Profiles in Medicine - Taylor Crawford
Decoding Prostate Cancer: Research and Realities
September is Prostate Cancer Awareness Month, making this an ideal time to encourage the men in your life to schedule a screening.
To illuminate this important issue, we highlight Taylor Crawford, a young female health professional and PhD candidate who serves as a member of the WIMLF Advisory Leadership Council. The Council provides strategic counsel and support to the WIMLF Board and Staff, leveraging members' expertise to advance the organization’s objectives and represent WIMLF within the community.
Taylor Crawford is currently a PhD Candidate at the UPenn School of Medicine in Philadelphia, where she leads prostate cancer projects in Dr. Kara Maxwell's lab. As a trained geneticist, Taylor works with electronic health records to analyze genetic testing results linked to clinical features, including treatment response, disease progression, pathological data, and tumor burden. For her thesis, she is modeling the biology of prostate cancer as seen in genetic carriers with the disease using primary cancer cell lines and surgical specimens.
Our conversation with Taylor called attention to the importance of diverse representation in medical research. As an example, in her focus area of prostate cancer research, a lack of collecting and utilizing patient samples from underrepresented patient populations has placed limitations on the ability to investigate the origin and progression of prostate cancer in men of color. Consequently, prostate cancer treatment outcomes between white men and men of color reflect this disparity, with Black men being twice as likely to die from the disease and twice as likely to be diagnosed compared to white men. Equitable representation has only relatively recently become a priority in medical research; therefore, many vulnerable populations do not benefit as profoundly from research advances.
Taylor expressed similar concern for representation in the field of medical research, including for women:
“...there are consequences from the lack of representation within science and medicine. Representation matters because research only happens in populations that are being studied. So, for example, if most researchers don't really care about vulnerable populations, they are less likely to study vulnerable populations, and less research is done on those populations. I’m truly so passionate about representation in science and medicine, because there is simply not enough of us, and women can bring very important and interesting perspectives.”
Was there a particular woman in medical research who piqued your interest in this field?
I've always been interested in science and medicine, so I followed a Pre-Med track. When I decided not to pursue an MD, one of my family members connected me with a woman named Dr. Alyssa Agnes, who was working in the biotech world. She's a Black woman, PhD scientist. She helped me understand what it’s like to be a woman in science. I let her know that I wanted to do patient-focused research because I was still interested in medicine. She then helped me work through how I could craft my applications to reflect that. She also helped me to understand what I could do with my PhD and still be able to work with patients. She really inspired me.
What personal experiences sparked your passion for medical research?
When I was younger, I was always interested in why our bodies do the things that they do and how our bodies work. The reason why I chose molecular biology research and genetics was because of the undergrad courses I took as a biology major. When I took anatomy, I thought, “I don't think I care about what bones do, but I do care about how cells work.” When I learned more about DNA, I was baffled at how there are so many genes, and they're so small, you can't see them, but they have huge impacts and can mutate and lead to many different types of diseases. Eventually, I discovered that I wanted to do cancer research while also pursuing my passion for genetics.
In what ways do you believe female medical researchers can bring unique perspectives or strengths to the field?
First, women think differently than men. Women tend to be concerned about vulnerable populations because of our position in society. As a result, a lot of women get involved in health disparities research and pursue finding solutions. Women recognize the disparities in medicine firsthand. For example, Black women are three times more likely to die from pregnancy compared to White women. But [Black] women know about that because we have to give birth to babies. There are many things that women can recognize in society that may be perceived differently from a male perspective. And there are consequences of the lack of representation within science and medicine. Representation matters because research only happens with populations that are being studied. So, for example, if most researchers don't really care about vulnerable populations, they are less likely to study vulnerable populations, and less research is done on those populations. I’m truly so passionate about representation in science and medicine, because there is simply not enough of us, and women can bring very important and interesting perspectives.
In what ways do you think this lack of representation contributes to the racial disparities that exist in healthcare?
Learning about health disparities was a big reason why I decided to study prostate cancer. In the United States, Black men are twice as likely to die from the disease and twice as likely to be diagnosed compared to white men. I got excited about studying prostate cancer because I realized I could make my thesis project into a health disparities project. I have had the pleasure of studying a large population of prostate cancer patients who self-identify as Black while working at the Veteran’s Affairs Medical Center in West Philadelphia because it is a predominantly Black community. The amount of patient samples we have from Black men is a tiny fraction of the amount we obtain from White men, and the availability of patient samples is important because if we're only answering questions for a single population, we are not really understanding the whole scope of a disease as it relates to other ethnicities and races. It's something that I am passionate about, and it's something that will be a major topic in my thesis.
What personal philosophy or guiding principle do you rely on to stay motivated and passionate in the demanding field of medical research?
At baseline, just getting to where I am was difficult, and now pursuing a Ph.D. is very hard. It's hard for everyone, but then, if you're a woman, and then if you're Black, and then, if you don't have people that look like you in the field, that's just a whole other layer of stress. That, unfortunately, is something that I've dealt with in science for many years now. But what motivates me is when I mentor high school and undergraduate students who are interested in science, they say, “I've never met someone in science that looks like you, and I really want to pursue a career like yours, but I don't think I can.” And I always tell them, “Your mind can learn whatever you teach it to learn. I’ve decided to do this with my life, but anyone could do it if they really want to.” So, talking to people who want a career in science but feel like they can’t motivates me to continue to pursue this career.
Also, working in academia is hard, because academia has a representation issue. When I go to Black Student Organization meetings and we share our experiences, we are creating a community among people who are going through similar challenges. Not only that, but we also want to make it known that these challenges exist. I am motivated to keep talking about these challenges because I have learned that not speaking about them is not helpful. If no one speaks about them, people think that they're going through it alone. Graduate school is already hard enough, so the things that motivate me to keep going are talking to younger people and having a community that understands the challenges that I have faced and talks openly about how to overcome them and stay focused.
What advice would you give to other women who are considering or currently pursuing a career in medical research?
I have two great pieces of advice that someone gave me when I started. The first one is to not be afraid to ask questions, not only in an academic class but also if you are deciding on a program. Ask tons of questions about how the program works, what daily life is like, and other basic questions. Find a person who plays a leadership role, and don't be afraid to ask them everything that will help you make a decision.
But the other thing that I learned very early on is to find someone to advocate for you as a student. That person could be in a leadership role, has been in the program for a while, or someone who knows somebody who is known to play that role for other people. This person will talk you up, advise you, and encourage you. Having a person like that in my life was super helpful to me, and that kind of relationship is very special. Find someone to advocate for you because, as a student, you don’t have much power.
How do you balance the demands of a career in medical research with your personal life, and what strategies have worked best for you?
I've gotten good at time management, and that's the first thing I had to get good at. I also had to get good at boundaries with whoever I'm working with, like how late I can work or how much time I give to people throughout the week.
My other rule is that I always give myself at least one day out of the week to do things for myself, like read a book, hang out in my house, grocery shop, or get coffee or dinner with a friend. The benefit of this is that I am not thinking about science that day because science is a lot to think about every day. I also want to make sure I allot time to choose myself in those situations because it is extremely easy to get lost in what we do. I am also blessed with an amazing cohort of people who started at the same time I was starting my program, and we all became really good friends. I do not know what I would do without them, I can't imagine how hard it would be if I didn't have amazing friends to support me.
As you look to the future, what are the aspirations that drive you, and how do you envision achieving them?
Two very different routes are both intriguing to me. I am very interested in biotechnology, where a company uses its resources to work on researching a specific disease or modeling diseases in pursuit of new therapeutics. The other route is to continue to work with medical information practices. In the lab, we designed our own database that uses advanced coding and database management techniques that analyze patient electronic health records to extract meaningful data. I can imagine there are rural healthcare systems with vulnerable patient populations that have not established a pipeline to collect and analyze important patient information; I would like to help change that. So, going the medical information or clinical informatics route would also be very intriguing to me if I decided to leave traditional bench science research.