Women’s Health Research Spotlight: Cheng-Han Lee
Cheng-Han Lee has spent the last decade examining the genetic basis and biology of aggressive gynecologic cancer. As the newly appointed Sawin-Baldwin Chair in Ovarian Cancer and associate professor of laboratory medicine & pathology in the Faculty of Medicine & Dentistry, Lee will focus on gynecologic cancers that are most aggressive and most in need of therapeutic advancement. He will also act as a consultant pathologist with a diagnostic focus on gynecologic cancer at the Royal Alexandra Hospital.
You’re returning to the University of Alberta after spending several years at the University of British Columbia and the BC Cancer Agency. What attracted you to return to the U of A?
There was a multitude of factors, but the most important one is the opportunity for me to pursue cancer research further. For the last five years, I have worked at BC Cancer and have learned quite a bit regarding the opportunities and challenges of cancer care—not just from laboratory medicines perspective, but also in terms of clinical treatments and through patient perspectives.
Returning to the U of A will allow me to focus more on translational research work to address some of these gaps and fulfill some of these opportunities. It was an easy decision as it allows me to do what I love to do as well as what is impactful for cancer patients.
Can you share a little about your research and what you like about it?
Being a researcher is like being an explorer. You have to venture into uncharted territory using your best judgment and intuitions on what type of questions to ask, and what type of study to do next. I enjoy the intellectual challenge and the unique type of mental gymnastics that research offers. There are also these exhilarating moments of revelation and triumph, when you make a novel discovery. It is quite addictive and exciting!
I have been focusing on cancer research since the start of my residency, and for the last decade, I’ve been concentrating on gynecologic cancer and trying to figure out what drives these cancers. More specifically, cancer cells usually contain genetic abnormalities that are present in the DNA, so what are the changes in DNA that are causing the cancer cells to behave badly and what can we do about it?
We’ve also devoted significant effort to try to develop experimental models of gynecologic cancer that possess the molecular changes we have identified in order to study them. One of the greatest challenges in personalized medicine is the reality that many cancers are actually incredibly diverse. One person’s ovarian cancer may not be the same as another’s—even if they are similarly labelled as ovarian cancer.
It’s crucial to develop pre-clinical experimental models that will represent all the different spectrums of gynecologic cancers. Once established, we can study them to figure out what makes them behave aggressively and more importantly, determine the drugs they are most sensitive to.
What do you consider your most significant contribution?
Around ten years ago I made a significant discovery in a new type of uterine cancer. It’s a type of uterine sarcoma that originates from the connective tissue cells of the uterus and behaves aggressively. This discovery led to its recognition as a new cancer type, which was subsequently adopted by the 2014 WHO classification system for tumours of the female reproductive system.
The importance of this discovery is that many patients with this type of high-grade stromal sarcoma cancer do not do well as the disease is very aggressive. Armed with this knowledge, we are able to identify the patients with this disease using molecular findings so that they can receive additional treatments and closer clinical monitoring.
What do you hope to accomplish as a researcher over the next few years?
In the last decade, there has been tremendous progress in cancer research due to advancements in genetic sequencing technology. We now have a much better understanding of what drives cancer and the fundamental molecular switch that makes cancer behave badly. However, therapeutic advances have lagged behind. A major hurdle is that we don’t necessarily have the best study model to figure out what drugs work the best.
Together with collaborators across Canada, I will focus on developing experimental models of aggressive ovarian and uterine cancer that contain the various molecular changes that we want to study and find more effective therapies. The main focus over the next five years is going to be very translational, where we work to apply these scientific insights more quickly to improve clinical practice.
Favourite piece of advice from a mentor or inspiring figure in your life?
I started my education in Taiwan and was exposed to some basic guiding principles from old Chinese proverbs. One in particular resonated with me: “Learning is like rowing upstream; not to advance is to drop back.”
This holds true and really applies to people in academics and in research. You have to keep striving forward and constantly thinking about ways to solve research questions without becoming stagnant and risking falling back.
What does the support of the Alberta Women’s Health Foundation mean to you?
It really represents the collective support from all the patients and donors, the patients’ families and friends, and the work they have done to provide support for research. The Alberta Women’s Health Foundation has entrusted and given me the opportunity to pursue women’s cancer research. This tremendous honour is also a responsibility and it motivates me to strive harder in order to ease the suffering caused by women’s cancer.
It is sadly ironic that gynecologic organs like ovaries, fallopian tubes and the uterus give life; but, these same organs can also cause so much suffering when they turn cancerous. All of us have a shared collective responsibility to help to bring an end to such suffering.
It is so important to increase awareness and advocacy around women’s health research and the Alberta Women’s Health Foundation really highlights this importance. Cancer is the leading cause of death for women, and in Canada is responsible for 30 percent of all deaths. There are some cancers targeting women specifically that are in decline—like cervical cancer—but unfortunately, there are other more aggressive types that affect women—like ovarian and uterine cancer—that are steadily rising.
My mom was diagnosed with a type of lung cancer that primarily affects women and is not smoking-related. Unfortunately, she was diagnosed with advanced-stage disease and passed away. When I think about the support from the Alberta Women’s Health Foundation, I think about all the women I have seen clinically in cancer diagnostics. I think of all the women and their families that I have had the privilege of knowing and meeting. And I think of my mom. We need to do better and we will.