Friday, October 17, 2014

SHINGLES

Linda and the twins, on a winter day in Michigan
 
I am enjoying a world-class case of shingles right now, so I haven’t much energy to spare for digging into the cancer literature.  Ebola has chased all other health-related stories from my usual newspaper sources, and Dick Ingwall seems to be in transit to Borrego Springs so I haven’t been able to count on him.   Rather than sit around feeling sorry for myself, I decided to see if other people are busy in the ovarian cancer field.  I used my old friend Google Scholar, and confined my search to articles published since January 1, 2012.  I searched for “exact phrases” but left the author line blank.  It seems that in the last 34 months there have been 37,400 papers published containing the phrase “ovarian cancer:.  Getting more specific, I find that over 1000 of them relate to early detection, slightly over 300 deal specifically with prevention, and the rest – presumably – with therapy.  I guess I should be pleased that there is so much attention being paid to ovarian cancer, but I am mildly disappointed that early detection and prevention are so conspicuously under-represented.  And that’s all the energy I have for today.  My main reason for posting  this blog, if you must know,  is to share this wonderful picture.


Tuesday, October 14, 2014

THE AMERICAN ASSOCIATION for CANCER RESEARCH


Linda and her Mom
Two beautiful women
 
For more than two years I have been scouring the world of cancer news, looking for information that I can pass on through this blog.  Many of you have helped, by alerting me to items published in the NY Times, Wall Street Journal, local newspapers, various news magazines, and on line.  Somehow, though, I have managed to remain completely ignorant of what may be a totally wonderful and convenient way to keep up with cancer research: the newsletter of the American Association for Cancer Research.  Somehow I have managed to remain unaware of even the existence of this organization, even though I conducted an intensive computer search for cancer foundations for the Rivkin Center just a year or so ago.  Anyway, I blundered onto the AACR web site just today, and discovered that – for free – I can receive a monthly update of advances in cancer research.  I just signed up, so I can’t tell you how valuable this e-newsletter will turn out to be, but I am hopeful.  If you want to sign up, here is the web address:
I know that all of you have better things to do with your lives than to join me in my inept but persistent crusade against ovarian cancer, so if you ignore this tip I forgive you in advance.  However, some of you might find it useful.  And, this is another excuse to post a picture of Linda.
 


Friday, October 10, 2014

THE CANCER-RESEARCHER WANNABE'S BOOKSHELF

Beach time
Wasn't she beautiful?
 
 
In my continuing attempt to learn about cancer biology and cancer therapeutics without really studying, I have purchased and read a good many “popular” books.  Perhaps you would like some recommendations?  No thanks, you say?  Well, I’m going to give them to you anyway.  That way you will have no excuse. 
 Those books I have read I will give a  letter grades, just as you would expect from a retired academic.  Some of these books I have not read, usually because I started them and found them dull, annoying, or both.  These get question marks.  I have several more books laying around somewhere which I haven’t even thought about yet, and I get wind of more every week.  I will keep this list up-dated.
Books I particularly recommend are shown in red.
Alphabetical, by author: 
Ackerman, Jennifer, Chance in the House of Fate.  ??.  This falls squarely into the category of “books I started and then abandoned”.  Part science, part poetry, part I-don’t-know-what, this book promises to be tough going – but I bought it, so I’ll read it,  Someday.
Carey, Nessa, The Epigenetics Revolution.  A   Certainly one of the most useful books I have found.  Everything you always wanted to know about heredity but didn’t know whom to ask.  She is bringing out another book next year, and I will be first in line at the bookstore.
Francis, Richard, Epigenetics.  C+  Covers much the same ground as Carey’s book, but with far less style and grace.
Goldacre, Ben, Bad Science.  D+?.  This guy evidently writes a science column for a British newspaper, in which – apparently – he eviscerates stupid scientific ideas.  So far, so good.  However, his style gets on my nerves.  Moreover, there is little about cancer in this book.  Read it at your own peril.   
Goodsell, David, The Machinery of Life.  B-?  I have merely thumbed through this book and admired the pictures.  This book contains descriptions of various “things” encountered in organic chemistry, each with its own set of beautiful illustrations.  Not much here about cancer, which may explain why I haven’t really read it.  After cancer is conquered I promise to give it a go.
Greaves, Mel, Cancer, the Evolutionary Legacy.  ??  This also falls into the category of “book I started, then set aside”.  The tropic promises to be interesting, but I find his writing style annoying.
Judson, Horace, The Eighth Day of Creation,  B  This is an excellent history and explanation of developments in biochemistry through what might be called the “heroic era”.  Unfortunately, it was published in 1975 so isn’t up-to-date.  Nevertheless I recommend it to all who are really interested in this stuff, and who has enough time on his or her hands.
Leaf, Clifton, The Truth in Small Doses.  A+  I have effused about this book before, so chances are you already know what I think about it.  In this book Leaf explains why we are not winning the war on cancer, despite having spent enough money on it to finance several modern shooting wars!  He is absolutely right, and this book is absolutely essential.  Go buy it forthwith.
Mukherjee, Siddhartha, The Emperor of all Maladies  , A-.  This is another very valuable book, heavy to the history of cancer and our response to it.  It is very hard to read in places, not because of difficult language but because the subject matter is so gruesome.   Mukherjee is a cancer researcher; I hope he has time left over to write a sequel.  How about a summary  of new therapies and their likelihood of success, Sidd?
Ridley, Matt, The Agile Gene and Genome  C+  Both books are artfully-constructed traipsings  through the world of genetics.  As painless background they are perhaps worth reading, but – cancer-wise – they lead nowhere.
Watson, James, The Double Helix  B+.  This is the classical account of the discovery of the structure of DNA, which lead to genomic studies and eventually to gene therapy in cancer.  Everyone should read it, once.  Watson was a brash little smart-aleck, but a clever one.  , His book is very entertaining – and you will learn some biology reading it.  Please don’t take his tale as typical of the way science is conducted; not then, and certainly not now. 
So, many of these books should be available at any good public library.  Those that aren’t can be purchased cheaply and expeditiously by going to Google, typing in Abe books, and following instructions.  Or, patronize your local bookstore – they probably need the business.


Wednesday, October 8, 2014

CHIMAERA: The mythical monster that fights cancer. We hope

In the main square of Quito, Ecuador
 
A new article in the Wall Street Journal has a direct bearing on some of the questions we have been stumbling over for several months, specifically: .  What kind of cancer treatment offers the most hope, and how can we pay for it.  Here’s the article:
The treatment described in this article  has been developed specifically for acute lymphoblastic leukemia, a common childhood leukemia (adults also are susceptible.)  However, it might prove useful in the case of other types of cancer.  It (the treatment) is highly specific to the individual patient – in other words, it isn’t possible (yet?) to affect economies of scale, by mass-producing a drug that would benefit everybody.  Instead, here is how it works, more or less:  (1) A blood sample is drawn from the patient; (2) A type of white blood cell called a T-cell is separated;  T-cells are part of the body’s inherent immune system; (3) The T-cells are modified by inserting (using virus "vectors") some alien DNA that will recognize and fight the cancer;  (4) These modified T-cells are cultured for a time, producing lots of them; (5) Finally, this new T-cell army is re-inserted into the patient, whereupon it seeks out the cancer cells and destroys them.  Hallelujah!  But curb your enthusiasm: so far this therapy has been applied to only 41 patients, in two separate Phase 2 trials.  The results have been exemplary so far, but a lot of testing still remains to be done – even though NIH has “fast tracked” this study.  (Three years instead of six?  I tend to be cynical about such matters.)  One important fact that remains to be determined is – is the “cure” permanent or temporary?
Another problem lies in the realm of adverse reactions.  A similar study recently conducted found that patients at risk for heart disease had a tendency to die when the modified T--cells are re-injected`.  They died of something called “cytokine-release syndrome”.  You can look it up on Wikipedia.  If you do, explain it to me.
Oh, by the way – these GMO T-cells are referred to as “CARs, which codes for “chimeric antigen receptors”.  “Chimeric”, in turn, refers to the fact that the modified T-cells are “Chimaera” – composed of two or more types of genetic material.    An “antigen” is something that “generates” an antibody (which are the dudes that fight infection.)  “Receptor” seems to refer to proteins or other stuff on the surface of cells that are shaped precisely to allow certain floating antibodies (or other kinds of cells) to fit into them, thereby precipitating  some kind of internal biochemical process.  That’s what the three words mean.  If you figure out what they mean when strung together, please let me know.
And, oh yes, the cost:  Nobody has come out with a definite number yet, but the estimates cluster around $½ million.  Let's puzzle about that later.
 


Friday, October 3, 2014

YOUNG, BRILLIANT & UNDERFUNDED


In Nogales
Back when it was safe to visit
 
In the 19th century and earlier many creative scientists could function without grants.  Some were wealthy men who did science for fun, or out of curiosity – Darwin, for instance.  Others had to work for a living and did their science on the side, as a sort of hobby – example: Newton.  But with rare exceptions you can’t do significant science today without financial support.  If you don’t work for a drug company or the like, you need a grant.  The National Institutes of Health gives grants to researchers in the medical field.  Who gets them?  Well, mainly old folks.  (Not  old , perhaps, but certainly mature.)  The median age of recipients of the most significant N.I.H. grant is 52.  More people over the age of 65 are funded than those under 35.  Does this make sense?
Of course it doesn’t.  A  government study  in 2005 reported that the bulk of Nobel Prize winners in science were between the ages of 35 and 39 when they did their significant work.  It is well known that even brilliant mathematicians flame out after about age 30.  Same way in physics.  Then shouldn’t we  be directing our resources toward younger scientists? Of course we should.  But we aren’t.
Patting myself on the back: I began to realize that this was the case several years ago, through my volunteer work.  I hinted at these opinions many times (in several earlier blogs), but it wasn’t until I read Clifton Leaf’s The Truth in Small Doses that I realized I had it right.  To read my review of Ciff’s book, click on http://ljb-quiltcutie.blogspot.com/2014/06/the-truth-in-small-doses-at-long-last_7.html 
Well, here’s more evidence, in the form of  a short essay by an ex NIH research scientist now serving in Congress.  He says what Cliff and I have been saying for some time: to conquer ovarian cancer, Alzheimer’s, or any of the other dreaded  human medical maladies, it will not do simply to attempt to smoother the problem in money.  Rather, the money must be used like a very sharp knife, precisely manipulated by the best, most original, most innovative workers in the field. In other words, by the young, the brilliant and the (currently) underfunded.  We are making shamefully slow progress in our “war on cancer”.  The problem isn’t lack of money.  The problem lies in how it is deployed.  Ii's as if on D-day we landed our troops on the beaches of - - Australia.  Pretty far-fetched and stupid analogy, I know, but the best I can do this morning. 


Monday, September 29, 2014

PROGRESS ON THE PANCREATIC FRONT

Mid 1980's
Kristen and Linda celebrate after just having jogged to the bottom of the Grand Canyon, and back
 
Within the last several years pancreatic cancer has taken two people highly important to me: A man I greatly admire but am glad I never worked for, Steve Jobs; A colleague of mine in the geology department, our “soft-rock” specialist, Dr. Chris Suczek.  Both were diagnosed after unmistakable symptoms arose, which equates to “too late”.  The life expectancy of a late-stage pancreatic cancer victim usually is measured in months, or at most a few years.  However, it is my understanding that pancreatic cancer can be eliminated, in many cases at least, if detected soon enough.  What is needed, obviously, is an inexpensive, simple, reliable blood test – to catch the damned thing while it’s still young and vulnerable.   None exist at present, but there is some hope on the horizon.  Here is all I know about it: http://www.cbsnews.com/news/scientists-detect-early-sign-of-pancreatic-cancer/
Apparently a special class of amino acids become elevated in many pancreatic cancer victims several (to 25!) years before the cancer becomes mature enough to cause symptoms.   As always, of course, much more work needs to be done, but…..  I will do a little more research on this topic, and if I stumble over important things that I can comprehend I will add them as a Comment.
Let us  all now join in a thunderous cheer:  Go, Seamus!  If you are one of my faithful “readers” from Poland and the Ukraine, you may not know what I’m alluding to.  If so, you should actually read my blog, don’t just let your computer scan them for key words!  Dammit!
 


Sunday, September 28, 2014

NOT A CURE, BUT...

Sisters, 1993
 
Sundays I usually go out to Bay View Cemetery to visit Linda.  I sweep off our stone, water her flowers, and chop back any long grass that is beginning to encroach on our territory.  I talk to her a little, usually telling her the family news and what I’ve been up to, and sometimes I give her hell for leaving me so soon - tongue-in-cheek, of course.  About then I start feeling very sad. and I promise her I will keep on fighting ovarian cancer until they carry me away.  The problem lately has been that I haven’t been going to Seattle at all regularly – to help if possible, and to get inspiration and enlightenment.  This leaves me with only my blog, and sources of cancer news I can dig up myself (with the help of several of you, of course.)  I also have been fixated on the medical miracle occurring at children’s Hospital in Seattle.  It appears that my great grandson’s (very serious) operation is a resounding success!  The whole brood will be here next Tuesday, and I am happy at the thought.  Go, Seamus!  Linebacker at U.W., then Nobel Laureate in medicine loom in the future.  Or something equally bright.
So, anyway, the NY Times carries an article about a recent clinical trial performed by the Swiss pharma company, Roche.  They call their drug Perjeta.  Bio-chemically it’s known as pertuzumab.  (You remember what “mab” stands for, right?)  It is used in the case of metastatic breast cancers, and has been shown to prolong life by some 16 months.  Sixteen months more than the heretofore standard treatment allows.  The median survival was 41 months; not a cure, for sure, but better than nothing.
Perjeta is administered together with another Roche drug, Herceptin, which has been a big winner for Roche (and for some women, I suppose).  As always there is a down side: the two drugs together cost more than $11,000 PER MONTH, in the United States.  The article makes soothing noises about this being less than some newly approved cancer drugs.  Yeah, maybe so – it’s still about $450,000 for 41 months. 
How does it work?  Well, it is a suppressor of the protein coded for by the gene HER2, which is a tumor-accelerator in some forms of breast cancer (about 20-30% of them, apparently).  Other sources describe HER2 as a “proto-oncogene”.  HER2 stands for “human epidermal growth factor 2”.  None of that explains what it really does, of course – and 30 minutes of diligent research left me in total ignorance.  I will take it on faith.  My final comment:  41 months of extended life ain’t a cure, at all – but  it’s better than nothing.