests for the rights of others, even when it adds no value to her own life. Melinda believes that one life on this planet is no more valuable than the next, and so she continues to fight for equity. Melinda Gates uses her power whether that is in the form of funds or influence to empower those in the world who need it most. The Bill and Melinda Gates Foundation's focus on global health which aims to reduce inequities in health and reduce the burden of disease and the leading causes of child mortality in developing countries is a cause I hope to contribute to one day.
Briefly describe a scene from the future you are striving to create.
The Middle East is a region of magnificent natural beauty, rich in culture and natural treasures. However, many parts of it are plagued by conflict and poverty. I have a strong passion for health equity, global health, and sustainable development and I envision a future where the middle east is a more equitable region with less discrepancy. My dream is to be able to support a more sustainable, reliable, and safer standard of healthcare for the people who need it most. As a future healthcare professional, I hope to be able to contribute towards implementing better and more equitable healthcare policies that can support the public in the region and prioritise their wellbeing. I want a future where we prioritize tools such as Universal health coverage (UHC), which address both the social determinants and the social implications of health by acting on the broader socioeconomic inequities that leave people behind. I want a future where there is absolute international cooperation to show leadership and initiative in working towards reaching the UN Sustainable Development Goals especially those centered around health. I envision a world where access to healthcare is based on need and health is not proportional to wealth. I hope to see a future where an individual’s fundamental human right to healthcare is truly acknowledged.
🌈 Something that made me feel joy recently: Being with my family for the holidays has been such a blessing. My mum and I had a little mother daughter date. Here is a picture she took of me painting a plate!
Aya is a Laidlaw Undergraduate Leadership and Research Scholar at University of York. Become a Laidlaw Scholar to conduct a research project of your choice, develop your leadership skills, and join a global community of changemakers from world-leading universities.
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