Antoinette Perry - Prostate Cancer Epigenetics 

In conversation with Aoife Gordon, undergraduate medical student, UCD School of Medicine
Reading time: 7 minutes

By way of introduction, could you tell me a bit about how you got to where you are now?

I studied human genetics in college and I really enjoyed that. I guess I was interested in pursuing a career studying the genetics of disease. From my undergraduate degree, I was particularly interested in cancer.

I went on to do a PhD in Trinity studying the epigenetics of prostate cancer. I really loved that. I found it really interesting and I really enjoyed it. So, I kind of fell into that as my area of expertise and interest. Since then, I have secured various funding and have developed a research team around that area. We have expanded more recently into ovarian cancer as well.

I am really interested in understanding how epigenetics plays a role in prostate and ovarian cancer, particularly in the area of biomarkers. We would rely quite heavily on patient samples for our research.

At the end of 2015, I moved to UCD so I have been there for nearly five years.

What is the focus of your research?

My lab is divided into two halves really.

One half is largely about understanding the role of the epigenome in prostate and ovarian cancer with a heavy emphasis on biomarker research.

The other half of my lab is more functional or explorative. We are really interested in studying the effects of different plant bioactives on different cancers. For example, we are studying seaweeds. We are also studying the cannabis plant and looking at the chemopreventive and chemotherapeutic applications of those terrestrial and marine plants on cancer.

I have a team of four, soon to be five, PhD students. I have another two research assistants. We are about seven or eight in total.

How important is Public and Patient Involvement in research?

I suppose it’s been a relatively new area for me to get my head around over the last few years.

Up until, maybe three or four years ago, I would have said it was hugely important because without patient involvement we would have had no samples. A large part of our work centres around trying to develop a urine test for prostate cancer.

Since 2012, we have recruited almost 600 patients from various hospitals in Ireland. That has been absolutely transformative for our own research and for collaborations that we have as part of an international effort to develop different biomarkers and different tests for prostate cancer.

More recently, we have started to think about what other important roles patients can play in research apart from donating samples. For example, hearing their voice and needs a little bit more, hearing their pains and involving them in the design of the research.

I got one of the IRC New Horizon’s Awards which is basically a PPI award. It’s called IMPROVER, and it aims to involve men with prostate cancer in research. That’s just about to kick off for me. It’s in partnership with the Irish Cancer Society and Breakthrough Cancer Research.

The aim there is to involve men from all around Ireland, from different sectors of society classes and actually listen to their needs when it comes to developing a urine test for prostate cancer. We need to go beyond acquiring samples and actually have patients involved in designing really pertinent research questions.

When did you become involved with the PVCR? How have you been involved with them since then?

I joined UCD in 2015 so it was probably 2016 when I joined the PVCR.

I have gone to various meetings with Amanda, Elaine and the other committee members. At one of the events in UCD in the Conway Institute, we opened all the labs and ran lab tours.

We had a number of groups come to my lab and we basically did demonstrations of some of the different experimental approaches. For example, one of the industry partners who provides the cannabinoids for us gave me huge cannabis leaves to bring into the lab to make it more tactile. They were very pungent!

That was a really nice day. I think we did two or three tours and there were lots of questions. It was brilliant.

Several of the PhD students in my group have been paired up with patients through the Conway. There is an annual presentation of research in a lay format, so the students have been paired with patients to work towards this. That has been really helpful. It helps them to translate their work.

How do you find the dynamic when interacting with patients?

I find it okay. I think I am kind of used to it at this stage. Particularly with the urine work that we do, it is very tangible for men. Generally, people can understand this concept very quickly. It is not an obscure science, it is an easy concept to grasp.

I had a number of meetings with one patient I met through the PVCR. He gave me a letter of support for one particular grant, which was successful. That was really helpful.

Did you learn the value of PPI through your training or through your work?

There was no specific training, I just picked it up as I went along. I suppose because my research has always been very clinical, even from the very beginning of my PhD, I would have interacted with a lot of doctors, more than with patients. The urologists and research nurses have been great.

In the lab we are very far removed from the patient. Even though we have samples from more than 600 men from biopsies, I haven’t collected any of them. I haven’t met any of them, it was all done by the research nurses. So, we are quite removed.

Over the years, I would have been contacted directly by a lot by patients on foot of various research articles that came out. Patients would have emailed me saying, “I have X, can I get the test?”

It’s not that those patients were reading medical journals, but sometimes the articles are picked up by mainstream media. I then get contacted by patients who I have never met. That is interesting.

Where do you see PPI going in your research field in the future?

As I say, I have this new IMPROVER project now. I think it is an 18-month project. We are really going to try to engage with men all around Ireland in terms of feeding into the development of a urine test for prostate cancer. We want to actually hear from them what they want and what will work for them. So that’s going to directly feed into the development.

In terms of ovarian cancer, we have a project under review at the moment which has a significant PPI objective. If that is funded, the patients will be involved in designing the consent forms and information leaflets for actually recruiting samples for patients. There is also a plan for biannual meetings with a smaller grop.

That is through OvaCare, which is a patient association for supporting women who have been through ovarian cancer. We plan to have a patient advisory committee serving on this project to regularly review its progress and to give their feedback.

We also had a plan to write an article with the patient advisory committee. The idea is that the article would detail the researcher’s perspective and the patient’s perspective a couple of years into the project. We would review how the experience was for the researchers and the patients. What impact did the patient involvement have for the researcher? and how did the patient find the experience of being involved in something so new to them?

Would you encourage other researchers or patients to get involved?

I think particularly for researchers starting out, it is hugely beneficial to get them to think about how to talk about science in a very accessible way. It can only be helpful.

A huge part of prevention is awareness and having public and patients involved more in research, by its very nature will increase awareness. That’s really important.

Even with other small things. Take this ovarian project I mentioned earlier. One of the patients told us that she found the use of the term ‘lady’ to be a bit off-putting. She would prefer that we use the term ‘woman’. Something as small and benign as that, can deter patients from becoming more involved.

It’s important to engage with different stakeholders and not be so narrow-minded in the lab just engaging with other scientists and clinicians. Hearing a broader perspective can make the outputs much more accessible and tangible to a much broader audience.

PPI opportunity examples
Communicating in plain English 
- written communications workshop (Pat Fahey, Debbie Hutchinson - communications@migraine.ie)
- oral communications workshop (Kay McKeon)
- judging written/oral communications (Moira O'Brien)