January 10, 2024

Battling colorectal cancer as a doctor, researcher and patient

Three medical researchers reviewing imaging in a darkened laboratory
Dustin Deming, center, reviews images with colleagues inside his lab.

Dr. Dustin Deming provides hope to patients with colorectal cancer, both as a gastrointestinal oncologist and an active laboratory researcher for UW Health | Carbone Cancer Center.

Deming, ACI/Schwenn Family associate professor in the Division of Hematology, Medical Oncology and Palliative Care at UW School of Medicine and Public Health, did not plan to treat patients when he started medical school — much of his experience had been in laboratory medicine, and he enjoyed it. It was having a faculty mentor who split his time between research work and seeing patients that gave Deming a new purpose.

“I got to see how the work I was doing in the lab provided hope for patients,” Deming said. “I could see how the time in the clinic provided new directions and urgency for the research in the lab. They kind of fed off each other, which I found extremely rewarding.”

His professional focus on colorectal cancer — the third most common cancer in the U.S. — took on a personal aspect in 2012, when he received his own diagnosis at age 31.

“For lack of a better word, it’s horrifying,” Deming said. “It’s one of those things where, doing what I do, I can rarely take my mind off of cancer.”

Provider and patient

Deming was diagnosed at a much younger age than the typical colorectal cancer patient. According to National Cancer Institute data, the median age of diagnosis is 66. However, there has been an increasing trend of diagnosis in younger adults, and the recommended age for colonoscopies changed from age 50 to 45.

Deming’s diagnosis came about two weeks after becoming a clinical instructor at UW, and eight weeks after the birth of his second child. Because of his background, Deming was in a unique position to fully understand the reality of his diagnosis.

“Where it makes it harder is that you know all of the information and there’s no secrets or no bluffing yourself about what this really means,” Deming said.

His treatments included surgery, chemotherapy and radiation, and he continued working as much as he could during that time. Deming was cancer-free for about 8½ years when he had a recurrence in 2020 — a rare situation that less than 1% of patients in his situation face. Over the last 2-3 years, he has undergone further chemotherapy, radiation, and surgeries to become cancer-free once more.

Being a cancer survivor gives Deming an added layer of understanding and rapport when talking with his patients, and he in turn gains inspiration and hope from them.

“We’re all in this together,” he said. “I start every new visit by telling the patient who I am, what I’ve been through, and the fact that I’ve been in their shoes. The chemo they’re going to get, I’ve already had. The radiation they’re going to get, I’ve already had. The surgery they’re going to have, I’ve already had some of the toughest versions of it. So I’ve been through it, there’s life on the other end of it, and together we are going to make the best of this situation.”

Creating hope

Deming’s lab focuses on creating precision medicine treatments for different subtypes of colorectal cancer. As part of that work, his team grows organoids from patient cancer tissue to recreate those genetically-unique subtypes and provide a more authentic testing model.

Historically, cancer research relied on growing cell cultures in dishes for study, but the cells do not act the same way as they would in the body, so study results would not always translate to clinical testing. Also, certain types of cancer just would not grow in those artificial conditions.

With the organoids Deming’s team develops, they can study a greater variety of cancer subtypes with a more durable model that offers better odds of translating their findings to clinical success. These organoids are being used for genetic testing, evaluating drug effectiveness and new therapy combinations. They’ve also received grant funding to evaluate how the organoid responses compare with patient tumors in one-to-one treatments.

“So the idea is, just like we do with an infection, where we culture the bacteria to see which antibiotic works best, we’re trying to do the same thing with patient samples and chemotherapy,” he said. “And excitingly, we’ve had a ton of success with this.”

He and Dr. Melissa Skala, a professor of biomedical engineering and medical physics at UW have recently received a new NCI Research Project Grant (R01) to use their organoid models to systematically test a large library of drugs in the hopes of finding novel combinations that can benefit colorectal cancer patients. Deming said initial screens have already yielded some exciting combinations to explore.

“The whole point of our research is to make things better for patients. I went into cancer care and cancer research to provide hope for my patients,” Deming said. “So does the hope I intend to provide for other patients help myself? Absolutely, that is the case.”