At a community event to celebrate 20 years of Women’s Health Research at Yale, three of the center’s successful faculty partners discussed why and how they conduct sex- and gender-based research.
Dr. Ryan Jensen, a leading researcher on the genetic origins of cancer, explained his acclaimed progress toward fully understanding how DNA repairs go awry in the tumor-suppressing BRCA2 gene, leading to mutations that result in breast and ovarian cancer.
“Most cancer is caused by a multitude of different mutations in different genes — very complex and very difficult to approach from a scientific standpoint,” Jensen said. “In part, I’m using BRCA2 as a model to understand how cancer cells initiate and how we can treat cancer. My feeling is that DNA repair really lies at the root of the whole problem in cancer.”
WHRY has provided funding for Dr. Jensen’s work twice, as he nears a practical test that can quickly and accurately determine whether an individual’s particular genetic mutation is harmful. With his most recent grant, funded with a WHRY Naratil Pioneer Award, Jensen has expanded his work from breast cancer to include ovarian cancer. In this work, he is focusing on how cells from fallopian tubes and ovaries react with and without a working BRCA2 protein able to repair routine DNA errors. He also hopes to eventually understand why a new therapy called PARP inhibitors, which block an enzyme that help cancer cells repair damage to their own DNA, can effectively target BRCA2-deficient tumors before some patients become resistant and relapse.
“We’re learning how this therapy works and how to overcome that resistance,” Jensen said.
Dr. Megan Smith, the founder and Director of a nationally acclaimed community-academic partnership to help women in need, explained how meticulous mental health research can lead to the creation of effective, data-driven social programs that improve the daily lives of women.
“I always talk about my work as harnessing the link between mental health and wealth,” Smith said. “The promotion of women’s mental health can really send women on a positive trajectory for economic and social mobility.”
She discussed how she has built on the training she received through WHRY to form a community-academic partnership with nationwide programs to improve maternal mental health and economic stability among low-income women through a community-driven approach.
In creating Mental health Outreach for MotherS (MOMS) Partnership, Dr. Smith has successfully aligned with federal and state government agencies to integrate mental health for women within existing social services.
“We’ve shown that when something is cost-effective, when you are able to show that there are quantifiable benefits for both women and especially their children, then you can garner the attention of policymakers,” Smith said.
For example, Smith described how MOMS is working with state workforce programs to first provide mental health treatment for women with depression or post-traumatic stress disorder so these women can then move on to an employment training program.
“It may not sound novel, but it is in practice quite novel,” Smith said. “This is one of the first times we are actually embedding mental health care into a social services delivery system.”
The third panelist, active cardiologist and educator Njeri Thande, M.D., discussed how her research with WHRY assesses the integration of sex and gender-based findings into the traditional medical school curriculum.
“When I was in medical school, we learned that the reference model for patients was a 150-pound man,” Thande said. “It was not implicitly stated, but it was assumed that women were small men or a deviation from the norm.”
Dr. Thande said she would have hoped that much has changed since then, but only 35 percent of medical students responding to a 2016 survey said they felt comfortable addressing sex and gender differences in health care.
To address this issue, Dr. Thande and WHRY launched a study encompassing 548 sessions of the pre-clinical curriculum at Yale School of Medicine and are using the data to propose changes that would offer a more expansive, integrated coverage of sex and gender.
“We found that in a lot of cases, instructors would talk about the relative prevalence of certain disease states in women versus men, and that was the end of the conversation,” Thande said. “Nothing about why there is a difference or its physiological basis. And no discussion of the different ways men and women might present symptoms or suggest different prognoses and treatments.”
Thande said that working with students, including WHRY undergraduate fellows, helped drive the administration toward taking action.
“A lot of the students had a background in gender studies,” Thande said. “They were really calling for a change in what and how they were being taught.”
Thande is currently a member of a national collaborative of educators from different institutions writing papers and working to change medical school examinations to reflect sex and gender content.
“Because if it’s on the exams, you have to teach it,” she said.
Dr. Mazure sees this and the other panelists’ contributions as important models for exporting and influencing health research, education, and practice around the country and the world.
“The good news is that we have more and more people like the people you see in front of you today who are committed to this kind of work,” Mazure said. “And with WHRY, they have a scientific home they can come to for funding and for support, and various ways we can all collaborate. Thanks to your support, that really makes a difference.”