Dr. Ostrander is one of the foremost canine geneticists in the world. Clear breeding lines make it simpler and faster to study the genetics of cancers in dogs than in humans. Yet, Dr. Ostrander and her lab’s discoveries translate to the study of other cancers in humans. “The genes we find that are important in dogs are important in human cancers as well,” she said. “Dogs and humans are much more closely related than mice and humans.”
Her lab observed that certain diseases are prevalent in certain breeds of dogs, suggesting strong genetic underpinnings. For example, Scottish Terriers have a 20-fold increased chance of getting bladder cancer when compared to other dog breeds. Her research group sequences the DNA of pet dogs to identify and study the underlying genetic causes of the canine cancers.
Working on prostate cancer
Dogs are not susceptible to prostate cancer. However, researchers in Dr. Ostrander’s lab are currently looking for specific germline genes that make men more susceptible to prostate cancer, particularly aggressive forms of the disease. Germline genes are genes that people inherit from their parents. She collaborates with Dr. Catalona and other scientists on this research. “They have put together these collections of remarkable families with several young brothers in their 50s who have prostate cancer, or those who are one of three generations of men with prostate cancer. This tells us there are prostate cancer susceptibility genes,” Dr. Ostrander said.
Her lab also uses genetic sequencing on prostate tumors to determine if the tumor itself gives off molecular signals indicating its aggressiveness. This work is important because the majority of men who get prostate cancer will not die from the disease. “We can get the sequence of the tumor, see slow-growing tumors and bad tumors, and ask ‘What’s the difference in their sequences’?” Dr. Ostrander hopes to be able to identify the smaller subset of men whose diseases are going to be aggressive and potentially lethal.
One example of her work is the BRCA2 genetic mutation. Men who have BRCA2 mutations have more aggressive prostate cancers. Some of her collaborative work with Dr. Catalona involves studying whether or not germline BRCA2 genetic mutations drive the presence of the mutation in the tumor, signaling a worse prognosis.
The future of managing cancer
Dr. Ostrander believes research on prostate cancer and genetics will impact the patient’s experience. “Of course we hope for a cure, and we hope for a cure that maintains a high quality of life,” Dr. Ostrander said. But in the near future, she believes genetic profiling will help physicians better treat each individual patient. A panel of markers and genes could help determine the likelihood of the patient’s tumor being aggressive, metastasizing, or becoming resistant to treatment. “The DNA profile will give the physician a head’s up,” she said. Also, physicians could use genetic profiling to identify immediately which drugs would best work for each individual patient. “We’re not fishing for the right therapies,” she said.
Perspective on physicians
Dr. Ostrander believes that the role of the physician’s intuition will always remain important. “There will be a lot of other things to factor in, like nutrition and general health,” she said. “What impresses me now are smart physicians who understand the underlying biology of disease, not just people who can offer cures or state of the art treatment.”
Dr. Ostrander described Dr. Catalona as a “rare physician-scientist,” and commented on his ability to think holistically about prostate cancer. “He looks at each man at the beginning and says, ‘Now the journey starts, and there are three of us: there’s you, your disease, and me. So how will we travel, and what will we do to make it the best medical outcome for you, and what will we learn to help the next guy?’” she said.
The importance of family
Dr. Ostrander lives in Potomac, Maryland, with her family. Her husband of 24 years, Dr. Edward Giniger, PhD, is a neurobiologist who also performs research at the NIH. The two have had the opportunity to collaborate on research papers a number of times throughout their careers.
Outside of work, their lives revolve around their two daughters, Sasha (age 14) and Genevieve (age 11). “At home I have this very full life with two kids who are doing a million things and projects,” Dr. Ostrander said. Both girls excel at school and are involved in a number of extracurricular activities, including an international choir with which they travel to sing with 8,000 children from around the world. “They’ve both been very fortunate to have gifted voices,” Dr. Ostrander said. The family has traveled abroad so the girls could sing with the choir in Paris at the Louvre and Notre Dame, and at a Papal Mass in Rome.
The family hopes to get a dog soon, and they’ve been discussing which breed to choose. “We haven’t settled on the perfect one, but I think we’re getting close,” Dr. Ostrander said.
Seeing medicine from the other side
Dr. Ostrander’s journey as a parent helped her better understand the experience of being a patient. Due to pregnancy complications when she was expecting her oldest daughter, she spent a lot of time in the hospital and with her doctors. Dr. Ostrander and her husband adopted Genevieve when she was 2 years old, after which she went through multiple surgeries for a cleft lip and palette. “It’s given me a perspective from the patient’s point of view. When you’re living it, you’re living it every single minute of the day,” Dr. Ostrander said. “When I go home and think of other things, these guys [with prostate cancer] are thinking of nothing but prostate cancer. It changed my way of thinking. When you get involved as a researcher in a disease process you become more than just intellectually committed; you have a responsibility to become as scientifically involved as you can.”
Her daughters also give back to others. In the summertime, Sasha and Genevieve make beaded jewelry by hand, then sell it at craft fairs. They donate all their proceeds to Operation Smile, a not-for-profit that provides free surgeries for children with cleft lip and palette. “They’ve funded four or five surgery themselves,” Dr. Ostrander said. “They’ve been doing it for 3 years and they’ll keep on doing it.