What is your current research project?
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| Dr. Noreen Walsh |
As a Dermatopathologist involved in patient
care my research broadly involves diseases of the skin. My particular focus has
been the study of a rare but lethal skin tumor called Merkel cell carcinoma,
one with a much higher mortality rate than malignant melanoma.
Affecting elderly and immunosuppressed individuals,
this rapidly growing cancer occurs mainly on the head or neck. Although some
patients are cured by surgery and irradiation, the tendency of the lesion to spread
quickly to other organs, and the absence of effective therapy for disseminated
disease, often lead to a fatal outcome. In a high proportion of cases a virus
(Merkel cell polyoma virus) is thought to cause the cancer while sun-damage is
responsible for the remainder. My
research has focused on defining different subsets of this disease based on
microscopic appearances, viral status, protein expression by tumor cells and
their genetic profiles. In fine-tuning
the characteristics of any disease the goal is to foster prognostic accuracy
and to facilitate development of novel and effective treatments.
How
did you become interested in your research topic?
Serendipity sparked my interest in Merkel
cell carcinoma. Almost 20 years ago, in the course of examining cases for
diagnostic purposes I made the little-known observation that Merkel cell
carcinomas could have different appearances under the microscope. In essence, some had a pure (homogenous)
pattern and others a combined (mixed) pattern.
In time, this core observation led to recognition of the diversity of
the tumor with respect to its inherent pathological characteristics, its
underlying causes, its biological implications and its susceptibility to
innovative targeted therapies. I have fortunately been able to make several
contributions to this unfolding story since the original “Eureka
moment.”
On this journey I have been supported by colleagues and students
within and outside of the Department of Pathology and Laboratory Medicine
(DPLM) and by funding from the Nova Scotia Health
Authority Research Fund and the DPLM Fund for Molecular Pathology housed at the
QE II Foundation.
What
has been unexpected about your findings so far?
In embarking on this research I was unaware
that the cohort of cases of Merkel cell carcinoma in the Maritime Provinces of
Canada would be different from those in other geographic zones, nationally and
internationally. The relatively high proportion of cases of “combined Merkel
call carcinoma” in this region afforded me an unexpected opportunity to study
this otherwise rare variant of the tumor and compare it with the more common
“pure Merkel cell carcinoma”.
What’s
innovative about your research?
Merkel cell carcinoma, first described in
1972, was historically considered to be one tumor. The innovative aspect of my research has been
in disclosing the diversity of this type of cancer. Following an initial
morphological observation I engaged in sequential scientific studies which
corroborated and expanded upon the seminal findings. Recognition of different subsets of the tumor
is now an important component of ongoing research in the area.
One
word that best describes how you work: Thoughtfully!
What
technology can’t you live without?
The microscope. In the words of the American scholar Theodore
Roszak “Nature composes some of her
loveliest poems for the microscope and the telescope.” By interpreting those
poems we can be of benefit to humanity.
How
do you envision your research benefiting the “public at large” ?
Medical research benefits “the public at
large” by enhancing health and/or preventing or curing disease. A key premise in this context is a
comprehensive understanding of the disease in question. By delineating different subsets of Merkel
cell carcinoma different causative factors have been unveiled which could, in
time, serve to diminish the incidence of the disease. Moreover, informed by the
“molecular fingerprints” of different disease subsets there is the potential
for accurate deployment of novel targeted therapies. These have already begun
to make a positive impact on the treatment of patients worldwide with Merkel
cell carcinoma.
