Photo courtesy of Dr. Evelyn Hsieh
Fogarty Fellow Dr. Evelyn Hsieh (on left), a
rheumatologist, is studying the link between breast
cancer and osteoporosis in China, here with
oncologist Dr. Zhang Pin.
As life expectancy rises around the globe, so do chronic diseases, fueling the need for research into low-cost diagnoses and treatments. Fogarty's Fellows program, which encourages scientists to research noncommunicable diseases as well as infectious diseases, is supporting Dr. Evelyn Hsieh as she examines the link between breast cancer and osteoporosis.
"Therapies for breast cancer put women at risk for osteoporosis and fracture," Hsieh said, noting that there are large global variations in breast cancer risk factors, age when it hits and treatment protocols. Her research project is in China, where breast cancer diagnoses occur at 49 years on average, 12 years younger than in the U.S. She will be able to access a large study population and use her Chinese language skills to facilitate collaboration.
Hsieh, a rheumatology fellow and doctoral candidate at Yale University, is supported by Fogarty's Global Health Program for Fellows and Scholars, which offers doctoral and postdoctoral students mentored time at an established research site in a developing country. The yearlong program, intended to encourage early-career scientists to pursue global health research, provides a training resource to the host institutions and nurtures international research partnerships.
Hsieh's focus on bone health grew from her specialization in rheumatology and interest in women's health. Her project is part of a retrospective study evaluating more than 4,000 women with breast cancer across China, and seeks to identify those at highest risk for fracture. She also designed a pilot study to measure vertebral fracture rates, vitamin D levels and bone turnover markers in 200 breast cancer survivors in Beijing and to evaluate the women's knowledge and health beliefs regarding osteoporosis.
To support the latter study, China's Cancer Institute was able to procure a bone density scanner, which otherwise would not have been feasible. "This is rewarding because, beyond the implications for research, we have added something tangible to the hospital and improved the standard of care for patients," Hsieh said.
Hsieh's fellowship is her second from Fogarty. As a medical student seven years ago, she received support to research sexually transmitted diseases among Ecuadoran sex workers in Peru. The study informed clinics on how to better reach out to the migrant sex worker populations and address their specific vulnerabilities.
Reflecting on the two fellowships, Hsieh said the hands-on experience in her first project, including developing a study and writing a grant, "enabled me to be much more focused during my second fellowship, which comes at a point in my career where I have identified a field that I am passionate about and feel I can best contribute to," she said. "In this new project, I feel much more prepared for the natural ebbs and flows that come with the process of research."
Trainees can get lost or be inefficient when new to research and working in an unfamiliar country, which is why the mentorship component is invaluable, she said. "The Fogarty program is a phenomenal mechanism to jumpstart that path, because the mentorship is really key. Having someone in the host country, such as Dr. Youlin Qiao, who is committed to making it a productive experience is worth its weight in gold." As well as Dr. Qiao, a Fogarty Visiting Fellow in 1986, Hsieh has been mentored by Fogarty grantee Dr. Patricia Garcia and Fogarty collaborator Dr. Silvia Montano.
When she returns to the U.S., Hsieh plans to complete the data analysis, prepare her findings for publication and present her doctoral thesis. Then she'll be ready to launch into a career in global health and clinical research, aimed at improving the health of women around the world.
Updated October 22, 2015
After returning to the U.S., Hsieh earned her doctoral degree and successfully applied for a career development award (K01) from Fogarty to study return to China to study bone loss risk in HIV-positive people in a resource-limited environment. Learn more about her work on the project Risk for Bone Loss Among Individuals with HIV in a Resource-Limited Environment, supported by Fogarty's International Research Scientist Development Award (IRSDA).