Spring 2003

In the Spotlight: Kala Visvanathan, MD, MHS

Dr Visvanathan is an Assistant Professor in the Department of Epidemiology at the Bloomberg School of Public Health. She graduated from medical school at the University of Sydney in Australia and completed her training in both Internal Medicine and Medical Oncology in both Australia and in the U.S. at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. She has also completed a graduate degree in clinical/cancer epidemiology at Johns Hopkins. Her main interests are in identifying markers of susceptibility and risk in breast and prostate cancer, as well as in identifying and assessing early detection and chemoprevention strategies. Clinically, along with a other physicians, genetic counselors and nurse practitioners, she sees women who have an increased risk of breast and ovarian cancer that come to the Johns Hopkins Breast and Ovarian Surveillance Service to learn more about their cancer risk and obtain information with regard to genetic testing, screening and prevention. She is also involved in recruiting women for a number of clinical studies including a ductal lavage study, the ROCA study and an MRI study in high risk women.

Dr Visvanathan is one of an exciting new breed of genetic researchers looking at factors that lead to cancer development as opposed to ways to treat the disease after it has developed. Her work blends an interest in cancer prevention, primary prevention and genetics. She will soon begin work on the Genetic and Environmental Modifiers Study of Cancer Risk among Women with BRCA1 and BRCA2 Mutations http://epi.grants.cancer.gov/CGN/studies.html#ovarian . This study will investigate genetic and environmental factors that may influence the risk of breast cancer among women who have inherited BRCA1 or BRCA2 gene mutations. The researchers are examining whether exposures including hormonal factors, and genes involved in hormone metabolism, carcinogen metabolism, and DNA repair modify risk for cancer in women who carry the BRCA1 or BRCA2 gene mutations.

“Cancer is a multifactor, complex disorder”, says Dr. Visvanathan, “my goal is to continue to understand how common environmental factors, for example, smoking, alcohol or obesity interact with altered genetic pathways involved in the metabolism of these factors or in normal cell growth and development that lead to cancer”. These altered genetic pathways are usually associated with genetic mutations and are commonly referred to as cancer “markers”. Today, some cancer markers are used to determine how aggressive a tumor is or how likely it is to respond to treatment. Dr Visvanathan is searching for markers that identify individuals at an increased risk for cancer or with premalignant disease in whom chemo preventive agents can be targeted. Says Dr. Visvanathan, “We are learning that there are many pathways to cancer development but we must identify the dominant pathways to have the greatest effect on cancer prevention”.