By Susie Allen, courtesy of the University of Chicago Magazine
Photo by John Zich
“ What I’m really trying to do is to prevent any woman from dying from breast cancer if I can help it.”
The Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics
“I know that we can save many more women from dying from breast cancer,” Prof. Olufunmilayo Olopade says, leaning forward in her chair. Olopade, who goes by Funmi, is sitting in her office at the end of a long day, but she sounds like she could be addressing the World Health Organization: “The drugs are there, the women are out there,” she says. What’s missing, in her view, is a will to diagnose and treat people, wherever they live.
Olopade, an oncologist who specializes in breast cancer, sees cancer as a personal threat and a global one. She evinces impatience with the disease and with what she sees as a laggardly response to it, especially in vulnerable and at-risk populations. In the United States, black women are more likely to die of breast cancer than women of any other ethnicity. Globally, more than half of all cancer deaths occur in developing countries. Olopade, the Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics, has made it her business not only to understand those numbers but to budge them. “What I’m really trying to do is to prevent any woman from dying from breast cancer if I can help it.”
Her interests span medicine’s most narrowly focused and intimate concerns—Why did this particular woman get breast cancer? What distinguishes her tumor from other tumors?—and its most sweeping. Why is breast cancer more likely to be fatal in some populations than others? Why do women in developing countries die from cancers we know are treatable? Why is cancer on the rise globally? Why? In her mind, small questions are inseparable from big ones.
This dual focus is “the mark of any great scientist, and especially a clinical scientist,” says her colleague Blase Polite, AB’91, AM’92, assistant professor in hematology and oncology, and it’s part of what earned Olopade a MacArthur Fellowship in 2005. Despite the hype about translational medicine (the ability to take scientific research “from bench to bedside,” as the saying goes), “very few people do it well,” Polite observes. “Funmi does it very well.”
What puts groups at higher risk?
Olopade likes to say that breast cancer is not one disease, but many. Breast cancers are classified by factors including their location in the breast, by whether or not they’ve spread, and by the types of cells within the tumor. These different breast cancers demand different treatments. They may also have different origins, whether environmental, genetic, or a combination of the two.
When she began her fellowship at the University of Chicago in 1987, Olopade saw many African American patients with family histories of breast cancer and aggressive cases of the disease. She was determined to figure out why.
Taken together, Olopade’s pioneering work helps to explain why breast cancer often hits women of African descent earlier and harder than white women. Her research has shown that West African women are more likely to have triple-negative tumors, which don’t respond to common treatments like Tamoxifen, and basal-like breast cancers, a virulent type of cancer that occurs frequently in women with gene mutations of BRCA 1, the so-called breast cancer gene. Olopade also coauthored a 2013 study that found many African American women with breast cancer had inherited genetic mutations, including BRCA 1 and BRCA 2, that put them at higher risk for the disease.
But Olopade thinks differences in tumor biology aren’t the only reasons African and African American women have worse outcomes than others. “There remain variations by race and ethnicity in the quality of breast cancer screening that contribute to this disparity,” she wrote in the Journal of the American Medical Association in 2015. Black women, she noted, often receive delayed and inadequate treatment for their cancer. And despite similar genetic ancestry, African women have higher rates of more aggressive tumors than even African American women, suggesting that environmental and lifestyle factors like tobacco use, diet and chemical exposure matter too.
International exchange of research
For years the data that existed about breast cancer was taken from a majority white population, so it’s no surprise that treatments and research focused on the types of tumors they had. But more data and better data taken from a diverse sample—Olopade recently joined a National Cancer Institute consortium of researchers working on just this issue—means a clearer biological understanding of what puts someone at risk for breast cancer, regardless of their race. With a deeper understanding of the disease, Olopade hopes the focus can shift from “Who dies from breast cancer?” to “What can we do to prevent anyone from dying from it?”
That includes women in developing countries, where cancer is on the rise—partly because people are living long enough to get the disease. Olopade wants to help countries like Bangladesh, Malawi, and her native Nigeria “leapfrog” so they don’t repeat the West’s mistakes and setbacks. For instance, Olopade hopes to see foreign doctors learn about personalized risk assessment for breast cancer rather than just mammography.
Last year, through the Center for Global Health, which Olopade directs, a Nigerian radiologist came to the University of Chicago to train on the latest equipment so she can teach others back home. The center formalized and broadened work Olopade and her husband, Sola, had been doing for years, returning to Nigeria to share what they’d been learning in the United States with doctors there. Now the center sends students from across UChicago to work and study in hospitals and clinics around the world. The center also brings international medical professionals to Chicago to study.
The two-way exchange, according to Sola Olopade, the center’s clinical director, is especially meaningful to him. As a foreign-trained doctor himself, he knows how valuable these opportunities for study in the United States can be. When he and Funmi arrived in Chicago in the ’80s, “there was no way we could come to an institution like the University of Chicago.” He believes “if our students are going to be taking advantage of being out there, other people should be able to come here and take advantage of what we have.”
She believes the key to cancer prevention is to attack the problem from all sides, with the help of all possible allies. “We can’t do business as usual,” she says.
Editor’s note: This story was adapted from the Fall 2016 issue of the University of Chicago Magazine. Click here to read the story in its entirety.
Originally published on April 18, 2017.