David Gomez - Cancer Signalling

In conversation with Aoife Gordon, undergraduate medical student, UCD School of Medicine
Read time: 11 minutes 

Why did you choose to follow a career in cancer research?

I wanted to study biology but I didn’t start with the study of cancer.

I first became interested in signal transduction which is how cells communicate. One of the main things that happens in cancer is that these signal transductions are broken. That led me into a study with the RAS proteins which are one of the best known oncogenes.

Since then I have followed a more applied or biomedical side of fundamental science. Still, today, I see myself as a biologist studying signalling that is related to cancer.

What is the focus of your research?

We have different lines of research but the main one is in understanding how signalling networks work. The signalling networks are the mechanisms that the cells used to communicate with the outside. As the name suggests, it is a “network” so there are many branches and points of connection. Some of these connection proteins are more commonly altered in cancer.

We try to understand how a cell works normally. Then we look at what happens when the proteins don’t work and the network is broken. To achieve this, we use a combination of lab research and mathematics.

We have developed a mathematic model that works very similarly to the models they use for weather forecasts. Instead of forecasting the weather, we try to forecast what is going to happen to our cell when there is a mutation or aberration in one of these proteins. With the model you can try to predict what will mutate, how you can target it and how this can lead to a possible treatment. This is the broad aim of my research.

Within this, I specialise in the use of a technique called proteomics. This allows us to study how the proteins interact with each other in a global way using complex machines. The important thing is that this is like fishing with a huge net. We still don’t know the whole map of the network. It’s like trying to navigate the London Underground without a map, you may get there in the end but it will take you longer.

Does this mean you have a diverse range of people on your team?

Yes, on my team there are biologists, bioinformatics experts and computer programming experts. I also work with physicists, engineers and many others which is part of the fun, because, although we are all scientists, we all speak different languages. If we take one scientific term, it may not mean the same thing for a biologist as a physicist.

Also, the way we are trained and the way we work is very different. There is a very wide range. I am lucky enough to work with clinicians, which is great because again they have their own approach.

Of course, we also work with patients. I have been working with patient advocates for six years now, this adds another layer.

How do you involve the clinicians and patients?

Some of them are my colleagues in the Institute. Many clinicians are very willing to collaborate with researchers. Like with most of the people that I mentioned previously, most things start with a cup of tea, just talking about football or whatever! It’s like everything, once you have the channels of communication open, it is easier to talk about common interests.

I started working with patients when I was applying for a grant in the United States. They asked for a patient advocate. At that time, in 2014, I didn’t know what a patient advocate was or how to involve one. I did a google search on patient advocates in Ireland and breast cancer and I found a group called Europa Donna. They were breast cancer advocates who were primarily interested in changing policies.

I contacted them asking if they would be interested in working with me as I needed a patient advocate. They agreed but they did not know what a patient advocate in research was supposed to do either!

So, it started from there and it has evolved. One of the Europa Donna members was appointed to work with me. She came to the lab and we started talking. She told me about her disease and I told her about my research. It was from there that we started to think about how we could work together and how she could be part of the research.

Back in 2014, there was no real patient involvement in research. They were involved in clinical trails but not participating in the actual research process. It’s not a concept that we have much of in Europe. It started in the States, but we have to learn it.

How do you incorporate the values of PPI in your own research?

One of the first and most important things that I have learned is how to communicate in less scientific terms, or “lay terms” as they call it. You realise that people really don’t understand what you are talking about. By speaking in very simple terms, you are not patronising people, you are just making things clear.

This is something that researchers are scared of, of patronising people. The best way of avoiding this is just to listen and to see if the patients are understanding what you are saying or not, and then you adapt.

PPI has also changed the way I organise my group. All the students in my group have to work with patient advocates and participate in the patient involvement activities that we organise.

It has shaped the way I try to teach when I lecture. I try to always bring it to a level that people are going to understand. I was involved in some of the activities to “Train the Trainer”. Basically, we look for ideas on how to explain things to the patients and the scientists and this helps you change the way you communicate a lot.

In terms of the projects that I have chosen, PPI has helped in the sense that I have gone for a more generic cancer approach. By doing this, I hope that if I am successful, it may result in faster specific treatments for a range of cancers.

How did you get involved with the Patient Voice?

I think I might have been involved even before the Patient Voice was started!

It started for me when I contacted Europa Donna Ireland for the grant application. Then, because I had started the relationship, I wanted to do something rather than just forget about it.

So, together with Systems Biology Ireland, the Conway institute and Breast Predict, I organised the first Breast Health Day in UCD. That year we did some activities on campus to promote healthy lifestyle, rather than focusing on the disease. That is what Europa Donna wanted. There were scientists and advocates running activities together. We had a series of seminars at the end of the day with patients and different researchers.

Dr Amanda McCann was one of the speakers and she had already started to organise the Patient Voice in Cancer Research. Some of the initial participants came from that meeting. Since then I have been contributing to the PVCR by doing some demonstrations. I have also been an MC at events because these things run on a very strict timetable and people respect me. I think it’s because I basically look like a bouncer!

I am also involved in the “Train the scientist” programme. On one hand, we train the people that are involved in advocacy and on the other, we train the scientists. I did a course to learn how to do this. With Elaine and others, we organise different training days for PhDs and post docs. We teach them how to include PPI in their work and how to communicate. We also bring over patients and they teach the scientists too.

I am also the Chair of the Class Seminar, which are the seminars run by the Conway Institute. We include at least one training where we bring people from UCD PPI and from the Patient Voice to explain what they do. This is the general theme for PhD students and postdocs and some group leaders.

What kind of things do you include in these training days?

Within the training, we teach how to write a lay abstract. The scientist writes what they consider a lay abstract and give it to a patient who then makes the corrections. That’s the funniest part because at the beginning the scientists don’t understand why the patients don’t understand and the patients don’t feel secure enough to correct a scientist.

But they work together, and at the end they compare the before and after products. We even have them presenting together which is very interesting.

For scientists, we teach them how to write a lay abstract, how to explain their research in an elevator pitch and how to include things in their research when they are putting a grant together. We show them how to incorporate PPI in a meaningful way and also how to communicate and get to know what patient advocates are – many people still don’t know. We use different approaches and it works well.

Are many groups in Ireland doing something like this?

In our institute, Systems Biology Ireland and in the Conway Institute, it is incorporated in many groups now. Outside UCD, RCSI has a similar system. I’m not sure about outside of Dublin.

Patient advocates and patient participation are now compulsory for many grants in Ireland. That is why the Irish Cancer Society are doing training in this at the moment. Patients are evaluating grants and they can decide whether you get the money or not, so you need to take it seriously. You need a proper plan for PPI.

Also, in the EU funded consortiums, you now have to recruit patient advocacy groups and include patient participation, so everybody needs this training. Maybe I am a little bit ahead because I started by accident and decided to take it seriously. It’s a growing movement though, you can tell by the numbers of people getting involved in the Patient Voice.

Would you encourage other researchers or patients to get involved?

Not only do I encourage them, but I pester them! I try to reach the whole scientific community, in the Conway, the SBI and the Charles Institute and also in the School of Medicine by extension. I have also done training for students and post-docs.

The challenge now is to bring over group leaders. Some of them naturally are doing this and there are similar Patient Voice movements in other diseases like diabetes and arthritis. Basically, they follow the path started by Dr Amanda McCann and the Patient Voice in Cancer Research. Some of the training we have done has been together.

I think the big challenge now is to make sure that people really are aware that they have to work with patient advocates and how to do it effectively. This is not a token involvement.

From a personal point of view, I think it is very rewarding. You get to meet a different group of people who are very important for your research. The patients are going through the disease and they know more than you in many respects. They may not know much about the molecular consequences, but they know how it really is to have the disease.

This is not a negative thing, but a positive thing. Most of the people that you meet are people who have actually experienced the disease which shows you that there is hope. They also tend to be people who have a positive outlook which is great for me as a researcher. It’s especially great for the younger researchers, they feel valued.

As a researcher, People often don’t know what you do. One of the advocates I was talking to didn’t even know that there was cancer research in Ireland and now it’s so nice to know that he now knows that it is happening here.

The other thing patients have learned is that we are normal people. Many of them are very daunted by the idea of coming to a university, especially if they don’t have a university degree themselves. They think they are sitting down talking to a “specialist” that knows everything.

I think everybody should try to get into PPI and do it in a meaningful way, with regard for the constraints of time and dedication. If you have a good plan, it’s easy.

This is a new thing, six years in research is nothing. It has only been one or two years since Irish funding bodies started requesting Patient Advocacy groups to be involved in research.

At the first Patient Voice meeting, we didn’t know how many people were going to show up. We didn’t know what we were going to say but now we go there and we all know each other. We see people coming to the lab with new people to have a look around.