Saturday, June 27, 2015

BLOGGER HIATUS CONTINUES


I am recovering from excess expenditure of energy in Iceland and lack the wherewithal to pick up my blog.  Here is a recent article on immunotherapy, covering ground we have been over before but, maybe, more clearly

http://www.economist.com/news/science-and-technology/21653602-doctors-are-tryingwith-some-successto-recruit-immune-system-help.

I slept 10 hours last night and I am tired again already, and it is only five o'clock.  Maybe nature is trying to tell me something.

Sunday, June 14, 2015

EXCEPTIONAL RESPONDERS

Linda, interesting geese, and flowers - in England
Note monkey puzzle tree at left.
Mine is bigger
Boy, the Bellingham Herald is morphing into the Pacific Northwest Journal of Medicine; at least its Sunday edition is looking that way.  Today they printed a long article entitled “Exceptional Responders” guide researchers to cancer therapies. Naturally they didn’t write it; rather, they simply reprinted it verbatim from the Washington Post.  Here is the latter’s article; it has better adds attached:
http://www.washingtonpost.com/national/health-science/looking-for-answers-in-cancers-exceptional-responders/2015/06/13/9cf0ec78-0571-11e5-a428-c984eb077d4e_story.html
In a small nutshell, people at Dana Farber in Boston decided to investigate why a woman with a nasty disease, anaplastic thyroid cancer  got better and so far has stayed better ostensibly by taking a drug called everolimus, whereas all the other patients in her clinical trial died taking the same concoction.  Gene sequencing being hot stuff these days, the Dana Farber researchers combed her DNA and located the very mutation that seemed to be causing her problems.  Everolimus apparently helps overcome the effects of this mutation.  So far, so we’ve seen all this before.
The next thing the D.F. people did, however, was creative.  They sequenced the DNA of other of their cancer patients – and found another woman, suffering in this case from ovarian cancer, who had the same mutation.  They gave her everolimus and, you guessed it, she got better, too.  Very encouraging.
The article ends with the usual cautions: not everybody that takes everolimus for a cancer having this mutation will get better; cancers often are home to many, many mutations, and some of them may contribute.  Also, it is not certain that the improvement wrought by everolimus is permanent.  Maybe it will only buy time – but time, lived healthily, is precious.
Surely this is more strong evidence that the way to conquer cancer is to thoroughly understand it.  Progress is being made.
 
By the way, I wrote about this same discovery almost three years ago.  At the time the “exceptional responder” was called an “outlier”. Read it yourself:
 


Thursday, June 11, 2015

OLAPARIB*: NOT A PATENT MEDICINE

A Michigan Halloween
We here in the U.S. have our NIH; in the U.K. they make do with NICE (The National Institute for Health and Care Excellence),  Both are  bureaucracies  charged with protecting the public from dangerous and/or fraudulent medical practices.  Both, in my view, tend to err on the side of caution.  Way over on the side of caution, sometimes.  How to fix ‘em?  Wish I knew.
My picture is that NIH and NICE were set up during an era where the public needed protection from – a hypothetical example – horse urine bottled in pretty containers and marketed as a sure-fire cure for baldness.  That era is now largely history, although some of the claims I see from time to time about the effectiveness of various diet schemes as therapeutic agent suggests it hasn’t completely vanished.  But all too often, in my view, drugs that could be of use are denied the patient out of an excess of caution.  I’ve written about this before.  The Hippocratic Oath often is rendered “First, do no harm.”  Maybe it should read “Do no harm, either of commission or omission” Letting someone die because a drug that might work could possibly do harm is a sin of omission, and is no less regrettable than offing them by prescribing  the wrong drug.  But what do I know: I’m just a dumb geologist. 
Here is the article that occasioned this outburst:
Oh, yes.  You'll have to put up with an accelerated pace of new blogs; I want you to have something to think about while Karen and I are in the Land of the Sagas.
*You'll have to read the website to find out what this has to do with anything.



Wednesday, June 10, 2015

THE WORK CONTINUES

Nova Scotia
Note Canadian coastal defenses.
 
I was on my way out the door to sit by a nice lake and look for birds, when my conscience abruptly  grabbed me by the collar and flung me into this chair.  In less than a week I am going to Iceland, so (according to my conscience) it is necessary for me to write a few more blogs right away.  Yeah, said I – and turned to my Google notification of articles on ovarian cancer.  There, at the top of the heap, was an article by Nora Disis on experiments involving “Programed Death” . We have talked of these PD molecules before; they can be used in ovarian cancer therapy.  As it happens, Dr. Disis works with Fred Hutch, and I have sat in several meetings and conferences with her.  She is very highly regarded.  Once I sat next to her in a small meeting; she busily taking notes, I, completely lost, scratching my butt and wondering how soon the next coffee break was coming. 
Well, her article had me scratching my head and looking wistfully at my binoculars.  It is about preliminary trials involving PD-1/PD-L1 where, as you know, PD means Programmed Death.  I am ashamed to admit that I didn’t understand much of anything.  Here it is, if you want to take a whack:
Luckily for me, next to Nora’s article was an invitation to watch a video on “The Future of Treatment for Ovarian Cancer”.  This turns out to be a combination of our old friends, targeted therapy and immunotherapy.  Nothing much new is covered in this short video, but it is worth watching nonetheless. 
Okay, now for the birds.  Yesterday I saw a Northern Harrier.  Today, maybe a condor.  Or a different kind of sparrow.  Or a duck.
I should add that I am increasingly optimistic about treatments for ovarian cancer.  It almost seems to me that if Linda had contracted OVCA now, instead of 7.5 years ago, she might have lived. 


Monday, June 8, 2015

JUNK DNA

Linda w/baby and cat
One of many
Well, I finally have put the cover back on Nessa Carey’s book “Junk DNA: A journey through the dark matter of the genome”, and put it on the bookshelf.  It still gets a grade of B+ and a warning*, but my appreciation of it picked up toward the end.  It remains a ten-minute, 2.5 X book, these being how long I could read it at a stretch and still remain conscious, and the number of times I had to read each sentence before I was sure I knew what it meant.  I will give it a second go in six months or so.
Just so you know, I am going on a “Farmhouse Holiday” in Iceland later this month, so you will be deprived of new blogs to read for several weeks.  Try to bear up.
*The warning:  Do not attempt this book unless (1) your background in genetics and biology are at least the equivalent of mine, (2) you are vitally interested in how human heredity works, and (3) you have  a hell of a lot of time on your hands.


Sunday, June 7, 2015

AN EFFORT TO CATCH UP


Linda and Carolyn, in 1981
They look happy.  Maybe they had just met me.
It has been week since I added something new to this blog, and the stern gaze of Abu Bakr ibn Beck al-Beaumonti has frightened me into frantic activity.  I have been busy, yes, but not doing things that are particularly useful.  For instance: yesterday I spent the afternoon stalking the elusive lazuli bunting, a tiny blue bird that flies like the wind and has an uncanny knack for hiding behind things.  I saw a blue streak darting across the road as I drove up to the place it had been reported.  I had memorized its song and its critical markings, and was sure it would be mine – that is, item 67 on my Life List – in a matter of minutes.  Not to be.  Neither hide nor feather nor diagnostic song did I experience, over the next two hours.  I may try again today (it is nice out), just as soon as I finish this blog.
So, I have just finished scanning several Google Alerts (on ovarian cancer), and found nothing much worth reporting. However,  I will tell you about several items that stuck in my mind.
One article, published in a British newspaper, reports that a woman whose ovaries were “riddled with cancer” cured herself by switching to a whole-foods, vegan diet.  I don’t believe it.
Another reported that eating ginger helps prevent cancer.  No statistics were cited, and no particular types of cancer discussed.  What the heck: maybe so.  There are so many different kinds of cancer that it is not beyond belief that ginger will inhibit some of them.  Eat ginger snaps.
Still another report left me depressed.  I won’t give you the citation (you wouldn’t read it anyway, although I am curious about how you would respond.)  The article describes very early stage clinical trial involving a few dozen patients.  All were in an advanced stage, with nothing much standing between them and death.  These poor souls were divided into two groups: one group got the drug, and the other a placebo.  Sure enough, the first group lived a significantly longer time than the placebo group.  Now, I wonder if I could be so rigidly scientific in performing this experiment.  If I had reason to believe that my drug would help, how in God’s name could I bring myself to feed half the group a useless sugar pill?  I know it has to be done – but let somebody else do it.
Finally, here is a good article, one that you should read.  It relates that there are five main instruments in the oncologist’s tool bag, namely surgery, chemo, radiation, targeted therapy – and a new one, immunotherapy.   We have talked about the last two several times in the past few years.  This article deals in detail with only immunotherapy, but it does it well.  It doesn’t break new ground, but it is a good survey.  Give it a whirl:


Monday, June 1, 2015

MONKEYS, DNA & A BOOK REVIEW

On a Bridge Somewhere - Sitka, I think.
Seems pretty scary to me
 
Back in the middle Holocene when I was in high school I recall a math teacher* trying to explain randomness.  Or maybe it was somebody else explaining Congress, I don’t absolutely know.  Anyway, what I remember is the statement that “if a monkey sat and randomly pushed keys on a typewriter, eventually he would write Hamlet.”  Well, maybe.  To put it in modern terms, if one million monkeys sat at one million computer keyboards and whacked away randomly, eventually they would write today’s version of the NY Times.
But we need a new copy, every day.  That would require an editor to scan this random output, select portions that happened to be interesting – and maybe even true – extract them and send them to the press room. 
So what does this have to do with anything?  Well, I am reading Nessa Carey’s new book, on “Junk DNA”.  This stuff no longer is “junk”, rather, it is recognized to perform myriad functions, often involving turning genes on and off.  As Dr. Carey explains it, these regulatory processes are complicated.  Very complicated.  Needlessly complicated.  It is as if a million monkeys banged away at the genetic code, turning out random garbage with an occasional bit of useful code imbedded in it.  Then, I guess, natural selection acts the part of the NY Times editor and preserves what works.  The result isn’t pretty, but we are here, and we function – most of the time.  No “Intelligent Designer” could come up with something this messy.
This blog has been inspired by my efforts – now under way for three weeks – to wrap my painfully finite brain around Dr. Carey’s concepts.  It hasn’t been easy, and I still have 88 pages more to tackle.  Regretfully, I have to warn you all that, if you want to read this book and get anything out of it you must: (1) read her first book, which was much easier and much more entertaining, (2) have absorbed at least as much molecular biology as I have thrown at you in this blog, and (3) have lots of time on your hands.  Sorrowfully, I am going to have to enter this book in my Cancer Wannabe’s Library:
http://ljb-quiltcutie.blogspot.com/2014/10/the-cancer-researcher-wannabes-bookshelf.html
 with a grade of B.  I guess I am asking too much when I seek a book that imparts useful knowledge about complicated processes but requires only minimal mental exertion.  Yeah, that’s for sure.
*I am fairly certain that the math teacher was Mr. Tierney.  Mr. Tierney once became fed up with my mouthing off to the extent that he literally tossed me into the hall.  Mr. Tierney was a weight lifter, and I was a scrawny little twerp.