Advocacy, Coaching, Science: It’s about the team
CHAPEL HILL, NC - Bob Millikan likes to point out, "There is no 'i' in the word 'team'." The epidemiologist and crew coach lives by that idea whether the team contains breast cancer advocates, crew members, or fellow scientists.
His own scientific career got off to an early start, he was extracting DNA from Mongolian Prezwalski's horses at the San Diego Zoo when he was in high school. That early scientific preparation, along with experiences in coaching and participation in athletics, shape his work as a leading cancer epidemiologist.
His population-based research has led to important discoveries about breast cancer, based on data collected from women in 44 North Carolina counties participating in the Carolina Breast Cancer Study (CBCS). The third phase of enrollment, now taking place, is called the Jeanne Hopkins Lucas Study, named in honor of North Carolina’s first African-American state senator. Millikan has also completed a 42-county study of melanoma, looking at sub-types of melanoma, the role of sunlight in those sub-types and the influence of geography on the disease.
For Millikan, patients and advocates are a priority. “When they’re with us, the focus changes: we know what’s important,” and he has involved advocates at all phases of his research career. “Some of the ideas for studies we have completed on farming and breast cancer and breastfeeding and breast cancer, came from comments and information given to us by study participants, questions we would never have thought to ask.”
Millikan is himself a longtime advocate. He is one of the founding faculty members for Project Leadership, Education Advocacy, and Development (LEAD), a training program of the National Breast Cancer Coalition begun in 1995, with the goal of getting breast cancer advocates a place at the table. “Having advocates in the room helps the research to be done better,” he explains.
In 2006, Millikan traveled to Ireland on a Fulbright fellowship to learn new techniques in tissue microarrays, to better define tumor types in melanoma and breast cancer. “I was able to test the beta models of products that we now use in our study, so going to Ireland got me a five-year jump on our current study by learning the technology ahead of time.”
He describes the challenges of population-based research. “You’ve got to see the forest for the trees, but you also have to be involved in the details. Another challenge is waiting 3-4 years for the big picture to emerge.”
Among many findings from CBCS, at least one has been groundbreaking. In 2006, Millikan, along with UNC colleagues Lisa Carey and Chuck Perou, published an article in the Journal of the American Medical Association. They reported that younger African American breast cancer patients show a high frequency of one of the aggressive subtypes of breast cancer called basal-like. Their finding was based on protein staining analysis of CBCS participants’ tumor tissue, and now studies are underway to develop therapies tailored for this type of cancer.
"People often ask the CBCS study staff why we are so passionate about women's health. Greg Mortenson gives the answer in his book, Stones into Schools. Greg writes that he builds schools for girls in Afghanistan and Pakistan because when you educate and empower women, you empower everyone. The same is true in North Carolina. If we can solve breast cancer, particularly the problem of breast cancer in younger women and the health disparities surrounding it, then we will have accomplished something very important. Not just for breast cancer patients, but for all cancer patients and everyone affected by cancer. And everyone striving for better health care. It's all about the power of research to change lives."
Learn more about the Jeanne Hopkins Lucas Study
- Watch video interview of Valarie Worthy and Brenda McCants , participants in the study and breast cancer advocates
- Read news release about the study
Read about findings from the Carolina Breast Cancer Study
- Study: Breast cancer in younger black women is more likely to be an aggressive variety
- Lactation and breast cancer risk
- Epidemiology of basal-like breast cancer
- A population-based case control study of farming and breast cancer in North Carolina.
Read more about Millikan’s melanoma research
- Number of nevi and early-life ambient UV exposure are associated with BRAF-mutant melanoma.
- Distance to diagnosing provider as a measure of access for patients with melanoma.