Chris Larson (calarson@ucsd.edu)

Graduate Program:  Biomedical Sciences
Lab PI: Stephen Howell
Undergraduate Education: Utah State University
Med-into-Grad  clinical training area: Cancer
Main clinical mentors: Stephen Howell (showell@ucsd.edu)

Quote: “MIG gave a human element to my research because I have met people who need the benefits of my research. I can see how even small advances in the ability to treat patients will help to save lives”.

Rationale for Med-into-Grad training:
Medical training and identification of medically-relevant research issues:
Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs:
Diagnostic, therapeutic, and research collaborations:
Student-specific experiences:
Long term impact.:
Advice for new trainees--autumn preparatory quarter:
Advice for new trainees--winter clinical training quarter:
Take home perspective on Med-into-Grad at UCSD:

Rational for Med-into-Grad training:  The focus of my thesis research is the study of platinum-based chemotherapeutics. More specifically, I am interested in why it is that there is such a high rate of resistance that develops after first line chemotherapeutic treatment. Very little is know about how, or even why, resistance is developed. While multiple experiments have been conducted no one group has ever identified specific genes that are key to resistance, the only common theme that has been identified is that of decreased accumulation of drug inside the cell. I am studying the major mechanism by which platinum drugs are transported into the cell. As can be seen, all of my research has the end result of benefit for the patient. I work with MDs and clinicians on a regular basis to determine if what we see can be applied to the clinic, or if similar observations can be seen in real life. The end aim is that we will be able to determine ways to either decrease cases of resistance or to discover clinically-applicable methods to enhance sensitivity to the platinum drugs. I have a great need ot better understand how what I see can be translated to the bedside, I need to be able to communicate and understand the medical/clinical aspect of what I see in the lab.

Medical training and identification of medically-relevant research issues: I was heavily involved in the clinical and long-term hospital care of cancer patients of all sorts. I spent a lot of time shadowing attending physicians for the Hem/Onc service. This included daily rounds with the doctor teams, talking with and helping to comfort the patients and their families, and discussing the planned treatment of the patient’s cancer. This aspect was of extra relevance for my research as the determination of how to treat a cancer is based entirely on the patient history and their past experiences with cancer. Some of the most important insights I received were the limited resources physicians have to treat cancers. There are usually only a few treatment options available, and even then many of them are overlapping, so if you fail out of one, you’ll fail out of four or five. I also gained a great insight into the need to emphasize the clinical research options available to patients that may not know that they can be eligible for potentially better treatment and can help to progress the research field.

Research collaborations: Prior to starting with the Med-into-Grad program I had been contacted to provide some insight on ways to enhance the uptake of cisplatin. Prior to the Med-into-Grad, I hadn’t really understood how I convey what the biology behind the uptake was in a way that made sense for the treatment of patients. I now have a much better way of understanding what the doctors need to know and what the scientists have already discovered.

Long term impact: This experience has changed the urgency and reality of my work. I can see how even small advances in the ability to treat patients will help to save lives. I also can see the human element of small things. Things such as a month extension on life doesn’t seem like much from a laboratory stand point, but it is huge for the person that gets the extra month of life.

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs: With the breadth of areas that are encompassed with cancer there are so many unmet needs, and there is always a need for new therapeutics. So while this didn’t come as a surprise to me, what I was surprised about was the limited types of treatment available in so many of the situations. Often times multiple diverse types of cancer will receive the same basic set of treatments, some of this is because of the similarities of the cancer types, but often times it is only because there is nothing else available. The most state-of-the-art types of diagnoses include PET, MRI, CT, and several other types of imaging. In a real extreme case laparoscopic, or even investigatory, surgery can be done to try to visualize the tumors. Obviously there is always need of new diagnostic tools, often times the diagnosis comes as a result of how the cancer responds to treatment- not the diagnosis determining the course of action. This is one area that could use some significant advancements. The problem lies in that it will have to become a very personalized type of diagnosis, due to the high variance of cancer from patient to patient. 

Diagnostic & therapeutic collaborations: Some of the biggest ideas that came to me during my work in the Med-into-Grad were that of improved combination therapies, trying to merge two distinct drugs together in a single course of treatment, looking heavily to synergistic effect over just summation. I have spoken with many MDs about this type of treatment and most agree that this is where the future is headed. I intend to use the multiple contacts and interactions that I made to look into possible clinical collaborations.

Student-specific experiences: I feel that the M-I-G experience has opened my understanding greatly as to the role of bench-top research in advancing the bedside treatment of cancer. I better understand what the doctors need to better fight cancer. It has really given a human element to my research because I have met people who need the benefits of my research.

Advice for new trainees--autumn preparatory quarter: The best way to prepare is to meet with doctors in the field you’re planning on working. Ask them a bit about their work and pay close attention to what they do and say during a normal day. A very good understanding of medical terminology is very useful, but don’t get bogged down in the exact names and doses of drugs, more importantly know what and why about them. So spend some time looking at what is being used a lot right now in the field. You’ll need to probably get a good book like Gilman and Goodman or the PDR. If not you should learn how to use UTDOL. Other than that I would suggest you study the basics of not only what causes cancer and how current treatments work, but I would also look at the stages of progression of several types of cancer and look at typical clinically relevant aspects of cancer in patients.

Advice for new trainees—winter clinical training quarter: Take a notebook with you always. Don’t be afraid to jot down LOTS of notes. I recommend a four-color pen so that you can mark different terms that you are unsure of in different colors (e.g. Red for Rx, Blue for Sx, Green for history of patient). Ask questions especially of MS3, residents, and fellows. They know the stuff and have more time to help than the attending some times. Again, don’t get bogged down in details, focus on the overarching of what’s happening. What’s going on with the patient? What are the concerns? Don’t worry if you don’t know what some aspect means, worry about why it is important. Always focus on what the MDs want to do to help the patient, how they figured out what to do, and what they wish they could do. Pay attention to what the attending physicians say and how the MS3 and residents react.

Take home perspective on Med-into-Grad at UCSD:  Over all, Med-into-Grad was a great experience. I learned invaluable things from the experiences I had here. I am enjoying it so much that I am continuing to work with the MDs even after my official time has ended. This has been a great chance for me to grow and really understand what I need to achieve as a scientist to help advance the fight against cancer. I would recommend this to other students as it is a great way to understand better the great divide that exists between bench-top and bedside. This training is one of the only ways to help translational medicine work in the future. Truly all parties have to be on the same page and this kind of experience allows me to figure where the MDs stand, what they need, and what I can do to deliver the science to answer the questions. Furthermore, this has provided me great networking and larger perspectives on careers and the future of both medicine and research. It was once in a lifetime that should be afforded to more scientists.