Research For The Sake Of Children

Applying science to protect our most valuable treasure

Jen Poynter, PhD, is an Associate Professor in the Division of Epidemiology and Clinical Research in the Department of Pediatrics. She is also one of our 10,000 Families Study co-investigators. Jen’s career is focused on helping children grow up healthy.

1. Can you tell us about yourself?
   I’m an epidemiologist in the Department of Pediatrics at the University of Minnesota, and I live in St. Paul with my husband and kids who are fourteen and eleven years old.
   
   I grew-up in a tiny town in northern Minnesota near the Canadian border, but I haven’t lived in Minnesota my whole life. I went to graduate school at the University of Michigan for 5 years, and finished my training with my fellowship at the University of Southern California in Los Angeles. It was quite the experience growing up in a town of 800 and then spending 3 years in LA–very opposite ends of the spectrum! After my time in California, I returned home to Minnesota to start my faculty career.
    
2. Looking at your bio-page: Your PhD is in epidemiology, and your research focus is the role of genetics and epigenetics in pediatric cancers.
   • Can you remind us what epidemiology is?
     Epidemiology is the study of health and disease in populations. It tries to understand why certain people get sick and others stay healthy by looking at risk factors for disease. 
      
   • How did you decide to study epidemiology?
     Initially, I thought I wanted to be a medical doctor. I did an internship through a program for pre-med students and the experience made me realize that medical school was not the right career fit for me. Nevertheless, I was still really interested in health and wanted to work with people. A professor I had when I was an undergraduate student introduced me to the field of epidemiology. I found it fascinating and decided to pursue that as a career.
      
   • What does epidemiology have to do with pediatric cancers, and what was your path to arrive at studying pediatric cancers?
     My work focuses on trying to understand why some kids develop cancer. That’s one area of epidemiology, understanding risk factors for disease. I also do some work looking at outcomes after people are treated for their disease to figure out risk factors for who is going to have health complications later in life. I didn’t have a direct path to study pediatric cancer. Most of my training was focused on studying colon cancer. Both my PhD and postdoctoral work were focused on looking at risk factors and genetics that increase risk for developing colon cancer. However, when I was looking for a faculty position, the University of Minnesota had a really strong pediatric cancer epidemiology program. I was interested in coming back here to work, so that led to my transition to studying a new type of disease. I wanted to utilize the skills I had applied to adult cancer, but now with a focus on childhood cancer. 
      
   • What does epigenetics mean, and why did you decide to focus on both epigenetics and genetics?
     Epigenetics is the study of how environmental exposures or things you’re exposed to impact how your genes function. You have the same genes in every cell in your body, but different ones are turned-on in different parts of your body, and what you’re exposed to may impact which ones are turned-on. When kids get cancer, they haven’t had the long life history or the long list of exposures that we know cause a lot of adult cancers. They haven’t been smoking for thirty years, and they haven’t had the time to be exposed to these things. Data is showing that genetics is more important when it comes to risk factors in kids. When it comes to the type of cancer that I study, pediatric germ cell tumor, we know that during normal development the germ cells are reprogrammed in terms of their epigenetics. In other words, children go through developmental changes during the growth process and we thought that might be altered in kids who ended up developing this type of tumor. 
3. Continuing about your pediatric cancer research: 
   • Tell us more about your pediatric cancer research. What do you study in this broad area, and why is it important?
     Most of my work in pediatric cancer is focused on germ cell tumors–the cells that become the sperm and the eggs. Kids can develop tumors in these cells, but they are also pretty common in young adult men with testicular cancer. Children, both males and females, can develop germ cell tumors and we don’t really know what causes them. There haven’t been many studies that are focused on this type of tumor. That was one of the reasons I was interested in doing research in this area because there’s a lot that we can learn. More recently, I’ve been looking at what happens to kids who have had germ cell tumors in terms of health effects after their treatment. We know a lot about childhood cancer survivors and the health impacts that they have, but most of those studies have not included germ cell tumor patients, so there’s a big gap. A lot of the people who participate in our studies have a lot of questions and have a hard time finding data, so we are working to try to fill some of those gaps. 
      
   • What are you most excited about in your research?
     I’m really excited about looking at survivorship. I just got a new grant from the Department of Defense to find answers to those questions where we don’t have data. Also I’m working with people from all over the world who are studying germ cell tumors, which is a pretty small field. It’s really exciting to be able to collaborate with people from all over the world and develop friendships, plus we work really well together!
      
   • How do you think environmental factors and lifestyle affect genetics/epigenetics in children?
     That’s a tough one! Environmental factors and lifestyle may not affect genetics, but they may affect disease. Unfortunately, we don’t have really good data on this. With adult cancers, we know a lot of the environmental and lifestyle factors that cause disease. In pediatric cancers, we have a lot fewer success stories in those types of studies because there aren’t a lot of clear environmental factors. Fortunately, children’s cancers are fairly rare. The difficulty in studying rare cancers is that the numbers are so small that there may not be enough cases to find correlations. However, things that are related may give us clues as to causes of cancers.
      
   • What are some of the toughest nuts to crack when it comes to pediatric cancers?
     Having a small number of cases to study is the biggest challenge. We think a lot of pediatric cancers are actually initiated in utero. Trying to measure exposures is really challenging because you have to ask the family about things that happened before the child was born. As kids get older, it’s harder for people to remember what those exposures might have been. It’s especially difficult to measure exposure if we do a case-control^[1] study. This is when we have children who have the disease and children who don’t, and ask the parents what they were exposed to. If your child has cancer, you are going to try a lot harder to remember, compared to someone who has a child who has not been affected by the disease. Maybe then you don’t think about what could have gone wrong. We try to be careful and remind parents that we don’t know for sure if any of these things cause cancer, so parents don’t feel blamed. 
     
     ^[1] _{Case control study: It is an observational study in which two existing groups are observed to identify factors that may contribute to a medical condition by comparing patients who have that condition/disease (named "cases") with people who do not have the condition/disease but are otherwise similar to them (named "controls").}
      
4. Tell us about your work with the 10,000 Families Study (10KFS):
   • How did you get involved with the study?
     The idea of the 10,000 Families Study (10KFS) started with a group of epidemiologists who had lunch together weekly. We were talking about starting a new cohort study. There are some existing cohorts in Minnesota and around the country, but many were started years ago, and a lot of new exposures wouldn’t have been captured. Plus, there aren’t a lot of family studies that try to understand health across generations. We also wanted to utilize new ways to measure people’s health and exposures. 
      
   • Knowing that 10KFS is a multigenerational family study focused on Minnesota, how does the Study contribute to your own research goals? 
     Making sure that we include children in the study will be important to try to understand health in children. This wouldn’t necessarily be for pediatric cancer because it’s so rare that we may not have enough children to be able to investigate it in this study. Regardless, it’s important to look at some of the risk factors and development in children in a family context.
      
   • Where do you see 10KFS’ greatest potential when it comes to pediatric cancers?
     The greatest potential would be in family-based exposure assessments. However, we would need to see more cases than what we likely will to tie 10KFS to the research on pediatric cancers.
      
   • You are one of the Principal Investigators for 10KFS’ new National Cancer Institute-funded project as part of the Cohorts for Environmental Exposure and Cancer Risk. Could you tell us what the grant is about and why it is important for cancer in Minnesota?
     This was a great opportunity! The National Cancer Institute doesn’t often offer funding to start new cohort studies, so we were really excited about this opportunity. We decided to focus on hematologic cancers, blood cancers like leukemia and lymphoma, because Minnesota has higher rates than a lot of other places in the United States. We also suspect that there are some environmental causes of those types of cancer, so we focused on some exposures where there is some suggestive evidence that they might be related to leukemia and lymphoma, but the evidence wasn’t concrete. We will be researching the exposure to radon, PFAS and glyphosate pesticide because they are suspected causes of blood cancers. 
      
   • Knowing you are originally from a rural part of Minnesota, what do you think is the benefit of this grant for the population or rural Minnesota? 
     It’s important to include rural participants in these types of studies. Most of the studies that have been done in the past have focused on people living in urban areas, and we know that people living in rural areas have different exposures compared to people living in urban areas. We want to make sure that we are capturing all of those exposures in our study. Our hope is that people from all areas and backgrounds participate in this study so that we can try to understand and provide some data that would improve the health of all Minnesotans.
      
5. You also are Associate Director of Community Outreach and Engagement (COE) at the University of Minnesota Masonic Cancer Center (MCC). 
   • Could you tell us about your role?
     I work with our COE team. Our goal is to try to help improve communication between the community, researchers and physicians who work on cancer research, prevention, care, and treatment at the MCC. We want the work that we’re doing to have the most benefit for people in Minnesota. 
      
   • Why are community outreach and engagement important when it comes to cancer among children?
     It’s important to make sure that the work that we’re doing really reflects the needs of the community, and that we are addressing issues that are important to them. Our work must be focused on the cancers that people are experiencing so it’s relevant for people, and we need to be answering questions, and ensuring that the treatment is equitable for everyone.
      
   • Can you tell us what you have learned in this role?
     This role has motivated me to learn more about community engagement, and how that can be included into my own research. I believe this leads to much more impactful research.
      
   • What do community outreach and engagement have to do with 10,000 Families?
     We’ve been trying to work on engaging communities and getting input for the 10,000 Families Study. Community outreach helps us address any concerns in the community, make sure our research practices align with what would make participants comfortable, share all of the findings from the study, and help people who participate in the study improve their health. 
      
6. Are there any support or research groups that you recommend for families with kids that have been diagnosed with cancer?
   There is a website a patient advocate I’ve been working with recommended to me: Elephants and Tea, which is directed at adolescents/older children and young adolescent cancer survivors. There is also the Children's Cancer Research Fund (CCRF), which supports families, especially as they are going through treatment. CCRF bring people together for community events–not just survivors, but a lot of families get involved after they have a child who’s been diagnosed with cancer. CCRF has also been a great supporter of our research work at the University of Minnesota.

Please remember that any families in Minnesota, including those with members in neighboring states, can participate in the 10,000 Families Study, regardless of their health. It is important to contribute to science so future generations can benefit from new discoveries. You can check if your family qualifies for our Study here - JOIN