NIKESHA HAYNES-GILMORE, a TT-born molecular pathologist and research assistant professor at the University of Rochester Medical Center in New York, recently received a career development award for cancer research.
Haynes-Gilmore, who grew up in Chaguanas, saw herself becoming a vet as a teen, but said the trajectory of her professional path changed in college after her grandmother died of cancer. The past student of Holy Faith Convent in Couva migrated to the US after completing her A-levels in 2002.
For the past 30 years, the Cancer Control Program has done cancer-related research across the US. The programme investigates prevention and management of the side effects associated with cancer and cancer treatment.
Haynes-Gilmore is among seven faculty members internationally recognised for their outstanding work in cancer research and treatment.
This grant was set up to fund the necessary infrastructure for research-based clinical trials. Haynes-Gilmore was granted the award to help with a pilot randomised clinical trial to investigate the effect of an anti-inflammatory nutritional supplement in reducing inflammation and frailty in older survivors of colon cancer. It has an emphasis on recruiting older black survivors of colon cancer.
Pathologists are medical professionals who study bodies and body tissues.
Describing her career so far, Haynes-Gilmore said, "I normally will say I am a molecular pathologist by training, with a focus on cancer molecular mechanisms. I have now fused that background with clinical and public health research."
Haynes-Gilmore said she hopes to help bring attention to inequities in healthcare.
"It is known that racial inequities negatively impact health. Blacks are disproportionately affected by cancer as well as cancer and frailty, meaning cancer and the elderly."
Frailty, she explained, "categorises an individual’s physiological reserves and is an important factor for oncologists in determining the risk of chemotherapy toxicity. Inflammation has been shown to be a major contributor to frailty.
"However, the majority of research linking inflammation to frailty has not been done in the context of cancer treatment. With my co-authors, I have published that in patients with breast cancer, inflammation prior to cancer treatment and the change of inflammatory markers with chemotherapy is a predictor of post-treatment frailty. We also demonstrated a longitudinal relationship between immune cell profiles and frailty."
She said research has shown that in people of African ancestry, there is increased inflammation compared to other racial groups.
Asked what causes this, she said preliminary studies found that "socioeconomic status and perceived discrimination were contributors to the increased inflammation."
The specific cause of the disparity in inflammation,, she added, "is still being actively researched. Research is suggestive that social determinants are as important or can be even more important than health behaviours as it relates to health."
Haynes-Gilmore is excited about getting her study off the ground and said the ultimate goal is to develop interventions that address health inequities, thus aiding black people in achieving their fundamental right of health – an inequity that has been evident in the covid19 pandemic.
"Issues related to health inequities are being highlighted again due to covid19. There are reports that people of colour are disproportionately dying from this disease. Many of the reasons for the increased mortality stem from inequities.
"I hope that in the future there is more research in health equity and that governments make policy changes to improve health equity for people of colour around the world."
For her doctorate in pathology, Haynes-Gilmore studied molecular pathways, some of the smallest pathways in the human body for transmitting information, utilised by cancer to escape recognition by the immune system. The rate of detecting cancerous cells is slowed, as the usual identifying symptoms are limited.
Asked to share her research interests and aspirations, she said she is passionate about improving outcomes for older adults with cancer and reducing health inequities faced by people of African ancestry.
"This passion stems from my lived experience. I lost my grandmother to cancer; she experienced no treatment benefit despite severe chemotherapy toxicities, reduced quality of life, and physical and functional impairments.
"Furthermore, as a female researcher and mother of African descent, I have experienced first-hand the negative effects of inequities on my family’s emotional well-being."
This fuelled her aspiration to become an independently-funded translational scientist (scientists who use research to improve human well-being) who designs and implements interventions to improve outcomes for older adults with cancer.
"I dream of a future where people like my grandmother can age successfully without concern about the influence of race on their health and well-being."
Explaining how her research is applicable to TT, Haynes-Gilmore said, "There was a wonderful epidemiology study recently published about cancer facts and statistics in TT. In this study, it was found that the incidence and mortality rates of most cancers were higher in Trinbagonians of African descent as compared to other racial backgrounds."
However, she stressed, "At this time, I am not aware of the rates of frailty or elevated inflammation by racial/ethnic groups in TT."
She said if her current work proves effective, she sees no reason why the findings may not be beneficial to the population of TT.
A summa cum laude graduate of the historically black Lincoln University, Haynes-Gilmore is a first-generation college student in her family. She did her PhD in pathology at the University of Rochester.
Asked what professional challenges she had to overcome, Haynes-Gilmore said, "In my fourth year of completing the PhD, my adviser accepted a job offer at a different university. At that time, I had to restart my thesis project.
"But in hindsight, I am reminded of a saying my friends shared with me: We plan and God decides. I think if I didn’t have to restart my thesis with a different adviser, I wouldn’t be doing the research that I am doing today and I love what I am doing."
As an international student in the US, she said there are also challenges – some opportunities available only to US citizens.
"It was challenging for me to find a research internship. I was unable to secure a research internship until my junior year of college.
"So instead of directly applying to go to grad school at the end of college, I decided to take a year off. In this time, I was able to work as a research technician and in doing so, gain some skills to help me be competitive in applying for graduate school...I think that this year off was extremely beneficial personally and professionally and helped pave the way for what I am doing today."
Having accomplished all she has as a woman of colour from the Caribbean, Haynes-Gilmore said she feels a deep sense of pride and hopes to serve as a source of encouragement for young women from the Caribbean to chase their dreams regardless of their current life situations.
"Our current situation should not be the canvas for what our future should look like."
She emphasised the importance of collaboration, highlighting teamwork as a way of building individuals by supporting each other.
"The field that I work in is collaborative. We believe we are stronger and go further if we do it together. You would notice when I told you about my research I used 'we' pretty often.
"That is because it is all a team effort. We work together and we support each other in all of our endeavours. Honestly, I think if this model could be adopted broadly, we would see greater things being achieved as a society. In this model, as I step forward, or someone else on my team steps forward, we pull along the others. It might mean that instead of you yourself going forward ten steps you only went forward one step, but if you count all the steps that went forward, it’s probably now 20 or more steps forward. So collectively we made more progress."
A wife and mother of two, a son and a daughter, she said she keeps motivated by the impact her work has on families.
"In the field of cancer, you always hear stories from patients and/or their families. Stories about how much their life changed as a result of their diagnosis. How many issues they still face even after their cancer is cured.
"Helping these patients have a better quality of life is my motivation. In the context of health equity, knowing that inequity results in a host of negative health outcomes is also a driving motivation. My colleagues and I frequently chat about what we can do to reduce health inequities and with this clinical trial I hope that this can help in some way."
Her message for people seeking to follow their professional dreams is, "When you are afraid to chase your dreams, sit and ask yourself what are you afraid of and be honest with yourself about the answer."
She said people are often afraid of failing, but added, through failure there are many lessons.
"So go ahead, chase your dream. If you succeed right away, amazing. If you don’t – like most of us – give yourself a short time to grieve your failure, then evaluate the lessons learned from that attempt and try again. We are all stronger than we think."
Haynes-Gilmore wished to encourage readers with a message she would have given to her 16-year-old self: "You got this. Keep your chin up, keep pushing. God has a plan for you."