by Shailesh Advani

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Students of Public Health: Voices & Profiles focuses on research projects and other contributions students are making to advance public health.

Student Voices–The field of epidemiology in cancer research provides an opportunity to understand the disease distribution and its impact on population health, trends, and patterns across diverse racial-ethnic groups and geographical regions, in addition to the impacts new treatments and policy changes have on both incidence and outcomes. As a cancer epidemiologist, my work has focused primarily in areas of gastrointestinal (GI) cancers, prostate cancer, and health disparities. The integration of lifestyle and demographic factors in understanding both disparities in incidence and outcomes has been a key part of my work experience throughout my doctoral program. I am particularly keen to look at genetic and epigenetic changes and their influence on cancer outcomes, especially in GI cancers.

The field of Epigenetics was introduced to me by Dr. Scott Kopetz, MD, PhD. He gave me this unique opportunity to explore the association of demographic and lifestyle factors with epigenetic changes, including DNA methylation among colorectal cancer patients, and its influence on cancer outcomes. As I entered this field, I came to understand the broad focus that epidemiology has, not only in basic public health research, but also in its application in bench science and translational work. My thesis took me longer than expected to complete, not only due to the complexity of my research topic but also due to family issues, which needed to be addressed. My mentors guided me step by step, from proposal development to proposal defense, thesis analysis, and final defense. Some of the key learning factors and skills that I realize all epidemiology students should learn is to have an open mind and learn as much as possible during their graduate education. Coming from a traditional Masters of Public Health (MPH) program where I worked in environmental sciences, during my thesis I learned not only about studying associations with risk factors and outcomes but also about an important concept of “why” by reading about underlying mechanisms between exposure factors and epigenetic changes. Additional key training aspects included having to learn clinical data abstraction, merging datasets from different patient populations, and connecting dots in data analysis. Using data from 3 cohorts of colorectal cancer patients, my work could identify a potential association of lifestyle factors with epigenetic changes and the impact of these epigenetic changes on clinical and quality of life outcomes. Secondly, it introduced me to the field of molecular pathology epidemiology (MPE)—one of the leading areas in the field of cancer and clinical epidemiology research. As I completed my thesis and moved on to my new position, I was keen to complete my manuscripts and disseminate the information through scientific peer-reviewed literature. My PhD was longer than a normal program. It took me 6 years to complete it due to numerous circumstances, but it’s a big achievement once completed, and I plan to cherish it throughout my life. Going through a PhD program gives you the necessary patience and perseverance one needs to achieve the end, while having a balance in personal and professional life.

For students who start their Masters or PhD program, one of the key factors to consider is that the programs they apply for have good accreditation and job prospects. For students pursuing a PhD, an important and critical part is to work with faculty or a group or a lab that can help cover tuition throughout their doctoral program or a portion of it. From personal experience, this can be a barrier to having a focused training program while getting a PhD. Second, keep an open eye and develop sustained collaboration with advisors and mentors. Respect everyone and learn from everyone. Don’t shy away from expressing your concerns or asking questions when needed. Students may not always find the exact match they are looking for, but the key is to learn, excel, and contribute to science. Don’t compare yourself with your batchmates or your cohort group; each one of you is different and talented in your own way. Try to be in the forefront to find opportunities and share them with your mentors and colleagues. Collegiality and collaboration are key to success in the field of epidemiology and biomedical sciences.

During my PhD program, the key factor that kept me motivated was the great length of learning experience I received in each and every task/work I was assigned: large database analysis, grant writing, teaching and networking, proposing ideas, ups and downs in a multidisciplinary group, and the importance to have multiple projects at the same time, as well as the need to focus and prioritize.

The end goal in science is to ensure that our work benefits mankind and moves research forward.

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Shailesh Advani is a research instructor at the Georgetown University School of Medicine. He completed his undergraduate in Medicine (MD) from the University of Seychelles American Institute of Medicine. He further pursued an MPH from Western Kentucky University and a PhD in Epidemiology from the University of Texas School of Public Health.