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Jennifer Loud Retires after 27 Years of Service to the NCI

Jennifer Loud, R.N., C.R.N.P., D.N.P., adult nurse practitioner and assistant chief in the Clinical Genetics Branch (CGB), retired from the Division of Cancer Epidemiology and Genetics (DCEG) in late August 2020, after 27 years of service to the National Cancer Institute (NCI). Dr. Loud played a pivotal role in multiple clinical and epidemiologic studies aimed at improving understanding of clinical cancer genetics and the psychosocial impact of high genetic cancer risk on affected individuals. 

Throughout her career, Dr. Loud has been an invaluable contributor to DCEG’s research portfolio on the behavioral and psychosocial effects of cancer risk assessment and prevention procedures on high-risk individuals. At the time magnetic resonance imaging (MRI) was becoming widely used in breast cancer evaluation, investigators in CGB were eager to discover what role the technology might play in the clinical management of BRCA1/2 variant carriers enrolled in the Hereditary Breast and Ovarian Cancer Study. However, there was significant concern that the intense protocols—i.e., multiple MRIs every three to six months and various follow up tests, potentially including biopsies—might cause an unsustainable amount of stress and anxiety in study participants. As associate investigator of this study Dr. Loud collected detailed behavioral and psychosocial data to assess the impact of the study’s rigorous screening program on mental health and overall well-being. The data illustrated the study participants’ remarkable resilience in coping with the rigorous protocol and reassured investigators of continuing their research without causing participants undue stress. 

As associate investigator of the Li-Fraumeni Syndrome Study, Dr. Loud has played many roles. At the beginning of her involvement, she ensured compliance with ethical protocols outlined by the Institutional Review Board (IRB) designed to protect the privacy of study participants and their families. Later, she became one of the main clinicians of the study, playing a primary role in seeing patients and families at the NIH Clinical Center, building relationships with them, sharing study updates, and following up on their concerns. Given her experience studying adults with genetic predisposition to breast cancer, her expertise provided critical knowledge to the LFS study, whose female participants experience highly elevated lifetime risk of breast cancer compared to the general population.

Women with LFS can develop breast cancer as early as their late teens and early adulthood. Because of this, Dr. Loud and other study clinicians often discuss a variety of screening and prevention options with their young patients, including prophylactic mastectomy. With an increasing number of LFS study participants choosing this option in recent years, Dr. Loud saw an opportunity to marry her clinical and behavioral-psychosocial research interests by investigating the factors young women weigh when choosing mastectomy, as well as the effects of choosing not to have it. She and her colleagues found that women who had already experienced breast cancer were much more likely to opt for risk-reducing mastectomy, and that the women who did not undergo the procedure were much more likely to develop contralateral breast cancer than both the general population and individuals with other known cancer predisposition syndromes. The findings suggest the need for further research into the decision-making process around risk-reducing mastectomies and the effect the procedure will have on LFS-associated breast cancer risk over time.

In addition to the studies mentioned above, she served as principal investigator of the Breast Imaging Study and the Familial Testicular Cancer Study, and as associate investigator of the Ovarian Cancer Prevention and Early Detection Study.  She executed, managed, and upheld NIH standards for several large and complex contracts for the branch as one of the senior Contracting Officer Representatives.  

Prior to her arrival in DCEG, Dr. Loud spent seven years as a Nurse Practitioner with the National Cancer Institute's Medical Oncology Branch, working with individuals enrolled in clinical trials of new cancer treatments. During that time, she was a Clinical Trials Coordinator and an Associate Investigator on two chemoprevention trials for women at increased risk of breast cancer. These experiences cultivated her interest in cancer genetics.

“Jennifer was one of the first people I recruited to CGB,” said Mark Greene, M.D., former chief of CGB, “which ranks as one of the best decisions I ever made as Branch Chief. I could never have envisioned recruiting an investigator and colleague with the extraordinary array of traits, skills and potential that Jennifer embodied. She exceeded every expectation.”

After joining DCEG, she earned her doctorate in Nursing Practice from the University of Maryland in 2008, and completed NCI’s year-long Senior Executive Enrichment & Development (STEED) Program in 2009.

With her growing credentials and experience, Dr. Loud stepped into leadership roles throughout the Division, at NCI, and other professional communities. In 2008, she was appointed Assistant Chief of CGB, taking on wide-ranging responsibilities until her retirement. She served on key committees, including the Technical Evaluation of Questionnaires committee, Committee of Scientists, and the NCI Women’s Health Activities Committee. Her dedicated involvement with NCI's Clinical Center Institutional Review Board, first as affiliated scientist and then as deputy chair, established her as an invaluable resource for human subjects research regulatory matters in CGB, DCEG, and NCI. She has also served multiple times as an ethics moderator for DCEG’s annual ethics trainings.

Prior to her retirement, Dr. Loud was integral in the development and curation of a new web-based data and patient management system. Her dedicated work on this system allowed DCEG to serve as a leader in the division’s COVID-19 pandemic response.  This system saved both precious time and funds across multiple institutes allowing DCEG to take the COVIDCode study from conception to production in less than 6 months.  

Finally, Dr. Loud has considered training the next generation of clinical epidemiologists one of her primary responsibilities. She formally mentored more than a dozen trainees, and was an informal advisor to dozens more. She was recognized for her mentorship excellence eleven times with Sustained Superior Performance Awards, twice with NIH Merit Awards, and with the NCI John P. Hartinger Executive Leadership Development Award.  Many of her mentees have stated that her involvement early in their careers has been crucial in both support and experience for thriving in their professional development.   

Dr. Loud has left an indelible mark on DCEG, both professionally and personally. “From the time she interviewed me for CGB’s first tenure-track position, to serving as assistant chief,” remarked Sharon Savage, M.D., clinical director of DCEG and chief of CGB, “Jennifer’s kind and gentle spirit, clinical and scientific rigor, and mentoring of staff at all levels has been the foundation for CGB’s continued success. She has been my right hand, my voice of reason, my sound board – and will be missed dearly.”
 

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