Monday, June 27, 2016

A WELL DESERVED BLOGGER HOLIDAY


Grand daughter Olivia
Great grand daughter Evelyn, atop
Daughter Kristen's excellent horse, Buddy
Photo Joe Mortimer

There will be no new blogs for about a week; try to contain your grief.  I have visitors from Alaska (shown above) and I intend to enjoy them to the fullest.  You may well ask: how did a troll like you produce such handsome offspring?  Answer:  Darned if I know; the rest of their forebears must have been pretty exceptional.

Saturday, June 25, 2016

THE GENE: An Intimate History

In search of fabric
St. Charles, Missouri

Remember  Rocky?  Of course you do; it was a great movie.  No matter what you think of boxing, Philadelphia, or Sylvester Stallone, Rocky was great.  Do you remember Rocky 2?  Probably not.  It wasn’t bad, really, but it just wasn’t up to the standards of its predecessor.  That seems to be generally the case; sequels are, to some extent, a letdown.

Of course, there are exceptions: The Godfather was one of the best movies of all time – but Godfather 2 was just as good.

Well, sadly, Siddhartha Mukherjee’s new book, The Gene: an Intimate History falls into the Rocky category; compared to his previous triumph, The Emperor of All Maladies, The Gene is over-long,  over-written, and difficult to follow – in fact, soporific.  (My open-the-book to nap interval was about seven minutes, a  record.)  I wish I could praise Mukherjee’s new book, because he is an indisputably brilliant scholar.  I think that winning the Pulitzer Prize with Emperor has made him secretly long to be a poet.  Instead, I hope he goes back to being a fill-time cancer researcher; then, in 20 years, he can write  the Godfather of modern medical  literature.

As to the structure of the book:  He begins with the history of research in genetics – all the way back to Mendel, for Heaven’s sake!  This story has been told before, usually simpler.  There is quite an extensive (and interesting) discussion of eugenics, Nazi and otherwise.  The bulk of the book deals with modern developments in genetic medicine, and is quite up-to-date; even CRISPR Cas9 technology is explained, and rather well at that.  The final few chapters, though, degenerate into medical metaphysics.  I got through them, with the help of much coffee.  I may try them again someday, but not soon.

In short: don’t read this book unless you are an expert in the field, an insomniac or, like me, a masochist. 


Friday, June 24, 2016

HEREDITARY CANCER

Linda and Kristen
Tucson, mid 1980s

 When Linda was diagnosed with ovarian cancer about a decade ago she was not offered genetic testing.  I believe that was because of how little was known about the genetics of ovarian cancer at the time.  Now, it is recommended that every woman be offered BRCA testing upon diagnosis, whether or not there is a family history of breast or ovarian cancer.  This is partly because treatment and prognosis in part are determined by BRCA state.  For instance, it appears certain that patients who are BRCA-positive have longer remissions.  If you have breast or ovarian cancer in your familial history you should study this web site.


(This must be a contender for the title of “most difficult web address to type accurately” in the world.  I wonder what it would look like in Arabic.)

As I have discussed elsewhere, the more OVCA and genetics are parsed, the murkier the connection becomes.  Apparently there are a dozen or so mutated genes that can contribute to ovarian cancer; BRCA1 & 2 merely have the highest “penetrance”.  (Rough definition: the higher the penetrance, the higher the probability of coming down with the disease.) 
If you study the web site you will find a pie diagram that illustrates just how difficult this whole thing of OVCA/genesis turning out to be.  The diagram shows the fraction of hereditary OVCA attributable to certain mutations – BRCA, for instance, is held responsible for ~20%.  The largest piece of the pie - fully 60% - is labeled “unexplained familial risk”.

By the way – health insurance will cover BRCA testing.

Wednesday, June 22, 2016

SOME RECENT COMMENTS OF INTEREST

Weddell Seal, basking in Antarctic sunshine
This blog isn't worth a picture of Linda

Read 'em all.  What else do you have to do?

More on the benefits of using oral contraceptives - and of having kids. http://www.clinicalendocrinologynews.com/specialty-focus/reproductive-endocrinology/single-article-page/study-confirms-role-of-oral-contraceptives-in-preventing-ovarian-cancer/7d253397f184402b915c6fe19d8c9acd.html on 
SGO: The good guys

More on the link between lack of exercise and ovarian cancer. Cause and effect rather murky. http://www.oncologynurseadvisor.com/ovarian-cancer/exercise-may-protect-against-epithelial-ovarian-cancer/article/504709/ on THE DEATH OF CANCER?


Will this topic never die? I am so upset that I plan to grill a steak this evening. http://www.cancertodaymag.org/Spring2016/Pages/What's-The-Beef-Cancer-Risk-Meat.aspx on 
BACON FOREVER!


And here is another use for NIR radiation. Recent experiments indicate that NIR can make the cancer surgeon’s job easier. In OVCA, surgical “debulking” – cutting out all visible tumor – is SOP. It is, however, notably inefficient, because the surgeon must recognize cancerous material “By eye”. Now it appears that help for the surgeon is within sight. Some clever people have developed a chemical that is readily absorbed by OVCA tissue, but by scarcely anything else. This stuff will glow when subjected to NIR, and guide the surgeon’s knife to hidden bits of bad stuff. As always – not a cure, but progress none the less. http://www.news-medical.net/news/20160615/Novel-imaging-technique-may-assist-surgeons-to-improve-visualization-of-ovarian-tumors-during-surgery.aspx on 
NCI brings you NIR-PIT

I am a sucker for anything having “epigenetic” in the title, so I picked up on this article – but learned darned little. Apparently there is something called “epigenetic medicine”. Maybe someday someone will tell me what it is. http://medicalresearch.com/author-interviews/breast-and-ovarian-cancers-may-have-common-epigenetic-origin/24690/ on EPIGENETIC APOCALYPSE NOW: I warned you.

More on endometriosis. Ladies, you should appreciate me http://thestir.cafemom.com/healthy_living/198268/5_things_you_didnt_know on NOT A GUY THING

More on BSOR, Does your gynecologist know this? http://news.yale.edu/2016/01/21/sparing-ovaries-and-removing-fallopian-tubes-may-cut-cancer-risk-few-have-procedure on FREE MEDICAL ADVICE (and worth every penny)


7


A USEFUL WEB SITE


Joyces, Becks, and Ocotillos

Remember Dream Teams?  Specifically, do you remember SU2C – Stand Up to Cancer?  I have blogged about them several times over the past many months.  Probably Dream Team efforts have been swallowed up and digested by the Moonshot by now.  If not, then soon.  Anyway, one of the outfits involved in the ovarian efforts of SU2C has come out with a nifty new web site which you should investigate and possibly bookmark.  Here it is:



Regarding the picture.  It must have been a cold day in old Borrego Springs.  Two days ago it was rather warmer: 123 degrees, to be exact.

Friday, June 17, 2016

FUN with the Economist

Linda on the Greek island of Rhodes

The Economist has two important stories of interest to us.  The second one deals with the relative cost of drugs.  You may need to “Register” to read them both, but Registration is quick, easy, and free.
Read them.  They’re FUN!






Tuesday, June 14, 2016

OF WOLVES AND WOODCUTTERS

Linda astride the Mendocino Triple Junction

VBL Therapeutics, based in Israel, has just presented evidence that one of its drugs (VBL-111) is useful in combating thyroid cancer, glioblastoma – and ovarian cancer.  Here is the press release:


But that’s what I want to write about.  No doubt you have read my characterization of the savage pack of tort lawyers that feast on medical mistakes.  To some extent the scene resembles a party of woodcutters in a forest, nervously huddled around a campfire while all around them twin eye-shaped pairs of lights blink on and off.  The sound of gentle drooling is distinctly evident.

God help the axman who has to go into the shadows to pee.

No doubt the “wolves” in this scene would prefer to be seen as trailing a migrating herd of caribou, weeding out the old, weak and undeserving, thereby bettering caribou in particular and the world in general.  Well, maybe.

As often is the case, there is some truth in both characterizations.  However, there can be no doubt that wolf-scrutiny inculcates caution.  Here, for instance, is VBL Therapeutics’ effort to cover its ass:

Forward Looking Statements:
This press release contains forward-looking statements. All statements other than statements of historical fact are forward-looking statements, which are often indicated by terms such as “anticipate,” “believe,” “could,” “estimate,” “expect,” “goal,” “intend,” “look forward to”, “may,” “plan,” “potential,” “predict,” “project,” “should,” “will,” “would” and similar expressions. These forward-looking statements include, but are not limited to, statements regarding the clinical development of VB-111 and its therapeutic potential and clinical results, including statements related to the Phase 3 pivotal trial for rGBM. These forward-looking statements are not promises or guarantees and involve substantial risks and uncertainties. Among the factors that could cause actual results to differ materially from those described or projected herein include uncertainties associated generally with research and development, clinical trials and related regulatory reviews and approvals, and the risk that historical clinical trial results may not be predictive of future trial results. A further list and description of these risks, uncertainties and other risks can be found in the Company's regulatory filings with the U.S. Securities and Exchange Commission. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. VBL Therapeutics undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise
.

That should keep the wolves at bay, by God!