Texas A&M Graduate Student Combines Patient Advocacy And Breast Cancer Research

Story by Courtney Price, VMBS Marketing & Communications

January 30, 2025

Doctoral student Hannah Carter finds motivation from her family history of breast cancer and other survivors as she explores treatment options for one of the nation’s most common — and deadly — diseases.

For doctoral student Hannah Carter, research is never just about science for the sake of new knowledge — there’s always a personal connection to the work.

In the lab of Dr. Weston Porter, a professor in the Texas A&M College of Veterinary Medicine & Biomedical Sciences’ (VMBS) Department of Veterinary Physiology & Pharmacology, Carter focuses on metastatic breast cancer — the point where breast cancer spreads to other parts of the patient’s body.

Breast cancer alone affects over four million women in the United States, and around 30% of those cases end up metastasizing, often spreading to the brain, liver, lungs, or bones.

Together with other members of Porter’s lab, Carter is hoping to uncover new treatment options for metastatic breast cancer patients.

But there’s one unusual ingredient in Carter’s research — patient advocates.

Patient advocates are breast cancer survivors who speak up for patient interests, often at rallies, marches, and even by meeting with government officials.

One place they haven’t always been common is the research community, but thanks to researchers like Carter, patient advocates are getting to play a larger role in shaping breast cancer research so that the personal connection is always front and center.

Getting To The Heart Of Research

Given how common breast cancer is, it’s likely that most people — even researchers — know someone who has or has had it. For Carter, the connection to breast cancer is close to home.

“The week of my recruitment interview for Dr. Porter’s lab, my grandmother died of breast cancer,” she said. “And the year before that, my god-mom died of breast cancer, too, so that’s why I’m here.”

Having known women with breast cancer is a huge part of why Carter is passionate about working with patient advocates and thinking about the end-user of the treatments she researches.

“I’ve been learning about patient advocacy through conferences for two years now,” Carter said. “My perspective has really shifted — hearing from patients has changed how I design my experiments so that I’m always thinking, ‘How will this help someone with this disease?’”

Carter and her lab mate Dr. Garhett Wyatt began thinking about how breast cancer patients perceive available treatments after attending the 2022 Metastatic Breast Cancer Research Conference (MBCRC).

“(At that conference) I met Christine Hodgdon and Julia Maués, the founders of a patient advocacy organization called Guiding Researchers and Advocates to Scientific Partnerships (GRASP),” Wyatt said. 

“Christine and Julia made me aware of just how awful the side effects of Piqray can be for patients. For them, it almost doesn’t matter that the drug works, because the side effects are so bad,” he said. “It’s one thing to read about side effects in clinical trial reports, but it’s another to hear about people’s real experiences living with them.”

This kind of feedback has become critical for guiding Carter, Wyatt, and Porter in conducting research that addresses both the short-term and long-term needs of breast cancer patients.

“When I’m working with cells on a plastic plate in a cell culture hood, it’s easy to get tunnel vision,” Wyatt said. “That’s what makes the chance to talk to patient advocates so valuable.”

Bringing Advocacy And Research Together

Carter’s interest in helping real people motivated her to apply for an $80,000 research grant from the Susan G. Komen Foundation called A Supplement to Promote Inclusion for Research Excellence (ASPIRE). The two-year grant aims to increase the diversity of the breast cancer research workforce by providing funding to trainees from communities historically minoritized and marginalized in research.

Grant winners are required to work with a patient advocate throughout the research process, which is how Carter began working with Patti Kellerhouse, a patient advocate who works with the American Cancer Society Cancer Action Network.

As a breast cancer survivor with a research background, Kellerhouse is uniquely suited to work as an advocate.

“In 2007, I started as a clinical research associate in the pharmaceutical field,” Kellerhouse said. “Two years later, I learned I had early stage breast cancer. I ended up working for companies that were developing different cancer treatments, including a very promising one that became known as Verzenio. I even worked on the clinical trials.

“The same month that Verzenio was approved by the FDA — nine years after my first cancer diagnosis — I was diagnosed with metastatic cancer in my liver,” she said. “However, I spoke with my oncologist, and we agreed to try it anyway. I’ve changed treatments a few times, but now I’m at six-and-a-half years with no evidence of disease. My quality of life is very good.”

For Kellerhouse, having prior knowledge of the research process and getting to work alongside cancer specialists has made her bolder about speaking up for patients.

“I’ve never had a problem asking questions,” she said. “And I know when to ask researchers, ‘How would you do that?’ or ‘Why would you do it that way?’ Sometimes they can get so focused on the science that they sort of have blinders on. It’s really helpful for them to work with an advocate.”

Uncovering The Key To Metastasis

Though Carter’s work with Kellerhouse is just beginning, patient advocacy has already made a lasting impact on her research, which focuses on sirtuins, a type of protein known to reduce signs of aging that may also play a role in breast cancer metastasis.

“Sirtuins are more commonly studied in the field of aging and neurology,” Carter said. “Finding a connection between sirtuins and metastatic breast cancer would be good news for patients because we might be able to use existing anti-aging drugs as cancer treatments.”

Carter researches a specific sirtuin known as sirtuin 3 — or SIRT3 — that may play a role in certain changes to mitochondria that are associated with metastasis.

“In healthy cells, SIRT3 helps regulate mitochondrial function, but in unhealthy cells, I hypothesize that it can actually contribute to proliferating cancer cells,” she explained. “Everyone knows that the mitochondria is the power house of the cell, but it does so much more than that. It governs a system of checks and balances that keep cells functioning normally.”

Another protein studied by Porter’s lab, SIM2, is usually present to regulate SIRT3 and to keep it in check, but that doesn’t happen in metastatic cancer cells.

“Loss of SIM2 is an important marker of metastatic cancer,” Carter said. “When it’s no longer present, cells and tumors become more reliant on SIRT3. In some of my previous work, I found that inhibiting SIRT3 actually causes cancerous cells to die. If I can figure out what that interaction is, then we may be able to work toward targeting sirtuins to treat metastatic breast cancer.”

Putting Passion To Work

For Carter, studying the inner workings of cancer metastasis and listening to patient advocates isn’t just a passing interest — it’s part of a lifelong commitment to improving breast cancer research and patient outcomes.

“I want to focus on oncology, specifically breast cancer,” Carter said. “That’s why I joined Dr. Porter’s lab in the first place. I’ve also participated in several breast cancer awareness marches, and right now I’m even partnering with a program that raises awareness in minority communities about breast cancer screening.

“One reason that I’m so passionate about raising awareness for breast cancer screenings is that there’s a lack of information and overall lack of treatment in minority populations, specifically with Black women. Even though Black women are statistically the least likely to get it, they have the highest death rate from breast cancer,” she said.

By working with patient advocates and keeping the personal connection at the forefront of her work, Carter said she has a higher chance of finding solutions that can help women with metastatic cancer have a better quality of life.

“Understanding the mechanisms at the cellular level is important, but I’ve learned to think about translating everything I do to the clinical setting, to ask myself, ‘How is this helping women?’” she said. “At the end of the day, that’s the most important thing about this project, because if I can prove that anti-aging drugs can be used to treat breast cancer, that will help women in the clinic.”

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Note: This story originally appeared in the Fall 2024 issue of VMBS Today.

For more information about the Texas A&M College of Veterinary Medicine & Biomedical Sciences, please visit our website at vetmed.tamu.edu or join us on Facebook, Instagram, and Twitter.

Contact Information: Jennifer Gauntt, Director of VMBS Communications, Texas A&M College of Veterinary Medicine & Biomedical Sciences, jgauntt@cvm.tamu.edu, 979-862-4216

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