Our laboratory is grounded in fundamental epidemiological principles to obtain a realistic perspective on what causes cancer in children and to determine what we can do as a society and as individuals to reduce the cancer burden. We study cancer within California as a primary resource, but also gather samples and data from around the world. Here are some laboratory activities.

• Measurement of the frequency of childhood cancers in the population.

We use the State of California resources to obtain information and materials to study childhood cancer statewide. This avoids biases if we focused only on one hospital or region. We can assess information about causes of childhood cancers in urban and rural environments, all ethnic groups, socioeconomic features, etc.

• Measurement of genetic factors at birth and genetic and epigenetic changes in cancer.

We examine germline genetic variation as a cause for cancer, and also the tumor genome to see what has changed. We hope to pinpoint the timing and cause of those changes to better identify the causes of cancer when they happen during our lives so we may inform the public on the causes of childhood cancer.

• Determining the role of infection and immune function.

Infections and other factors cause inflammation that can cause damage, but also provide normal immune “exercise.” The immune system can also detect and destroy cancer cells. We explore immune factors that affect cancer risk.

• Investigating chemical and dietary triggers for mutations.

We examine the effects of smoking, other combustion fumes, pesticides, and other environmental chemicals and dietary factors that can cause mutations and developmental aberrations and lead to cancer.

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We hear new information daily on the causes of cancer. This information is fed to us through news sound bites, without the context of how the research was done or how we can use the information within our own lives. Why is it so hard to get clear information?

• Population based research is difficult.

The great variety of people and how they live their lives, what they eat and do makes discovery of risk factors difficult.

• Population-based research makes conclusions based on comparisons of groups of people and not individuals.

A cancer risk factor may be discovered by comparing a group of exposed persons to a group of unexposed, but this does not mean that any one person within that group can personally point to the exposure as a cause for their cancer.

• Measurement of risk factors after someone contracted cancer is problematic.

Since people cannot always recall their past exposures, diet, or infections we do our best to examine objective markers of these features. One source of invaluable material for childhood cancer are neonatal blood spots which can be used to investigate exposures, infections, genetic and epigenetic changes which occurred before birth.

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Primary research findings are published in small pieces and often make a good news bite, but the full story often takes multiple research projects and many years of investigations. This full information may be available through research review papers. (for example: wiemels leukemia review)

Our ultimate goal would be to develop a personalized risk model for childhood cancer while also being able to provide specific measures for risk reduction in those at high risk.

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