Meet Our Memorial Sloan Kettering Cancer Center Fellow: Zaeem Nazir

Tell us a little bit about yourself. When did you first become interested in science?

Ever since I was a child, I was always eager to explore how and why things worked. Over time, I realized that I could test my theories and come to my own conclusions about the world around me, thus sparking my interest in science. Having been born before the turn of the century, I grew up seeing how rapid advances in technology completely changed the way we live our lives. As technology enabled positive change across the world, I wanted to help drive change in my own community. I approached the challenge by launching some outreach projects, volunteering for several political campaigns, and working as a programmer and data scientist.

When I learned I could combine my interests in science and advocacy with a career in medicine, I felt I had found the right field for me. Medicine would give me the tools to use my clinical, research and advocacy acumen to positively impact my patients as well as my community. Gaining independence and expertise in clinical research is the next step for me as I hope to improve patient care during my career. This realization is what guided me to the Clinical Research fellowship in Dermatology at Memorial Sloan Kettering.  

You are currently working as a fellow for the Memorial Sloan Kettering Cancer Center – can you tell us a little bit about what you are working on (in terms us non-scientists can understand)?

I’m currently working on a variety of projects which utilize skin cancer imaging to improve care. Across our faculty of skin cancer experts, we’re investigating nearly every imaging technology which can come between our eyes and skin (glasses and contacts are an exception). I work with Dr. Ashfaq A. Marghoob MD, the director of clinical dermatology at MSK Hauppauge and Dr. Chih-Shan Jason Chen MD PhD, the director of dermatologic surgery at MSK Hauppauge, on projects investigating dermoscopy, 2D and 3D total body photography, artificial intelligence/computer vision, electrical impedance spectroscopy (EIS), reflectance confocal microscopy (RCM) and optical coherence tomography (OCT).

As each of these technologies provides a different view into the underlying biology of skin cancer, our research helps gather insights which allow us to improve the early detection, management and treatment of skin cancer. For example, we are investigating the use of a combined RCM-OCT device to identify basal cell carcinomas which can be treated without surgery. This insight could be particularly impactful when treating basal cell carcinomas located in cosmetically sensitive areas such as the face and hands.

What excites you most about this research?

As we are investigating some of the latest skin imaging technologies available, it’s exciting to be able to see the difference it makes for our patients. Our understanding of the strengths and limitations of each technology allows us to strategically integrate them into clinical practice—allowing us to identify cancers early and prevent unnecessary biopsies. 

What are the biggest challenges?

One of the biggest challenges is managing the breadth of research ideas and opportunities at MSK Hauppauge. As our faculty are very committed to research and collaboration, we can evaluate skin cancer outcomes at all points of one’s care, including disease epidemiology, pathophysiology, diagnosis, and management. Naturally, this means there are many different research questions we can answer. While it was challenging to decide what to investigate during my time here, I decided to focus on studies evaluating the improvement in patient care that new technologies can provide. 

How do you see this research changing the way we detect skin cancer in the future? What impact do you think this technology will have in reducing the mortality rate for skin cancers and melanoma specifically?

In the future, ubiquitous availability of imaging technologies such as total body photography and artificial intelligence will democratize access to skin cancer screening as they can be used with devices such as our own phones. Broader implementation of these technologies in dermatology and the primary care setting may be the simplest and most effective way to improve early detection of melanoma and other skin cancers.

Early detection of skin cancer often decreases the need for extensive surgical intervention and may result in more skin cancers being amenable to non-surgical treatment. Once identified, imaging technologies such as RCM and RCM-OCT can help avoid unnecessary biopsies and assist with tailored treatment selection. 

Although improved patient and clinician education have allowed us to identify thinner melanomas than we have previously, early detection’s impact on melanoma mortality has yet to be shown. At a population level, the improvement in melanoma mortality over the past decade remains an important public health achievement.

However, as different groups of people experience different risk, we must now tailor our efforts to the patients who need it most and develop strategies to improve outcome disparities across age, gender, race and socioeconomic status. While the availability of new biologic-treatments for metastatic melanoma has already began to improve melanoma mortality, there is still much work to be done.

Do you think this technology will someday go beyond skin cancer detection and into treatment delivery?

Definitely! Traditionally, we remove skin cancers with a margin of tissue ranging up to 2cm depending upon the diagnosis. Recently, several studies have demonstrated the usage of RCM and combined RCM-OCT to map the margins of cancer, or even recreate a 3D model of the cancer for precise surgical removal. Today, we are currently using RCM-OCT to identify basal cell carcinomas amenable to non-surgical treatment as a part of a longitudinal project with Dr. Chen. In the future, we anticipate that this technology could be used for devices which automatically map and treat a cancer with very high precision. 

Is there anything else you would like to add?

I would like to thank the Dennis Gross Skincare team for their incredible support to skin cancer research and the field of dermatology. It is both an honor and privilege to be able to try and answer some of dermatology’s biggest questions with mentorship from leaders in the field. I would also like to thank the many mentors who have helped me across the different stages in my life’s journey.

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