Have you ever thought, looking through the microscope on cancer cells or tissues, that we may be organised in the similar way and experience similar processes? Don’t think I am crazy or overworked. My own experience led me to this strange conclusion. I am Marina, a PhD student, studying epithelial-to-mesenchymal transition. Funny thing is that for that I had to transition by myself from being a clinician-oncologist to researcher-pathologist. And I really liked the experience.

I’ve always been keen on science and wanted to be a cancer researcher. However, first I decided to become a medical doctor just to understand the disease and to be able to work with patients and help them. However, several years after graduation I applied for a PhD position and became a PhD student. I chose to study epithelial-to-mesenchymal transition (EMT), as it looked like a not fully understood process important for metastases and treatment resistance. And later on after studying literature I also decided to pay some attention to cancer stem cells (CSC) phenotype as possibly linked to EMT. Interestingly, as the source of CSC is not yet well defined, in some works a less known term of “somatic-to-stem transition” can be met.

But in parallel with reading literature I had to learn new techniques. As I was a clinician-oncologist, working in the pathology lab was a new experience for me. I studied the basics of prostate pathology, preparation and staining of histological slides, immunohistochemistry and immunofluorescence. I tried to apply that for my own research, having both successful and failed attempts. I learned to look at cells and glands and understand their architecture, as if I was reading a story they were telling me. I also continued to practice as a clinician and at some point I realised I am paying much more attention to pathology report details, sometimes being in doubt of it, asking for a second opinion and even changing the diagnosis as the result. I became much more proficient in molecular pathology of cancer, combining knowledge from both areas, being like in-between pathology and oncology, clinical work and lab research. And I enjoyed balancing between those areas.

Once I came upon a nice review on EMT, discussing the latest advances and stating that it is a metastable state. “Metastable – nice word”, I thought. After that even more works have shown that for successful metastasis cells need to be neither epithelial, nor mesenchymal, they need to be in a transient EMT state, combining features of both cell types. And that was the moment I felt like déjà vu: that was how I felt myself – in a metastable state, experiencing plasticity, transitions between states that may be shifted into different directions. Have you ever felt like having much in common with a cancer cell? Strange feeling, really. But I realised that I need to maintain both clinical and scientific capacities to better serve my patients and to succeed in science.

And a broader idea came up to my mind. The sizes are different, but the principles for us and the cells are the same. Plasticity is necessary to be best adapted and to be able more than anyone not being plastic. So if we want to conquer cancer why not to try to use the weapons that our enemy does? Possibly if we experience more transitions, we could be even more adapted and do much more. And even transitions between work and hobbies are possible.

I like Shakespeare’s poetry. And what if he could transit to a cancer researcher? Than maybe one of his sonnets would be like this:

The cells change states, and during EMT
Cadherins switch and cells change their shape,
So epithelium gets traits of mesenchyme,
Somatic cells get features of the stem.
And scientists are in transit just as cells
From PhD to postdoc to PI,
The clinics and the lab research as well
May be by them successfully combined.
And that’s the common point in us and cells.
Transitions are around – that is the fact,
The life is the transition by itself,
We need to transit quickly to adapt.
And in the end it seems to be the fate:
Transition is the only stable state.

About the author:

I am Marina Puchinskaya, MD, an oncologist from Minsk City Clinical Oncologic Centre, Minsk, Belarus. I am also a PhD student studying epithelial-to-mesenchymal transition, cancer stem cells features and their hormonal regulation in prostate cancer. I am deeply convinced that combining both clinical oncology and lab research is essential for success in beating cancer. Or at least I love doing that. And passion is already a reason to proceed.

About this article

This is one of our shortlisted entries for the 2023 EACR Science Communication Prize on the topic of Science in Motion: Navigating Transitions. Choosing a winner was incredibly difficult and we’re delighted to be able to share our amazing shortlist.