Merkel Cell Carcinoma Research

Dr. Paul Nghiem's Laboratory

Photos (clockwise from top left): MCC pathology under a microscope, the Nghiem lab at a Mariner's game, the PUPDate team, and a team photo in-lab

As one of the many UW students with her eyes set on medical school, I knew that getting involved in scientific research as an undergraduate student was something that I would pursue. In fact, one of the primary reasons why I chose UW is due to the vast amount of research opportunities that the university offers to its students. Coming from a small, rural farm town in Oregon, I had zero experience with any sort of scientific research, so when I got to UW I hit the ground running. I applied to lab after lab, received numerous rejection emails, obtained and attended a few preliminary interviews, and was ultimately left defeated and jobless. Dr. Nghiem’s lab application was no different than all of the others--I spotted an advertisement in the student biology listserv, drafted my application, and sent it off with the five other lab applications that I did that day. I did not think twice when I received a call-back about scheduling a preliminary interview--there was no way that I could get this position as a freshman. And then I got a notification that I was selected to interview with Dr. Nghiem himself. Walking out of my introductory biology midterm one spring day, I quickly checked my phone to find a text from an unknown phone number. Then my phone started to ring. I picked it up and promptly heard Dr. Nghiem congratulating me on being chosen as one of the two new undergraduate research assistants for the Nghiem Lab.

That summer, the summer of 2019, I dedicated eight weeks to working full time at the Nghiem Lab. I completed my training and onboarding under the direct supervision of the two senior undergraduate assistants, and then I began working on my summer project: PUPDate. The Nghiem Lab operates one of the largest Merkel Cell Carcinoma databases in the world. This database contains a multitude of clinical data on over one thousand MCC patients. PUPDate (which stands for the Patient Update Project) is the annual project completed by undergraduate research assistants in which the database profiles of all patients who Dr. Nghiem has not seen in clinic in over six months are quality checked and the patients are contacted in regards to their health. In total, there were around five hundred patients on our PUPDate list, meaning that each undergrad student had over one hundred patient charts to check. I spent weeks reviewing patient charts, medical records, clinical notes, and radiology scans to check that all of the information in the database was accurate for each patient. I then sent out mass emails inquiring about patients’ health and any new and pertinent medical information from the past year. Finally, I began calling patients to get an update on their health. Throughout this project, I was able to learn countless medical terms by scouring patients’ medical records and clinical notes, I learned more about Merkel Cell Carcinoma, I was able to practice interacting with patients, and I improved my communication skills as I had to constantly keep in contact with the other undergraduates in order to make sure that the project was completed correctly and in a timely manner. In addition, I was also able to witness the impact that medical research has on countless patients’ lives. During PUPDate, I received numerous calls and emails sincerely thanking Dr. Nghiem and the rest of the team for all that they had done for them or their relative. It was eye-opening to see how medical research truly connects people. Not only by providing cutting-edge care to countless patients, but also by connecting physicians and researchers with amazing people who have accomplished unbelievable feats.

Besides working on PUPDate, I was also able to have many experiences this summer that truly validated my desire to pursue medicine. For example, almost every Tuesday I had the opportunity to attend noon conferences at Fred Hutch. During these conferences, there would either be presentations on new treatments or a large group of doctors (dermatologists, radiologists, medical oncologists, surgical oncologists, pathologists, etc.) and nurses would discuss and try to determine treatment plans for patients with challenging cases. It was fascinating to witness the unique perspective that each physician gave regarding a case. I also learned how much the social history of a patient affects his or her treatment plan. For instance, if a spouse or relative is involved, if there are language barriers, other diseases or mental illnesses, or travel issues, physicians have to take all of this into consideration when determining the best way to care for a patient. Finally, towards the end of my summer, I was able to shadow Dr. Nghiem in the clinic at the Seattle Cancer Care Alliance. This opportunity really demonstrated the importance of what myself and everyone else in the lab is doing. I saw patients who had recently undergone a wide local excision of their primary MCC, and I also met with patients who had been in remission for more than five years. It was truly amazing to get to meet the patients, watch the interactions they had with Dr. Nghiem, and to see and hear how Dr. Nghiem formulated treatment plans for each patient.

Overall, I accomplished a lot, became more comfortable with my coworkers, and was able to have numerous validating experiences as an undergraduate research assistant in the Nghiem Lab this summer. I am very excited to continue to learn, grow, and help at the lab during the rest of my undergraduate career and I cannot wait to begin to form my own hypotheses and begin doing my own clinical research in the future.