UCLA Journal of Radiation Oncology SUMMER 2024 - Flipbook - Page 56
UCLA RADIATION ONCOLOGY JOURNAL
might be able to harness chronobiology as an
inexpensive, noninvasive way to improve cancer
treatments (whether increasing efficacy or
decreasing toxicity).
system, specifically, how subtle changes in
the intensity and wavelengths of light affected
sleep and cognition, with measurable effects
on salivary melatonin levels. I learned about
the dose-dependent association between
artificial light at night and an increased risk
of breast cancer around this time, but not the
mechanism. Eventually I worked at UPenn's
Isolation–Confinement Analog Research Unit for
Spaceflight ("ICARUS," not the most auspicious
acronym for space endeavors), and when writing
our grants and NASA updates I kept finding
studies that connected chronobiology to cancer
biology. That's when it really interested me as
something I wanted to pursue.
E: Another front of your research efforts is
cancer screening/prevention for the LGBTQ+
community. What do you perceive as the most
pressing challenges in 2024 for the community
regarding access to screening, as well as
possible solutions?
N: It's important to keep engaged with the
LGBTQ+ community to understand from
them how specific needs evolve. When we
did our research, sexual and gender minority
respondents tended to cite negative interactions
At the level of the cell, mammalian circadian
rhythms are driven by a conserved set of
"clock genes" which have been implicated in
key metabolic and DNA damage pathways.
This might underlie the line from circadian
disruptions to carcinogenesis, but I wanted
to know if the opposite could be true—could
clock gene-driven functions be leveraged to
boost anticancer therapies? I wasn't the first;
time-of-day effects have been investigated in
the setting of chemotherapy (with positive
results!), with a limited number of studies
published in the radiotherapy setting. While
these are encouraging, all of these studies
(including the one I ran in med school) share a
glaring limitation, which I actually hope to try
to overcome in a future study using some of the
strategies I learned about from sleep studies.
with the healthcare system as the most common
deterrent to routine health screenings. There
were other challenges too, and each of them
impacted the transgender community hardest.
For example, not only do they face greater
discrimination—implicit and explicit—but also
sensitive cancer screenings can provoke gender
dysphoria. On the provider side of things, our
other study suggested that even with the best
intentions, lack of awareness about LGBTQ+
health contributes to the omission of indicated
screenings. Across the nation, though, newer
providers were significantly more likely to
have received LGBTQ+ health education, so
hopefully that's a sign that these knowledge
gaps are closing. As a gay man, I'm grateful to
have worked for health systems with supportive
policies and incentives, but if you're asking
what the most pressing health challenge for the
So yes, in a society beaming with artificial light
and other stressors to chronobiology—and
increasing rates of some cancers—I think it's
worth researching strategies for better circadian
hygiene. But moreover, I hope that researchers
LGBTQ+ community is in 2024, unequivocally
I'll say it's the traction of regressive policies
targeting sexual and gender minorities,
including women.
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