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Dr. Electra Paskett

The eastern edge of Ohio is rimmed by a mountain range called the Appalachian Plateau, a densely wooded territory marked by rolling hills, streams, and stunning waterfalls. Most of the people who visit do so for the camping, fishing, hiking, or to tour historic landmarks that reflect the Native American and coal mining heritage.

Dr. Electra Paskett and her colleagues at Ohio State University (OSU) come here for a different reason. In this part of Appalachia, where the job market is depressed and poverty runs deep, the use of widely available cancer screening tests is low and, in turn, the cancer incidence and mortality rates are distinctly higher than in other parts of the state. "There's a problem here," she says. "We need to understand why and then do something about it."

The residents who live here are a world away - both economically and culturally - from where Dr. Paskett was raised. She grew up in Manhattan, where her late father, who was Greek, worked as a concert violinist and conductor. Nonetheless, in the course of her life and research, Dr. Paskett has developed a profound commitment to the welfare of people in Appalachia and other underserved areas of the country where circumstantial factors contribute to cancer health disparities.

"This is really important for the work that we do," says Dr. Mira Katz, a colleague at OSU. "She can take off her 'Dr. Paskett' hat and has the ability to talk one on one with people from different communities to find out the best way to connect with them. She's there to really help people, and that comes through all the time, despite differences in race or gender or any other demographic factor."

The connection may exist because for Dr. Paskett, this work is personal. Her first breast tumor was diagnosed in 1997 on a routine mammogram. Despite the fact that her mother and grandmother both suffered from the disease, she says, "The diagnosis still came as a shock." After surgery and radiation, she developed lymphedema in her hand and arm. Four years after the initial diagnosis, she had an axillary node recurrence. The second round of surgery and radiation, this time with chemotherapy, caused her to develop an enlarged, weakened heart, commonly called cardiomyopathy.

Her training as a cancer researcher (at the University of Utah and University of Washington in Seattle) brought only some comfort during the experience. "I knew that the treatments were good," she says, "but I also knew what could happen." She learned quickly that her familiarity with the health care system helped her identify who could answer her questions, "But this made me feel more empathetic for everyone else who is not a faculty member and doesn't have as much knowledge as I do."

Despite the long-term effects of her treatment - now mitigated by compression garments to limit the lymphedema swelling and medications to offset her heart damage - her friends and colleagues, including young investigators who she mentors, say that cancer has not kept Dr. Paskett down. In fact, they all remark on her energy and enthusiasm, which have led her to expand her research into lymphedema prevention and treatment, as well as quality of life for breast cancer survivors.

"Not many researchers span the cancer control continuum as she does," says Dr. Julia Rowland, director of NCI's Office of Cancer Survivorship. "Most people focus only on one aspect, such as treatment or prevention, but she has considerable breadth. This is one of the things that makes her such a strong researcher. She is a classic investigator who asks good questions and is open to new ideas. Integrative health, the interplay between mind, body, and environment on health, diversity and cultural competence…She just gets it."

Those who know her also admire her ability to accomplish so much while also finding time to enjoy her husband and three sons. She says that the secret is working smart. "You have to have a balance between your family, your work, and yourself - hobbies and other things that you like to do." As an example, she makes time for exercise almost every morning, and takes her husband, a physician assistant, along on trips if work requires her to leave during his birthday or other special occasions. If she is invited to a speaking engagement in New York City, she usually accepts because it gives her the opportunity to visit her oldest son, who is a college sophomore there.

Dr. Paskett says that one of the things she enjoys so much about living and working in Ohio is the diversity of surrounding populations. She also enjoys the direction that her research program is heading. "We're bringing biology in with behavior to look at the effects of lifestyle interventions on disease markers," she says. She's especially enthusiastic about ongoing research within the OSU Center for Population Health and Health Disparities, which is one of eight centers that work together as a network to explore the complexity of health disparities.

"We're looking at the issue of stress and how it relates to cancer, as well as other diseases," she explains. A research group in Chicago had done previous work showing that stress in animals can be induced by isolation, and that this in turn increases their tumor burden. This relationship in humans is now being examined across the eight centers.

"On the south side of Chicago, we saw big parallels with the animal models," she says. "In economically depressed, very urban neighborhoods, African American women didn't want to go outside of their houses. And here in Appalachia, we saw the very same things. We spoke with mainly rural white women, most of who had an abnormal Pap and were positive for HPV, and they said, 'I can't leave my house. We have no transportation, we have no jobs, we have no money to do anything.' So it's very interesting to see that underserved populations from different backgrounds and regions share the same problems. That deep down, they're more alike than they are different."

—Brittany Moya Del Pino