Halting cancer's genetic legacy - Dr Meryl Oyomno

The Kenyan-born colorectal surgeon explains that pre-implantation genetic testing of embryos of parents with genetic predisposition to colon cancer carries prospects for elimination of rogue genes and the hope of halting generations of suffering and grief.

Dr Oyomno, who is conducting her research at Steve Biko Academic Hospital, believes that this hope can be realised in a few years, and could make hers the last generation of doctors to see polyposis and hereditary colorectal cancer syndromes. Polyposis syndrome is a hereditary condition associated with an increased risk of developing polyps in the digestive tract, most commonly in the colon or rectum. In time, these often develop into cancer.

In 2017, she spent time at Oxford University and St Mark's Hospital in London, which has the biggest polyposis registry in the world. The experience is one of the things that inspired her to begin molecular profiling of colorectal cancer in young black South African patients.

In pursuit of new cancer data

After completing her colorectal surgery training at the Wits Donald Gordon Medical Centre, Dr Oyomno became head of the colorectal surgery unit at the Steve Biko Academic Hospital where she conducts about 100 surgeries a year.

Then, in 2018, her data unexpectedly revealed that younger black patients were increasingly developing colorectal cancer. This finding sparked her curiosity about the unusually high prevalence of aggressive colon cancer, which accounts for 35% in young black South Africans.

"I wondered, at a genetic level, what mutations were they having that caused the cancer? It may not be polyps but something else. This is what my research is about," she explains. She noted that in 2020, colorectal cancer was the second leading cause of cancer death globally, at 9.4%. Better colorectal cancer data capturing from all local hospitals is thus vital.

Well-rounded upbringing

Dr Oyomno was born in Nairobi, Kenya, as the middle child of five siblings. Her mother Violet was a high school biology teacher and her father, Gordon, a retired IT management specialist and former senior lecturer at the Wits School of Governance. The family lived on a half a hectare property at one of Kenya's top boys high school. Her brothers attended the school, while she and her sisters commuted to one nearby.

Violet took full advantage of the high-level academic and sporting skills on her front porch. Dr Oyomno recalls, "It was like a barter system. My mum taught the other teachers' kids biology and they taught us French, art, music - whatever our interests were."

She swam, ran track, threw javelin and played tennis for the national team until her medical school years. Her parents allowed TV watching for an hour a week, encouraging the reading of recommended titles instead. It produced academic results. Dr Oyomno's brother Peter, a PhD holder in mobile information security, is a mobile security researcher, while her sisters Faith and Jill have their master's degrees in electrical engineering and architecture respectively. Her brother Timothy is a senior IT manager.

While Dr Oyomno was in high school, her parents moved to Johannesburg and in time secured permanent residency and citizenship for the family. After finishing her medical education at the University of Nairobi, Dr Oyomno did her internship at Helen Joseph Hospital where she grew fascinated with surgery. She completed her general surgery specialisation, MMed and sub-specialisation in surgical gastroenterology at the University of the Witwatersrand.

She is married to Dr Gideon Botha, a chartered accountant with a PhD in healthcare price tariffs and costing structures of South African private hospitals.

Books with a seminal influence in her life are Gifted Hands by Ben Carson, the first neurosurgeon to separate conjoined twins, and Nelson Mandela's Long Walk to Freedom.

"Don't let gender be a limitation"

Dr Oyomno loved surgery so much that, under colorectal surgeons Professor Julien Oettle and Dr Brendan Bebington, she developed an empathic bedside manner. "I would have lived in their gastro-intestinal wards if I could have!" Among her greatest pleasures is meeting healthy, happy patients she operated on years before that were cured of their cancer.

Her advice to young women in a male-dominated field? "Don't let your gender be a limitation and don't use it as an excuse. Work hard, be socially responsible, humbly pursue God's purpose for your life and have empathy for those around you. Look at the needs in your society and how you can help solve them."

This article was created for the 2021 Discovery Foundation Awards and has been edited for the Discovery Magazine.