Onetime cancer patient at Packard Children's aims for career in oncology
New Stanford graduate Nico Poux, a former pediatric oncology patient at Lucile Packard Children’s Hospital Stanford, hopes to bring his experience with cancer to future work as a physician-scientist.
As a kid, Nico Poux showed up for every doctor’s appointment with his backpack fully stocked.
“I had a Zuca backpack, like a mini-stand-up suitcase, that I would fill up with stuff, even for checkups,” Poux said recently. He needed a big stash of books, games and activities to keep himself busy if his doctors delivered bad news. “Any checkup could turn into a several-month stay in the hospital.”
Diagnosed with B-cell acute lymphoblastic leukemia in 2005, when he was 6, Poux spent the next seven years undergoing treatment for the blood-cell cancer. He estimates he spent 18 months hospitalized, ultimately needing many rounds of chemotherapy, as well as a bone marrow transplant at Lucile Packard Children’s Hospital Stanford.
Today, Poux, 21, is healthy. In June, he earned a bachelor’s degree in molecular, cellular and developmental biology at Stanford, and after conducting research for the last five years in the lab of Stanford stem cell pioneer Irving Weissman, MD, he’s about to start Harvard’s MD-PhD program, the next step in his plan to become a pediatric oncologist and cancer researcher. Due to the COVID-19 pandemic, his classes will be online this fall. He’s planning to stay in California for the time being and move to Boston in January.
Poux hopes to help young cancer patients who have been ill so long they aren’t quite sure what regular life looks like anymore. For a long stretch of his childhood, he needed people around him to help nurture his hope that eventually he would live a life without illness.
“As a kid, you just want to be normal again, when you feel so different,” Poux said. “I found it helpful whenever people could remind me that there does exist a life outside of this.”
A scientific friendship
One of the people who helped shape Poux’s view of the possibilities beyond hospital walls was Jonathan Tsai, MD, PhD. They met in the fall of 2011, when Poux was 12. Several months earlier, Poux had suffered a relapse in which malignant cells had appeared in his spinal cord, and he had undergone a stem cell transplant. Tsai was a first-year medical student enrolled in an elective class in which students are paired with Packard Children’s patients who have long-term illnesses.
Before they met, Tsai was concerned there might be a language barrier. He knew that Poux had lived in Paris until he was 11, and that Poux had received much of his cancer treatment in France before his family moved to the Bay Area in 2010. Tsai had spent three years living in Brussels and spoke some French, but he wasn’t fluent. Still, he hoped he could keep Poux company while the latter received infusions of intravenous immunoglobin, an immune therapy he needed after his stem cell transplant.
Tsai needn’t have worried. “We really hit it off,” Poux said.
Though Poux is fluent in English and French, Tsai soon realized the 12-year-old wanted his help decoding another language, that of medicine. “Slowly, he asked me more questions about his cancer,” Tsai said. “He was very curious, very interested in the science behind it.”
As a new medical student, Tsai hadn’t yet studied leukemia. He found himself looking things up so he could answer Poux’s questions. “He pushed me to explain a lot of the pathology, which helped me learn and helped him learn,” Tsai said.
Shaping his future
The two stayed in touch after Poux finished his cancer treatment at age 13. Tsai attended the same church as Poux and his parents, brother and sister. They met every few months to catch up.
Though his cancer was gone, Poux faced other challenges. Not long after starting ninth grade at Palo Alto’s Henry M. Gunn High School in 2012, he developed shingles and had to be hospitalized for a few weeks. He switched to attending the Packard Children’s hospital school. “The teachers helped me gain confidence in my ability to do schoolwork, and I made my own friends,” said Poux, who had mostly completed his schoolwork independently before this. “There are things that other sick kids really understand about one another that you can’t find in the general high school-aged population.”
He kept those friendships when he returned to Gunn for 10th grade, where he eventually became more comfortable with elements of high school life that had seemed foreign at first, such as sitting in class all day and making friends with kids who hadn’t been sick.
In 11th grade, a routine blood test suggested his cancer was back. While waiting for confirmation, Poux spent a week taking stock of how he felt about his life. He decided he wasn’t trying hard enough to shape the life he wanted.
The follow-up test came back clean; the first result had been a false positive. Poux was relieved but still searching for direction. Tsai, by then conducting research in Weissman’s lab, had an idea.
“Jonathan said, ‘Why don’t you come work with me?’” Poux said.
Research into clonal growth
The opportunity to work in a Stanford lab gave Poux, then 16, a doorway into science without waiting for medical school. “Two of my doctors, Dr. Porteus and Dr. Weinberg, were primarily research scientists, so I knew the medical world existed in a bigger space,” he said.
Weissman directs the Stanford Institute for Stem Cell Biology and Regenerative Medicine and is a professor of pathology and of developmental biology at the School of Medicine. Both Matthew Porteus, MD, PhD, and Kenneth Weinberg, MD, are professors of pediatrics at the School of Medicine and provide clinical care as pediatric hematology-oncology specialists at Packard Children’s.
I could not have picked a better lab, both in terms of people and projects.
Poux began assisting with Tsai’s research on clonal growth, developing techniques to follow how one cell gives rise to many daughter cells. They labeled cells with multiple fluorescent proteins, using the colored proteins to track how the tissue changed as the cells divided and matured. Tsai helped Poux make the decision to attend Stanford, and Poux continued conducting projects in Weissman’s lab throughout his undergraduate years.
“I was super lucky because I didn’t know anything about the world of biomedical research, and I ended up working in the lab of the guy who first isolated and purified the blood-forming stem cell,” Poux said. For someone whose scientific curiosity began with questions about the pathology of his own blood cancer, “I could not have picked a better lab, both in terms of people and projects, if I had tried,” he said.
In 2018, Weissman, Poux, Tsai and several other members of the lab traveled together to RIKEN, a scientific institute in Tokyo, where Poux presented some of his research.
“It’s super rewarding, seeing him go from middle school, to high school and through college, seeing how much he’s learned,” Tsai said.
Drawing on experience
As he heads to Harvard, Poux is excited about what’s next, both as a scientist and a future physician.
“I don’t want my seven-year experience with cancer to just be a bad mark on my life, like, ‘Now it’s over and we don’t talk about it,’” Poux said. He hopes his past will help him guide future patients through the difficulty of cancer treatment.
He also understands, on a personal level, that caring for cancer patients can be fraught with loss. He hopes that research developments will help him keep his spirits up.
“I know many people who didn’t make it through their cancer treatment, and as a pediatric oncologist, I’ll have to hold onto many more stories of people who didn’t make it, and for whom I’ll be responsible,” he said. “Being integrated into research is, I hope, a way to maintain my own hope.”
Besides, when he needs someone to talk to, Tsai, now a medical fellow in molecular genetic pathology at Boston’s Brigham and Women’s Hospital, will be nearby. Poux will have the ear of the friend and mentor who has known him since he was a curious 12-year-old with lots of questions about the biology of his leukemia.
Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.