This month EPWS gives the floor to Marina Kvaskoff. Dr. Kvaskoff is an epidemiologist with a special interest in endometriosis and cancer. She is a tenured scientist at the French National Institute for Health and Medical Research (Inserm).
EPWS: What made you want to go to science? How did you decide to choose your discipline and your particular field of research? Did you have an inspiring model (parent, relative, teacher, literature, etc.)?
When I was a child, I was very curious about health and disease. It fascinated me that something as small as a virus could cause such health consequences in humans, and I remember always asking my parents about different conditions and their symptoms. I wanted to understand what caused them, and why some people were sick and some were not.
The first time I heard about epidemiology – the discipline that explores risk factors for diseases – it felt like a calling. After studying biology and biochemistry during my undergrad, I did a Master’s in epidemiology and public health, then a PhD in epidemiology.
I was very interested in cancer and started to work on this theme. After an internship in Brisbane, Australia in 2005, I became particularly interested in cutaneous melanoma – a lethal cancer that represents a major public health threat in this country, in which melanoma reaches the highest incidence worldwide. It was when I explored the influence of sexual hormones on melanoma during my PhD that I first heard about endometriosis, a hormone-dependent gynaecological condition on which little is known. As my PhD research progressed, I became increasingly aware of the importance of this disease and of its considerable impact on the lives of millions of women worldwide, and I developed a passion for endometriosis.
What do you work on? How important is your research topic for science development or society?
Over the years, I continued to develop my two research areas: today I am working on cancer, particularly skin cancers, and on endometriosis.
Skin cancers are the most common cancers worldwide and their incidence is rising. Unfortunately, this rise is likely to be intensified over the next decades due to climate change. Melanoma is the least frequent but deadliest form of skin cancer; while survival rates are high for thin tumours, they are particularly low for metastatic disease. Non-melanoma skin cancers are associated with lower mortality rates, but their treatment (surgery mostly in sun-exposed areas such as the face) importantly impact quality of life. Prevention is key to reducing the burden of these cancers, and we need to identify individual risk profiles, beyond what is known on sun exposure, in order to inform public health strategies and prevent the disease and its progression in melanoma patients.
Endometriosis is a chronic inflammatory condition in which tissue resembling the lining cells of the uterus grows in external locations, mainly the pelvic cavity and ovaries, but sometimes in remote areas such as the lungs or brain. The external implants respond to ovarian hormones during the menstrual cycle and bleed as they would in the uterus, causing inflammation, scarring, and adhesions between organs, which lead to debilitating pain (during periods, sexual intercourse, urination, defecation), chronic fatigue, and infertility. Endometriosis affects 10% of women of reproductive age (~180 million women worldwide) and has a deep impact on women’s quality of life and mental health. It is also associated with remarkable healthcare costs (10 billion €/year in France). However, current knowledge on the causes and natural history of the disease is exceptionally poor. Much remains to be done to understand the disease in order to improve treatment options and patients’ quality of life, and to ultimately develop endometriosis prevention.
What is your greatest success as a researcher (and as a teacher if you teach), the one you are most proud of? Could you share the memory of a great personal satisfaction during your research career with us?
One great memory of success was the award of a Marie Sklodowska-Curie Fellowship from the European Commission in 2011. This grant enabled me to pursue research work in endometriosis epidemiology and gave me the chance to be trained by the World’s top scientists in this field at Harvard University in the US (Prof. Stacey Missmer’s Group) during my postdoc, which has been a crucial experience in my career.
As a tenured scientist at Inserm, I also have remarkable memories of the day I was selected for this position and the day I passed my research habilitation. Today, I am extremely proud of the students and fellows I am supervising, and very proud to lead an amazing group of people!
In which country/countries have you been doing research?
Over the past ~15 years, I have been doing research mainly in France. During my PhD and postdoc I also worked in Australia (1.5 years) – I did a joint PhD between the University of Paris (France) and the University of Queensland (Australia), where I had the chance to be trained by internationally-recognized scientists in skin cancer research (Profs. David Whiteman and Adèle Green’s Groups at QIMR in Brisbane). During my postdoc, I also spent 3.5 years in Boston in the US to work on endometriosis.
These experiences of living abroad have helped me to gain new skills, both technical and ‘soft’, to understand different research policies and cultures across several continents, and to broaden my horizons. They also led me to better know myself, to improve my English language, and to expand my network internationally.
EPWS: What is your agenda for the coming months?
Since 2005, I have been developing my research on the epidemiology of cancer and of endometriosis. Considering the tremendous gaps in knowledge on endometriosis, and the important contrast between current knowledge, allocated funds, and the impact of the disease, I am planning to devote most of my research in the coming years to improving our understanding of endometriosis.
My vision for the coming months and years is to develop epidemiological research on endometriosis in France, to contribute to move the field forward and discover the causes and different forms of the disease. For this, I am working with patients, clinicians, and other scientists to develop innovative projects that will help tackle some of the challenges posed by the disease.
Did you meet any barriers (personal/social/structural) during your career as a scientific researcher? Did you benefit from mentoring?
Certainly – I think that potentially every scientist, particularly women scientists, meet barriers at some point in their career. This is an important stage during which to seek mentors, in order to persist and overcome one’s challenges.
I benefited from the support and advice of many mentors throughout my career, and I am still seeking mentors’ help for various aspects of the current challenges I am facing today. In turn, now as a PI, I have a deep interest in sharing my knowledge and experience. I am passionate about mentoring, and it is very important to me to support the career development of my students and fellows.
It was in the US that I really became aware of the importance of mentoring in scientific careers. During my postdoc in Boston, I participated as a mentor in a mentoring programme organized by the Massachusetts Chapter of the Association for Women in Science (MASS-AWIS). We were 1-2 mentors and 4-5 mentees per circle, and each circle met every month to discuss the career objectives of the mentees, their conundrums, or the difficulties they encountered. I was very enthusiastic and impressed about this programme and the positive effect it had on both mentees and mentors. Following this experience, as a member of the Postdoctoral Association of the Brigham & Women’s Hospital BWH in Boston, I created a similar programme for postdoctoral fellows. The programme was continued by its prospective leaders and is still ongoing today with ~50 participants.
Upon my return to France in 2014, I wanted to import this mentoring culture, which has been little developed in our country so far. I contacted the association Femmes & Sciences and proposed to develop a mentoring programme for female scientists. At that time, May Morris, a Research Director at CNRS, was launching a similar programme in Montpellier. Based on our experiences, I developed a mentoring programme for female PhD students in the Paris Ile-de-France region. The pilot phase included 9 mentor-mentee pairs this year, and we are now preparing the deployment phase, which will extend the programme to the Université Paris-Saclay in 2019 with the support of the Collège Doctoral of the University.
The evaluation of the programme in Montpellier and the feedback from participants in both regions have been extremely positive. It is my hope that many young female scientists can get support through our programmes and beyond, for the benefit of their career development. Ultimately, these programmes, which are likely to further develop in other institutions around Europe over the upcoming years (see eument-net), will help young women to remain in scientific careers and help promote gender equality in science.
What is the situation of gender equality in your working field? In the countries where you have been working, were there gender equalities policies and did you experience their effects? What do you suggest for a better implementation of gender equality in science?
The field of epidemiology is mostly female in terms of absolute numbers. However, as for any other field, the proportion of women decreases as level of seniority increases.
There have been discussions about promoting gender equality in the institutions in which I have been working in France and overseas; however, I am not aware of clear gender-equality policies in place, or it is perhaps too soon to appreciate their effects at the individual level. Such policies are crucial, however, to promote gender equality in all science fields and at all professional levels. It seems that for now we are still at the stage of raising awareness. For a successful implementation of gender equality in scientific institutions, policies should be introduced and inspired from top to bottom. The future is hopeful however; raising awareness can take time, but it will lead to concrete actions, one step at a time.
Next to gender-equality policies at the institutional level, much can be done to empower women and foster gender equality in science at the individual level. Women may themselves seek mentoring and support networks, and help one another navigate their scientific career.
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Did you experience networking between women scientists? Can you comment your answer and explain why yes or not?
I did experience networking with other women scientists, and it was each time extremely enriching and stimulating. Specifically, I had the opportunity to connect with many female scientists through ‘women in science’ associations, in France (Femmes & Sciences) and in the US (AWIS, MASS-AWIS). The framework of such associations makes it easier to meet other women interested to connect, who share similar values, of various position levels and various fields of work. Together, women scientists can be a support network for one another, and this can lead to a substantial boost in courage and confidence.
If you could start again your life, would you choose again to be a scientist? What would you change?
I think I would. And I wouldn’t change a thing!
Could you leave a message to young European women scientists?
Connect with other women scientists – you will often meet women who share similar values, concerns or experiences. You might also either find mentors or make new friends (see above).
Volunteer/get involved in professional societies (such as your national or local ‘women in science’ association) – you will experience new adventures, naturally expand your network, and build new competences that will look good on your resume!
Seek mentors – talk to potential mentors about your needs. Chances are that you will find someone who has been through similar challenges or conundrums at some point in their career, and you can learn from them.
Think big – and regularly step out of your comfort zone. If it is scary, then you will learn something new and grow.
When difficulties arise, be kind to yourself. Do your best, keep going, and seek mentors. #ShePersisted