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October is Breast Cancer Awareness Month in the United States. To recognize the more than 360,000 people who will be diagnosed with breast cancer in 2024, Nikon Instruments conducted an interview with previous Small World winner Malgorzata Lisowska. Lisowska’s captivating image of her breast cancer cells forming the shape of a heart earned her third place in the 2023 Nikon Small World competition. The image serves not only as a remarkable scientific accomplishment but also as a powerful symbol of hope and beauty in the face of adversity.

In this interview, Malgorzata Lisowska shares her personal journey as a healthcare advocate to then becoming a cancer patient herself, describing how her diagnosis of triple-negative breast cancer in early 2023 inspired her to turn the lens on her own cells. Through her photography, Lisowska aims to reshape the cancer narrative, using the art of microscopy to bring new depth and understanding to patient experiences and public awareness.

Responses have been edited for length and clarity.

Nikon Instruments: Could you tell us about your career in healthcare, and how it has developed over time?

Malgorzata Lisowska: My desire to photograph cancer cells appeared long before my diagnosis. In early 2020, I made a career move toward healthcare. I traveled to the Netherlands to learn the Value Based Healthcare concept, which addresses the measurement of medical outcomes. The Dutch organization Value Based Healthcare Europe invited me to be their Ambassador in Poland. Since then, most of my professional projects have been related to healthcare.

I immediately noticed the visual aspects and messages surrounding me in healthcare, and I was surprised by how few professionals were in this field. It's important to consider that our surroundings in medical facilities and how we present disease-related messages (including visually) have a huge impact on patients. Unfortunately, there's often a lack of awareness about how this can affect medical outcomes, prevention, or the experience of disease.

While working on a project in oncology, I decided to focus on this specialization. I wanted to address not only the aspect of measuring medical outcomes, but also bridge the gap in the visual aspect.

NI: What first inspired your interest in microscopy, and how has that shaped your career?

ML: More than three years ago, while working with diagnosticians, I became aware of microscope photography. I realized that with it, I could contribute to changing the visual layer in healthcare, which I had always wanted to do but didn't know how. I started learning microscope photography and imperceptibly fell in love with this cosmic world and all it can reveal to us. Microscope photography has become a form of art for me, and my purpose is to take it from the laboratory space to the public space.

NI: What inspired you to submit an image of your breast cancer cells?

ML: Six months before I received my diagnosis, I started a postgraduate program in psycho-oncology to deepen my knowledge and understanding of the perspectives of cancer patients so I could better help them. After just one semester, I was diagnosed with triple-negative breast cancer (TNBC) at the end of February 2023.

I coped with the diagnosis by examining my cancer cells under a microscope. I photographed these cells, believing that microscopic photography of cancer is the missing link in the oncology narrative. To my amazement, this image won third place in the Nikon Small World competition in October 2023.

Throughout my journey, I underwent 16 chemotherapy treatments and surgery. While I'm now in remission, I prefer to say that I am healthy. This experience has reinforced my belief that microscopic images of cancer can be an important part of the patient experience and add significant value to the perception of cancer, both for patients and in the broader social and cultural context.

I dream of making this niche art accessible to a broad audience. Through microscope photography, I intend to address a variety of themes, including but not limited to disease. I want to present a world that is invisible to the naked eye. In my opinion, microscopic photography provides an opportunity to show various taboo subjects that we often turn away from (or simply don't see) in an engaging way.

I've discussed this image with numerous pathomorphologists. I asked them if it's common to see such a regular heart shape in cancer cells. They told me that while cells and tissues sometimes form interesting shapes, they had never seen such a perfectly regular heart shape before.

NI: What exactly are we seeing in the image of your breast cancer cells?

ML: The heart-shaped image is a remarkable blend of breast cancer cells, surrounding tissue, and tumor stroma. This unique arrangement occurred naturally to create this striking heart formation. This image not only showcases the structures present in breast cancer but also symbolizes the hope we all need in the face of cancer. It's a powerful visual representation of oncology and the beauty that can emerge from scientific research, even when studying such a challenging subject.

NI: What technical steps were involved in capturing this image, and did you face any specific challenges during the process?

ML: Technically, it's a very simple image. The greatest challenges were primarily emotional. I captured the image using a brightfield, stacking 28 individual photos, and using a uniform pink filter.

NI: How has photographing your breast cancer cells impacted or influenced your understanding of the disease?

ML: Photographing my cancer cells transformed my perspective on the disease. When I first saw my cancer cells under the microscope, I burst into tears of amazement, thinking, "It's impossible for something so beautiful to want to kill me!" The fantastic, abstract images created by my body during carcinogenesis impressed me from the very beginning. I saw "dancing" and "lost" cells that I couldn't take my eyes off. This experience helped me stop being afraid and focus on treatment. I realized there was nothing to fight against, as I would be fighting myself. Instead, I decided to treat myself with the greatest tenderness, support, and love I knew how to give myself.

NI: How do you think microscopic imaging, like your breast cancer photo, can play a role in advancing treatments or enhancing awareness about cancer research? In the past, you have shared your microscopic images with other oncology patients – can you tell us a little more about that?

ML: Microscopic imaging of cancer cells can significantly impact patient experiences and add value to how cancer is perceived, both by patients and in the broader social and cultural context. I believe that microscopic images of cancer are the missing link in the oncology narrative. By sharing these images with other oncology patients, I aim to bridge the gap in the visual aspect of cancer treatment and awareness. It's strange to me that while we all know what COVID-19 looks like, very few people know what cancer cells look like. Sharing these images can help demystify the disease and potentially transform many narratives in healthcare.

NI: Are there any current projects you're working on that you'd like to share?

ML: In June of [2024] I opened my exhibition “The story inscribed in the body in three acts,” documenting my oncological experience and journey to health through microscopic images of my biological material: breast cancer cells from my February 2023 diagnosis (TNBC) obtained through biopsy, tissues after my sixteen chemotherapy treatments, and healthy breast cells after my mastectomy. The aim of the exhibition is to supplement the missing, authentic visual layer in oncology narratives and to alleviate social fears associated with cancer.

I'm also writing a book about narratives in oncology, which I plan to publish in 2025. I've conducted 20 interviews with cancer patients and supporters. It will be a unique book, illustrated with artistic microscopic images of various cancers that I've taken.

I just launched a project called “Oncostories,” a platform where I bridge the gap between patients and healthcare professionals. My personal experience as a cancer patient has shown me how much I can do to improve the quality of experiences in oncology and beyond, and I want to continue focusing my efforts on designing and measuring cancer patients’ experiences based on the Value Based Healthcare concept.

NI: Why do you think competitions like Nikon Small World and broader scientific communication are important for research?

ML: Competitions like Nikon Small World are crucial in bridging the gap between scientific research and public understanding. They provide a platform for showcasing the beauty and complexity of the microscopic world, making scientific discoveries more accessible and engaging for the general public. These competitions also inspire researchers and photographers to push the boundaries of microscopic imaging techniques, potentially leading to new scientific insights.

Being on the podium in such a prestigious competition with a grand tradition is an exceptional honor. My third-place finish marks Poland's return to the podium after 31 years. The competition grows fiercer year by year, and it's increasingly difficult to place in the top three. Many of the scientific centers that have previously won have access to excellent equipment and exceptional specimens that I can only dream of. I feel incredibly proud and humbled to be part of this tradition that highlights the intersection of science and art.

NI: Anything else you would like to include?

ML: October is a special month for me as I celebrate my first year in good health. I would like to address cancer patients, encouraging them not to lose hope and to be gentle and kind to themselves during treatment, as this truly helps. Of course, I remain under regular medical supervision. I feel good. I’m honored to have been included in this interview.

Malgorzata Lisowska has been an ambassador of the Dutch organization Value Based Healthcare Center Europe since 2020. She also collaborates with EIT Health (European Institute of Innovation and Technology, and specializes in building strategies and measuring treatment outcomes. She holds a Master's degree in economics, completed postgraduate studies in psycho-oncology, and earned an MBA from Jiao Tong University in Shanghai.