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Pathology

Eric Yee. Photo by Felicia Allard

By Daniel Dunaief

In the second of a two-part series, Times Beacon Record News Media will feature the work of Eric Yee, who, like his wife Felicia Allard who was featured last week, is joining the Pathology Department at Stony Brook University.

Eric Yee

Eric Yee, who started as an Associate Professor and Director of Surgical Pathology at Stony Brook Renaissance School of Medicine on July 1, described the focus of his scientific research as translational.

He consults with and helps science researchers put together ideas for experiments, while he and his wife Felicia Allard focus on bringing that work into the clinical setting.

“We provide expertise mainly in clinical gastrointestinal and hepatobiliary pathology,” Yee explained in an email. “We also give insights and perspectives as practicing pathologists to help [with the] analysis of data and how that data in the lab or in animal models may be relevant to clinical medicine.”

Yee completed a gastrointestinal pathology fellowship, working on collaborative research projects and publishing manuscripts with investigators.

As one of the newest members of the staff at Stony Brook, he has worked on some studies looking at certain kinds of inflammatory diseases in the liver. He collaborated with senior investigator Zhenghui Gordon Jiang of Beth Israel Deaconess Medical Center to look at mediators of inflammation in the disease steatohepatitis. He has also worked on different cancer research projects, which is part of the appeal of Stony Brook.

Stony Brook has “important pancreatic research,” Yee said, adding that. Pathology Department Chair Ken Shroyer is a “renowned investigator whose research team has done great work that has led to important insights into pancreatic cancer biology.”

Pancreatic cancer is of particular interest to Yee in his clinical work and he hopes to explore the variety of research expertise at Stony Brook, to support ongoing efforts and to develop projects of his own.

Relocating to Stony Brook from the College of Medicine at the University of Arkansas for Medical Sciences, where Allard and Yee both worked in the Pathology Department, took some convincing for both of the scientists.

“We were very happy in Little Rock and purchased a home in Arkansas two years prior and were just starting to set down roots,” Yee described in an email. “We made lifelong friendships and very much enjoyed the camaraderie among our peers and other departments.”

Yee and Allard had no plans to leave as they approached their third year and were hesitant to move.

In his first visit, Yee said he was impressed with the amount of research in the Stony Brook department, which, he said, has more researchers compared to other institutions of similar size.

On the other side, however, Yee said he and Allard had to reconcile the higher cost of living in New York. They also weren’t eager to make too many moves in their career, especially when they were happy in Arkansas.

Even after the first visit, Yee said he was hesitant to make a move, which would require time to settle in, build relationships, find a home, learn a new system, and find new opportunities, among other challenges..

Shroyer was “very understanding of my hesitation,” Yee explained. “He’s been one of my mentors since medical school and knew exactly where I was coming from.

Clinically, the couple also believed in the potential for career growth.

“There’s a lot of energy in the department,” Yee said. He also appreciated the opportunity to be the Director of Surgical Pathology, where he could shape the operations that support the clinical mission. He would like to optimize the department by specialization, creating a sub-specialty model.

“This is something I want to do to increase the efficiency in the department,” Yee explained. “I’m hoping as we sub-specialize that we make our clinical work flow more efficient” which will create more consistency. “Part of what I’d like to do is to help [Shroyer] create a department where it’ll allow the clinical faculty to thrive.”

Yee thinks any work efficiencies will provide researchers with more time to build on their teaching efforts, and to develop new lectures and teaching models.

Yee will measure his success through a comprehensive report that includes an analysis of the efficiency of the response to clinical needs. He hopes to create a system that will enable the success of the entire anatomic pathology division. He will also become actively engaged in the academic mission, which is measured in the number of publications as well as in staff appointments to editorial boards or major national societies.

“The more people we can get into the national arena the better it is for the institution,” Yee said. These contributions bring good public relations and expertise to the institution.

Yee and Allard will also contribute to Stony Brook through their efforts in education.

Yee believes the school has an advantage in telepathology and distance learning. He believes the Department of Bioinformatics led by Dr. Joel Saltz facilitates telepathology and distance learning.

With the uncertainty caused by COVID-19, Yee believes maintaining social distancing and finding innovative ways for communication and education will provide valuable alternatives to communicate and collaborate.  Radiology has had digital methods in place to send MRIs and CAT scans for a longer period of time than pathologists, who still produce glass slides.

“There will always be some challenges and limitations that are unique to pathology,” Yee suggested.

A native of San Francisco, where he and his older brother, who now works in Boston, grew up, Yee was interested in medicine during the middle of his college career.

Yee and Allard met in medical school and, among numerous other parts of their lives they have in common, discovered they were both fans of the Star Wars films. Early on when they were dating, the pathology couple saw Star Wars: Episode III – Revenge of the Sith together.

Yee enjoys tennis, table tennis, riding road bikes and hiking. He has also developed an appreciation for bird watching, which has allowed him to practice amateur photography.

The couple also shares an interest in music, as Yee grew up playing the piano, while Allard played the trumpet.

When he was in medical school, Yee published his first  paper with Shroyer. He has remained in touch with the pathology chair over the years and appreciates the advice Shroyer has offered.

Yee described Shroyer as an “inspirational leader” and appreciates his energy, selflessness and passion, among other qualities.

Felicia Allard

By Daniel Dunaief

Stony Brook University recently added a wife and husband team to its Pathology Department. Felicia Allard and Eric Yee are joining SBU from the University of Arkansas.

Allard and Yee will “replace an individual who had moved to a leadership position at another institution and to meet increased caseloads in surgical pathology and cytopathology,” Ken Shroyer, the chairman of the Pathology Department, explained in an email.

Times Beacon Record News Media will profile Allard and Yee over the next two weeks.

Felicia Allard

Eric Yee and Felicia Allard. Photo by Joshua Valencia

A self-described “mountain girl” from Colorado, where she attended medical school and met her husband Eric Yee, Felicia Allard had only been to Long Island three times before accepting a job at Stony Brook.

She came once when she was interviewing for a residency and twice during the interview process.

Allard and Yee accepted the jobs in the middle of February and weren’t able to look at potential homes during the height of the lockdown caused by COVID-19.

For now, the couple have moved into temporary housing in Port Jefferson Station, as they look for longer term living options.

Allard, who will be an Associate Professor at SBU, said the move started with Pathology Department Chair Ken Shroyer, who was looking to fill two positions and reached out to Yee.

Shroyer was involved in a type of cancer work that interested her.

“The active pancreatic cancer research group was a big draw for me as I am hoping to expand my research career,” Allard explained in an email.

Allard said she was particularly interested in pancreatic cancer, in large part because of its intractability and the poor prognosis for most patients.

“It was clear to me that this is one of the areas where we had a lot of work to do in terms of being able to offer any type of meaningful treatment to patients,” she said.

Allard said she, like so many others in the medical community, entered the field because she wanted to make a difference. She searched for areas where the “greatest good could be done, and pancreatic cancer is still one of those.”

In her initial research, she studied the pancreatic neoplasm, exploring how cells went from pre-invasive to invasive to metastatic conditions. She is interested in how the tumor interacts with the patient’s immune system.

While Allard will continue to provide clinical services, she plans to collaborate with Shroyer in his lab. “I’m hoping naturally to be integrating into Dr. Shroyer’s group,” Allard said.

Shroyer welcomed Allard to the department and to his research team.

Allard is “a highly-qualified surgical pathologist with subspecialty expertise in GI tract pathology,” Shroyer wrote in an email. “She has a specific interest in pancreatic cancer, which will also complement our translational research program,” he said.

Shroyer expects that Allard will be integrated into several cancer research programs and he is “looking forward to having her join my team that is focused on the validation of prognostic and predictive biomarkers for pancreatic cancer.”

Shroyer’s lab, which includes Luisa Escobar-Hoyos, who is an Assistant Professor in the Department of Pathology, will work with Allard to advance the translational aspects of keratin 17 research, building on earlier work to understand the mechanisms through which K17 causes tumor aggression, he explained.

As for her clinical work, Allard said she analyzes biopsies and resections from the esophagus, stomach, intestines, liver, and pancreas. She has also used cytopathology to look at pap smears and to analyze salivary tumor aspirations.

The time to consider any of these slides varies broadly. Sometimes, she receives a slide and the diagnosis is unequivocal within 30 seconds. Other times, a biopsy from a six-month old patient with diarrhea, for example, can have an extensive list of differentials. In that case, the diagnosis can take considerably longer, as a baby could be sick because of an autoimmune disorder, inflammatory bowel disease or an infection.

She said she can “perseverate for hours or even days” over the subtle clues that may help with a diagnosis.

Allard likened the diagnostic process to reading a detective novel, in which the reader might figure out the perpetrator on page three, while other times, the culprit isn’t discovered until page 300.

Allard said she and her husband have a similar clinical background.

Yee is “more of a tech geek than I am,” she said. “He understands artificial intelligence, computer science and bioinformatics more than I do. He is also interested in administrative and leadership to a greater degree.”

Allard said she and Yee may have professional overlaps, but they have unique interests, backgrounds and perspectives that they bring to work that give them each different strengths.

Allard said she knew she wanted to go into medicine in her junior year of high school. When Doctors Without Borders won the Nobel Peace Prize in 1999, she recalls being impressed with that distinction.

In medical school, she said the field of pathology appealed to her because she appreciated the marriage of clinical care and basic science in the field.

She and Yee started dating just before medical school started for her. Yee was two years ahead in school. They continued their relationship from a distance while he did his residency at Beth Israel Deaconess Medical Center at Harvard Medical School. While she was a resident, Allard said Yee had the “distinct pleasure of trying to train me.”

She likes to explore the boundaries of diagnosis to understand the nuances and all the data that factor into interpretations, to tease the art from the science.

Outside of her work, Allard enjoys reading and calls her Kindle one of her favorite possessions. She hopes to learn how to sail while a resident of Long Island.

Allard is excited to start working at Stony Brook. Shroyer was “very persistent and once he got us up to New York to interview, he was persuasive with respect to the type of career growth we could both potentially have,” she said.

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John Haley photo from SBU

By Daniel Dunaief

Once they reach their destination, they wreak havoc, destroying areas critical to life. All too often, when cancer spreads, or metastasizes, through the body, it becomes fatal.

John Haley, a Research Associate Professor in the Pathology Department at Stony Brook, is trying to figure out how cancer become metastatic and, even further, what they do to avoid recognition by the immune system.

Haley is “working on the mechanisms by which metastasis occurs,” he said. He is also studying the “immune recognition of tumor cells and, in the near future, wants to link the two.”

Understanding the way metastasis works can greatly reduce mortality in cancer, Haley said. Researchers are currently attempting to develop therapies that target metastatic cells, but these are often more difficult to kill than their primary counterparts, Haley explained.

The stakes are high, as 90 percent of cancer deaths are due to complications from the spread of cancer rather than the primary tumor itself, he said.

About 80 percent of human cancers are carcinomas, which are derived from epithelial cells. Those are the cells that make up the skin, and line the stomach and intestines.

“As cancers become metastatic, those cells have the ability to shape shift,” he said.

They become much more like fibroblasts, which are underneath the skin and glue the skin to bone and make up connective tissue layers. Haley said he has made some progress in understanding the molecular mechanism that allows cells to shift from epithelial to fibroblastic cells. They have “defined factors which promote” this transition, with differences in survival and growth pathways.

Haley works with a machine called a mass spectrometer, in which he identifies proteins in complex biological samples and measures how changes in composition alters function. He spends about half his time working on his own research and the other half assisting other researchers who are seeking to get a clearer view of key changes in proteins in their work.

In his own research, he wants to understand how cancers modify a cell’s proteins. He has helped define how cancers can change their protein signaling pathways to become drug resistant, which suggests targets for drug therapies.

Haley is tapping into an area of science that many other researchers are exploring, called bioinformatics. Using statistics and mathematical models, these scientists are cutting down on the number of genes and proteins they study, honing in on the ones that have the greatest chance to cause, or prevent, changes in a cell.

“We’re taking the data sets we’ve generated and trying to predict what we should look for in human patient samples,” Haley said. “We can find a tumor cell that have mutations or this expression profile and find drugs they are sensitive to.” Once scientists find those drugs, researchers can test them in cell cultures, then in mouse models and eventually in people, he said.

“We try to isolate someone’s cancer to understand what the molecular drivers are that occur in that cancer,” Haley said. The approach, as it is much of modern medicine, is to understand the patient’s genetics and biochemistry to select for a drug that would be effective against the particular mutations present in their tumor.

A resident of Sea Cliff, Haley is married to Lesley, whom he met while he was pursuing his PhD at Melbourne University. A native Australian, Lesley was completing her Masters in Opera when the couple met at a tennis match. They still play today. Lesley has sung at New York premieres for several living composers at concert venues including Avery Fischer Hall. She teaches music at her studio in Sea Cliff. Their children share their interests. John is a freshman studying biochemistry at Stony Brook University and Emma, who is a senior at North Shore High School, plans to study science and singing.

As for his work, Haley would like to see his efforts culminate in cancer therapies and diagnostics. Any novel therapy might also become a product for a start up company which could create jobs on Long Island. “There are some fabulous scientists” at the university, he said. “A major goal of the Center for Biotechnology and Diane Fabel, its director, is to create small businesses here in New York. I’m trying to help them in that goal.”

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Counterclockwise from front row left, John Haley, Geoffrey Girnun, Scott Powers and Patricia Thompson. Photo from Stony Brook University

When local teams bring in superstars, the typical sports fan salivates at the prospect of winning a national championship. At the player level, success often breeds success, as other stars and talented players are eager to join teams where they believe in the philosophy of management and the talent of their teammates.

With considerably less fanfare to the typical Suffolk County resident, Stony Brook University has lured some promising researchers from around the country to its growing pathology department. What’s more, the newest members of the team not only have big plans for themselves and their department — they want to help Long Islanders who are battling cancer.

Their research aims to give doctors tools to make a more informed cancer diagnosis, create jobs by developing start-up companies and contribute to the Cancer Center’s goal of receiving a National Cancer Institute designation, which would allow Stony Brook to bid on multimillion dollar grants.

“We are looking for new ways to advance the practice of pathology that will improve the quality of health care nationwide and worldwide,” said Ken Shroyer, the head of the pathology department.

When Shroyer arrived in 2007, he said his first goal was to bring together the talent that was already working at the university. Like siblings who grow apart after they leave home, the clinical research and basic research efforts were working in parallel, rather than together.

After finding common ground for those groups, Shroyer added staff on the clinical side. His next priority, he said, was to boost the research department, which had only one externally funded investigator. That number now stands at 12, with four of the new staff coming in the last 18 months.

The newest researchers joined the pathology department and became leaders in the Cancer Center. “Each of these four individuals has a national reputation and special expertise in a particular area of cancer research,” Shroyer explained, saying he combed the research landscape to find the right experts in their field.

For their part, the new staff share an enthusiasm for the department and a vision for where it’s heading. An expert in finding biomarkers that help identify patients at risk of cancer recurrence, Patricia Thompson plans to encourage basic scientists to make discoveries that affect patient care.

Geoffrey Girnun, meanwhile, continues to study how cancer’s metabolism works, hoping to find differences between cancer cells and normal cells that can become targets for intervention and therapy.

After two decades searching for therapeutic targets for cancer, Scott Powers shifted gears and is now looking for ways to detect cancer earlier.

John Haley is concentrating on exploring how cancer cells escape detection from the immune system and become metastatic.

The director of the Cancer Center, Yusuf Hannun said the partnership with the pathology department is “key to bridging basic research discoveries to cancer specific research and then to human applications,” which could include biomarker discoveries, new therapeutics and individualized and personalized genomic cancer research.

Hannun believes the Cancer Center will continue to push the envelope in diagnosis, treatment and prevention. “We want to bring more special and unique abilities in the war against cancer,” Hannun said. “The inroads in cancer are happening.”

Stony Brook could become involved in prevention, where doctors and scientists work with patients before they develop any signs of the disease. “That domain is clearly within the scope of the Cancer Center,” Hannun said. “We are working on novel biomarkers that could detect very early cancer.”

Hannun described Shroyer as his “alter ego” in the Cancer Center. “He is a very capable leader and does very exciting cutting edge research with a steeped history in early diagnostics.”

Shroyer focuses his work on the discovery of biomarkers that can be used to improve diagnostic accuracy, provide prognostic information and identify more effective treatments for cancer, he said.

Five years from now, the success of the effort will be reflected by the extent to which the group can enhance the national standing of Stony Brook Medicine and the Cancer Center as leading institutions in basic and translational cancer research, Shroyer said.