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As Dr. Jason Farrar sees it, the profession of pediatric oncology offers the opportunity to practice an unparalleled spectrum of patient care. "Pediatric oncologists practice both in acuity and continuity. We treat patients who are, at times, very sick. But, unlike in an emergency department or intensive care unit, we see them again and again. Sometimes we follow them all their lives," Dr. Farrar says.
He finds the research aspect of pediatric oncology equally attractive. "The biology of cancer is innately appealing to me," says Dr. Farrar, who first developed an interest in molecular biology as an undergraduate student. "Cancer biology in some ways is very basic. It goes to the heart of cell biology. A cancer cell is a normal cell gone bad," he says.
Dr. Farrar's interest in molecular biology led him to the promising area of science known as Epigenetics: the study of abnormal changes in cells caused by mechanisms other than alterations to the underlying DNA sequence.
"You don't have to disrupt the gene itself. The sequence structure of the gene may be perfectly normal," says Dr. Farrar. Rather, he and other scientists are honing in on the processes that regulate gene activation. "It's a relatively young area of molecular and cancer biology. We began by looking at one gene abnormality in acute leukemias that appeared to have an important role in epigenetic regulation," says Dr. Farrar. Now he and fellow researchers are looking for efficient ways to examine these changes across many genes, and to identify new patterns of epigenetic abnormalities, which he believes may be critical to the development of many types of pediatric cancers.
Though epigenetics is a fairly new field of study, Dr. Farrar marvels at the rapid-fire pace at which it has progressed in a relatively short period of time. "Our present ability to look at genes is so vastly different than when I was in medical school," he says.
Dr. Farrar believes that understanding changes in both genes and their regulation holds the key to developing new and more effective types of therapies for pediatric cancers. He envisions a time, in the not-too-distant future, in which pediatric oncology researchers will be able to evaluate gene differences in individual patients. But he realizes this goal won't be reached without obstacles.
"Every time a layer of biology's complexity is rolled back, another one appears. You wonder where the bottom is," says Dr. Farrar, who admits that it's this complexity that drives him and fellow physician-scientists.
As if the scientific pursuits that consume Dr. Farrar's workdays aren't heady enough, in his spare time he has begun to dabble in computational biology, a field that applies a combination of computer science, applied mathematics, and statistics to biological problems.
When the challenges presented in the laboratory and the bedside threaten to become overwhelming, Dr. Farrar admits that one antidote always puts things in perspective. "I spend a lot of time with my own kids. I definitely have those days when I need to go home and give them a big hug," he says.