For Dr. Rachel Hanisch (Ph.D. ’12), the practice of epidemiology became a study of the world – how it works and how to improve it. While at the University of Washington Department of Epidemiology (Epi), Hanisch spent a summer in Senegal, a West African nation that moves to its own beat. Vibrant colors in city markets beckon like the sounds of steady Sabar drums; inland, dust settles on the dry months like slow, lazy beats. To Hanisch, this land and its people became a source of inspiration.
Hanisch took her experience working in the infectious disease ward at Fann Hospital in Dakar, Senegal and brought it back to the United States. Two different cultures are united by the universal desire to live and prosper, disease-free. In her current position within the National Cancer Institute (NCI) at the National Institutes of Health (NIH), she looks at cancer from all angles to improve lives.
For World Cancer Day, we sat down with Hanisch to discover her story – from an influential trip abroad to the future of cancer research and care.
1. What do you do in your position at the NIH?
I am a Cancer Program Manager for the President’s Cancer Panel (the Panel). The President’s Cancer Panel is a Federal Advisory Committee supported by the National Cancer Institute, one of eleven agencies that comprise the Department of Health and Human Services (HHS) at the NIH. The Panel was created by an Act of Congress during the Nixon administration in the 1970s. Its purpose is to bring important issues in cancer in the U.S. to the public and the president’s attention.
My main job is to advance the mission of the Panel by providing the support that the Panel members need to accomplish this regular process of identifying critical issues, holding meetings, gathering information to better understand the problem, framing actionable recommendations, and communicating their findings via reports and other platforms. So, I help in many steps of the process. The majority of my work involves identifying the experts we need to get to the bottom of an issue, reaching out to these experts, coordinating the meetings that these experts and Panel members attend (along with members of the public), helping to do additional background research and information-gathering, contributing to the thought process behind report development, and helping to edit and produce the report.
2. What do you love most about the work that you do?
I love the fact that reports produced by the Panel have the potential to have significant reach in the field. Although it is hard to make a definitive correlation, it is our hope that these reports, along with other accumulated findings, will be the motivation for important policy changes and for some really big pushes in the field to get issues fixed that are currently impeding progress against cancer in the U.S. For example, one of the reports that the current Panel chose to put out was a report on the low vaccination coverage of human papillomavirus (HPV) vaccines. The Panel made actionable recommendations with the goal of pushing the agenda forward on this topic. This is a trademark of our work: our recommendations should be actionable. Since then, there have been some really great policy changes related to HPV vaccination in the U.S. and some improvements in vaccination rates (53.8 percent coverage among 13- to 17-year-old girls in 2012 compared to 65 percent in 2016). There is no way to directly link things that happen in the field to our work, but [our work] seems to have been an important player in moving the vaccination coverage issue forward.
Doing something that could potentially make an impact is important to me. Hopefully, the work that I do will have an impact on how the cancer field advances in the future.
3. What led you to pursue a degree in epidemiology?
I loved the idea of having a career in the health field. I didn’t see myself being a perfect fit for a career as a physician attending patients – but I wanted a career where my contributions could still work toward improving people’s health and lives.
When I was in my last year of undergraduate school at the University of Wisconsin – Madison (UW-Madison), I saw a notice for the university’s first ever class on public health. I enrolled in the class and soon became fascinated by the idea that this could be a career where I could potentially impact many people at once, on a large scale.
I would also say that this career path plays into my personal interests of traveling and learning about different worlds and cultures. Public health attention is most needed in places where health resources are particularly strained, all across the world. Epidemiology, in particular, seemed like a useful field in that it employs both statistics and science to come up with firm hypotheses and answers for why a certain health phenomenon is happening. So, epidemiology seemed like a great way to obtain the analytical tools needed to perform good public health work in the U.S. and worldwide.
4. Throughout your life, what has been the most influential moment that shaped your career?
There are several. When I was at UW-Madison, I worked in a cancer biology lab at a time when I didn’t know the career path I wanted. At that same time, I was introduced to the public health class I spoke about earlier. I talked to the professor running this lab about my interest in pursuing public health. My professor directed me to a public health colleague of his at Emory University. So I flew there to visit his colleague and to see the Emory campus and public health school. While in Atlanta, I visited the Centers for Disease Control and Prevention (CDC) and spoke to many individuals who seemed to be very passionate about public health and epidemiology. Seeing the grounds of the CDC and watching these epidemiologists in action really inspired me.
One of the other most influential moments in my life was when I went to Senegal while I was a Ph.D. student at the University of Washington. I was working on a research project with my Ph.D. advisor Professor Stephen Hawes, and I spent a summer working at Fann Hospital in the country’s capital, Dakar to complete the project. Part of this project involved investigating the benefits of food prepared for patients using the vegetables grown in a garden on the hospital grounds (the director of the infectious disease ward at Fann conceived the idea for this garden as a way to feed his patients). This really stuck with me. Through this, I realized that efforts to improve people’s health could be made from all angles, by those in many different positions and with many different skills. Something not complicated to us like access to food added stability to these patients’ lives. This simple act of humanity made me passionate for the field. I learned that when you care about the patient, the way to help them will become clear.
5. What do you look forward to in the field of public health and cancer research specifically?
I look forward to all the exciting technology that is on the horizon for the detection and care of cancer and other diseases. There are many cancers, like cervical cancer, that are extremely treatable if caught early. This is not as easily accomplished in developing countries. Many health clinics cannot afford the infrastructure costs associated with cancer detection and treatment (for example, expensive machines, making sure patients are followed up, recruiting trained staff). However, there are so many great new technologies coming out – like apps that can analyze skin lesions almost instantaneously or read cervical smears using virtual trained pathologists.
One of the Panel’s most recent reports dealt with the use of technology in cancer care- it was on the topic of connected health. We defined connected health as the use of technology to facilitate the efficient and effective collection, flow, and use of health information. This could include improving a patient’s ability to access his or her medical record or the linking of medical records to other laboratory information or vital registries (improving interoperability). Connected health could ultimately make it easier for the patient to be treated and the population-level burden of cancer to be reduced. This will lead to big leaps in the improvement of healthcare.