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Andrea Miyahira: Hi everyone. I'm Andrea Miyahira, and I'm the senior director of global research and scientific communications at the Prostate Cancer Foundation. March is Women's History Month, and we want to celebrate women in prostate cancer research and oncology.

Today I have the honor of being joined by Dr. Leanne Woods-Burnham. Dr. Woods-Burnham is an assistant professor in the Department of Physiology at Morehouse School of Medicine and is a 2020 PCF Young Investigator. Her research focuses on understanding the biological determinants of the more aggressive disease and the worse survival outcomes that disparately affect black patients with prostate cancer.

Her overarching goal is to develop therapeutic strategies using a precision medicine approach to improve overall survival for late stage prostate cancer patients and to ultimately reduce worse outcomes in black men. She's also highly involved in community engagement efforts and actively partners with key leaders to increase education and make cancer screening accessible for all in an era where differential access to equitable healthcare remains prevalent. Dr. Burnham, it's such a pleasure to have you join us today.

Leanne Woods-Burnham: Thanks so much for having me. I'm really excited to be able to share today.

Andrea Miyahira: Dr. Burnham, as an early career investigator who is already a rising star, a leader in prostate cancer research, I really look forward to hearing about your career journey. What inspired you to pursue prostate cancer health disparities, any unique challenges you have faced, especially as a woman in science in your ongoing research program?

Leanne Woods-Burnham: Thanks so much for having me. Yeah, I have a lifelong commitment to prostate cancer research, specifically as it affects black men. The reason for that, I do like to share with others that my dad was diagnosed with prostate cancer when he was 50. So there's a picture of he and I. He's still with us, thank God, but he was diagnosed at age 50 with aggressive prostate cancer.

From that moment on, I was interested in sort of knowing what were the reasons that he was diagnosed so young and he really didn't have any symptoms. He sort of found out on accident. At the time his PSA was 64, so to find something out like that on accident was a bit alarming.

And then pictured here as well, these are some men from my community where I grew up in Akron, Ohio, and some of the men in the picture have been diagnosed with prostate cancer as well. So for me it was something that's prevalent among family members, among men in the community. And so that's how this sort of shapes my trajectory of why I do what I do.

Prostate cancer in black men, we know that they're more likely to be diagnosed earlier in life, they're more likely to have aggressive disease, and they're more likely to die from prostate cancer. And there's lots of different reasons that go into that. We can talk about access to healthcare, genomics, biology, different cultural influences that may affect that risk and differential outcome.

But I wish there was just one answer because that would make our job really easy. But there's so many things that go into it, and so my research team and others that I work with are dedicated to sort of looking translationally from a few different angles to see how we can mitigate these worse outcomes.

I don't share all the time, but I think this forum is a perfect opportunity for me to share as a woman in science, while I was a student, I was diagnosed myself with stage 4 Hodgkin's lymphoma. And so here I was doing cancer research at the bench and going to class and working on my dissertation, and I was walking around with cancer myself for months and had no idea. It has to be for months if you're diagnosed at stage 4. It means you passed 1 through 3 just going about life.

That happens a lot I see with women because we're taking care of the family, we're making sure everybody else is okay, we're meeting our deadlines, and we're sort of putting our health in the background a lot of times and sometimes when it's too late. I had to take time off of school and do six months of chemo and surgery and all that. And thank God I been in remission since then.

But that also shaped me looking at cancer, not just as a scientist, but then realizing what it actually feels like to be receiving some of those treatments and what it's like for your family to support you and how it is to navigate the healthcare system from that angle. While I can't say that I would do it all over again, it is what it is and it does help shape who I am today and the work that I do.

In terms of what I do as a scientist, I do have a lab at Morehouse School of Medicine where our specific scientific question that is currently funded by Prostate Cancer Foundation and Department of Defense is to look at the role that HER2 plays in prostate cancer aggressiveness in black men versus other men.

We hear about HER2, we know it's a breast cancer gene, but we want to see if there is any role that HER2 plays in prostate cancer because our preliminary evidence is suggesting that it does. And if it does, then that would be something that we could target in the clinic to help improve outcomes for men who would have HER2 positive prostate cancer.

I have a lab that I run, and then also I do spearhead a community-based prostate cancer screening program that we're getting up and running in Atlanta. I did help to develop one with Dr. Rick Kittles in LA for a few years that was very successful. So now we've transitioned to Georgia and we're getting that going here where we provide free education and PSA testing, which is prostate-specific antigen.

We provide that testing in the community because what we know is guidelines for prostate cancer screening have fluctuated through the years, and we want to make sure that men who are at highest risk for aggressive disease, which are black men, that they don't fall through the cracks as these recommendations have fluctuated over the years.

And then we also make sure to get the word out in terms of media, radio, television, social media, anything that we can do to sort of spread the word that men are at higher risk and that if they are detected, if the prostate cancer is detected early enough, then the cure rate is amazing. That's our goal is to be able to detect prostate cancer at early stages.

The picture up there on the right, that's my husband and my three kids. Work is just a portion of my day. I have a child in college, a child in high school, and a child in junior high, and they keep me on my toes for sure. My life is not just dedicated to one sort of thing, and so I have to compartmentalize as I'm sure many of our viewers have to do as they go throughout their daily routines.

I want to share a little bit about the science, just briefly about what I do. I am co-investigator on a clinical trial that's funded by Prostate Cancer Foundation and then also in collaboration with Pfizer. This study looks at androgen receptor characteristics that define populations who have metastatic hormone-sensitive prostate cancer who can benefit from early PARP inhibition.

And so a team that I work with where we developed this trial is we realized that there are differences in the function of androgen receptor based on differences in trinucleotide repeats that can vary because of genetic ancestral influences and genetic variants in the androgen receptor. And so in this study, we recruit African American patients, Caucasian patients, and then also Asian American patients. Right now we are teasing out whether genetic differences in androgen receptor affect treatment response to this PARP inhibitor, which is talazoparib or also known as Talzenna.

And then in the lab, I am looking at HER2 and androgen receptor signaling in prostate cancer. And so in this project, we are collecting circulating tumor cells. We're isolating and characterizing these tumor cells from patients who have metastatic disease. And then we are comparing amplification of HER2 and androgen receptor and seeing if there's any relation to prostate cancer genomics and if that occurs differently in black men versus white men.

And then also we are using cell lines and patient tumor tissue specimens where we can assess HER2 expression and we can compare it to genetic ancestry. And then we can look and see if there's differences in this HER2 expression and genetic ancestry, if there's differences in cell growth, how the cells migrate in the in vitro model. But then also in patient tumor specimens, we can see if this increase in HER2 expression and West African ancestry is correlated with worse outcomes or more advanced disease stage or potentially treatments that these men have been on.

That's just a brief overview of how I got into this work in the first place, a little bit about my family and personal histories so you can see how it shapes my day-to-day approach to cancer health disparities work, and then a little bit about the science of what I do.

Andrea Miyahira: Well, thank you for that, Dr. Burnham. It was so inspiring to hear about everything that's pushed you forward to where you are today. I guess, were there any unique challenges as a woman in science that you have overcome or feel still persist?

Leanne Woods-Burnham: Yeah. You would be surprised some certain comments that I still hear today as a woman in science and mentoring younger women who are in this path where I feel sometimes there's a double standard on maybe our appearance, maybe even how my office is decorated, to be honest. Somebody told me a few weeks ago, "Oh, your office is cute. Can you still get grants like that?"

It's interesting to hear things like that. Or I've heard another comment recently where someone said, "Oh, well, her desk looks cute, but hopefully she can pipette well." This is a person who their CV resume is outstanding, and they certainly don't have any issues pipetting.

But I think these are sometimes issues that men don't have to worry about when they're at work. And so I think being able to be a woman and keep your personality, whatever that is, whatever you're bringing to the table and your own communication style and your own flare and still being able to be successful in that lane is important, is important.

I was trained by one of my initial mentors, rest in peace, her name is Dr. Janet Houghton, and she's a colon cancer researcher out of Cleveland Clinic. She was one of my very first mentors. I remember going in her office and she had on a skirt and heels and she was running a lab. I just thought, this is the coolest thing of all time. How she presents herself, she's not phased and she still is very successful. And so I always held onto that where I was like, I can be me and do me and still do the things that I want to do and make a difference on paper as well.

Andrea Miyahira: Thank you.

Leanne Woods-Burnham: I would say the achievements that I'm most proud of is to be able to communicate to the science world and to make a difference there. But then also when we're in the community and we're able to see that difference where we know we're in the community, and I'll hear a week later, "I'm so glad you tested me. I didn't have any symptoms. I have elevated PSA and now I'm getting tested," or, "You told me about this and I went home and told my buddy and told my brother, and they had elevated PSA and they had no idea."

I would say my biggest achievement is knowing, yes, I can have a successful lab, but at the end of the day that I'm making a difference in people's lives for sure. That helps me to sleep well at night and I feel comfortable and confident in what I do every day.

Andrea Miyahira: I actually think it's so impressive that not only are you doing research in the lab and you're balancing this with your personal life and your family, but also that you're reaching out to the community and creating these initiatives and programs that can affect people in the community. Do you have any advice for other researchers in academics or just in the clinic who want to do something similar and make a difference that way?

Leanne Woods-Burnham: Yes. I feel that everything that I've done at the bench and in the community has always been a part of a team. It's always been well mentored because I definitely believe no man is an island. I don't know how to do everything. I don't even know how to do half of the things and neither does anybody else who's on the team that I'm on. So we're all bringing the pieces and the parts that we excel at.

I think it's so important to realize areas that other people are more skilled at, and then you collaborate with them and have a full picture of how to approach the community. It's always important to have people on the team who are culturally sensitive. Culture is so overwhelming. It's not just one lane. And so culture even entails, my team just moved here from LA to Atlanta.

There's cultural differences even in that, just different geographical regions. So one thing that I'm here at Morehouse School of Medicine as I'm starting to collaborate with different individuals and institutions and community partners. And when they say, "You know, Dr. Burnham, what can you do for you to help your program?" And I say, "If you see anything that you just feel I'm not doing it the Atlanta way." It could be something little.

I want to be effective, I don't want to be offensive. So you don't want to walk into any space and just feel like, oh, I was successful here and I know how to do that, so I'm just going to do the same thing. There's always ways to navigate and shift to make and effect a change where you're at.

Andrea Miyahira: Speaking of cultural differences, you started all these programs while you were at City of Hope in LA and now you're making these programs also in Atlanta. Do you see big cultural differences between the LA and the Atlanta communities?

Leanne Woods-Burnham: I do. I do. There's different communication styles, there's different pace. There's different priorities that are placed on certain things versus other things. So yeah, there are big differences.

I'm from Ohio originally, so I feel Georgia is a little bit more what I'm used to actually, and California was like a learning curve for me a little bit more while I was there for a decade. But there are definitely differences, and there's differences in institutions as well. That's the one thing when we're collaborating, and usually we're doing multi-institutional studies or trials to just sort of get to know how one institution does things versus another is super important as well, because a lot of times the administrative piece can be tricky to navigate.

Andrea Miyahira: Thank you for that. Another question that comes up a lot in disparities research is what factors are making the biggest contribution to this disparity that we see in incidence and worse mortality in the black pop community with prostate cancer?

How do you think about that? How do you decide what's the most important priorities when it comes to studying the contributions of ancestry versus biology that's been acquired from systemic racism versus just institutional, systemic racism, for instance, in medical treatments and things like that?

Leanne Woods-Burnham: Yeah. It's hard to say which one is more important. I personally start with the biology because I saw my dad be diagnosed so young. He's a pescatarian. He works out every day. He's that person where you're like, "Oh, they're doing everything right. They're not going to get cancer."

And then I was diagnosed in my 30s with my own cancer. And so I do feel there's hereditary factors. There's biology that we can't overlook. We can't change our DNA. I will tell men that in the community as well, because sometimes they're just like, oh, if I eat this or do this right. And yes, we definitely want to have these lifestyle factors in place, but at the end of the day, there are some genetic contributions that we still have to be careful and advocate for ourselves and know the genetic component is not going away.

So then if we can figure out a way to address that clinically with a therapeutic option, then to me, that's sort of the easiest fix and that's where we're going to. The more difficult areas are what role does cumulative stress over the lifetime and discrimination over lifetime and institutional barriers that are still very much prevalent in certain areas of our society?

That part of it is important to address. And so one way that we address it is by going out into the community and letting patients know that you have to advocate for yourself in that doctor's office. Your doctor, they may not tell you that based on your family history that you should be screened for prostate cancer, but we're giving you the tools where you can let your doctor know this is your age, this is your race, this is your family history. Whether or not they would recommend it or not, you will feel better if you can just have that testing done. For that reason, that's why you want them to do it.

We also work with clinicians and different institutions more on a systemic level because sometimes there's implicit bias that individuals just aren't aware if they necessarily are giving that off when they're interacting with patients. That's a little bit more difficult to navigate, and there are ways to do that. There's a lot of initiatives out there, especially since all the social unrest in 2020. There are different initiatives to sort of reduce health disparities from that angle, but to me, the biology piece is a little bit easier actually.

Andrea Miyahira: Thank you for that, Dr. Burnham. What are some of your top pieces of advice for young people who hope to have academic careers in oncology, cancer research, or healthcare disparities research?

Leanne Woods-Burnham: I would say to stay true to yourself and the process. I have enjoyed the journey of it. The beauty of it is that science is science. You can do science in any lab. You can go anywhere and do science. But if you're passionate about the health disparities piece as I was, then what I did find is those weekends or late hours in the lab when I would be there, I could draw upon, I'm doing this for this greater good that I feel, and that would motivate me through some of the more difficult times of the journey.

If that's in you, that's something that really can't be trained or taught, it's just in you. You know that's what you want to do. And so there will be hard times, but push through because another piece of advice I would give is all of the good ideas that are going on in your head right now, when you get your degree and you're sitting in those important rooms where the decisions are being made, you will feel so proud of yourself and know that you're making a difference because a lot of the ideas that I bring to meetings and bring to teams now are the same ideas I had when I was a student. I just didn't have the credentials yet.

So believe in what you're working on and the vision that you have. And when you see it through, I promise, when you get to the other side, it will be a lot easier for you to be able to effect the change that you want to see happen.

Andrea Miyahira: Thank you. That's so inspiring. Before we close, I just wanted to put in a plug for our new PCF Women in Science Networking Initiative. We'll be having our first virtual forum that's going to focus on work-life balance on March 31st. These forums are free and they're open to anyone who's interested. So if anyone out there is interested and you want to know how to participate or join our mailing list, just send an email to .

Again, thank you so much for joining us today, Dr. Woods-Burnham. It was such a great pleasure to hear about your career journey and your research and all the differences and impacts you're making in your community.

Leanne Woods-Burnham: Thank you so much for having me.