PROFILES IN RESEARCH EXCELLENCE 3; Dr. Melissa Thrall

Linda's First Quilt

Now in Alaska, I think

Melisas Thrall earned a Rivkin Center Scientific Scholar award in 2010.  She has been with the University of Washington Medical School since 2009 as a Fellow of the Department of Gynocolgical Oncology ; previously she seems to have practiced in Page, Arizona.  Dr. Thrall has published three important papers involving ovarian cancer since her award date, and they have been fairly heavily cited – indicating that her research has important implications.  I count eleven research papers  published under her name since she obtained her M.D. degree, in 2001. 

The research supported by the Rivkin Center was presented under the title “A population based evaluation of the use and outcome of neoadjuvant chemotherapy”.    Don’t hang up now!  I will explain.  “Adjuvant” is merely medico-speak for “helping”, and neoadjuvant therapy is therapy administered before the main event; for instance, chemo before a debulking (cancer-removing) operation.  Dr. Thrall’s citation states that “the current standard of care for advanced stage ovarian cancer involves surgery with a maximal effort to remove all visible tumor, followed by the administration of platinum based chemotherapy”.  This describes Linda’s treatment exactly, insofar as I understand it.  However, it seems to be the case that not all women are treated according to this precise formula.  Dr. Thrall intends to evaluate outcomes, using a “large population-based sample of patients treated in the last ten years”.  Between the Hutch and the MRC, such records are available – attesting to the great and growing importance of data-bases and the people who understand them.

I am impressed by Dr. Thrall’s record and evident abilities, and I am encouraged to find people like her fighting the disease that took my wife.  I do admit to being a little confused, however.  The title of her proposal implies that she will study the efficacy of neoadjuvant chemotherapy – that is, chemo before surgery.  Do they do that?  Under what circumstances do they do it?  I’m curious, although I probably wouldn’t understand the explanation!

Yeah, I know – this was boring, even if important.  Enjoy the picture.







LINDA ON HER WEDDING DAY: Our 31st

Four beautiful women and one lucky guy

This is our 31^st wedding anniversary.  If I look a wee bit smug in the picture (above) it’s because I was, and had every right to be.  I had just hit the jackpot.

I will be home (Bellingham) by April 3^rd, whereupon I will look through our wedding album as described a year ago, and generally mope around and feel sorry for myself.  And even sorrier for Linda, of course.  Life has a way of getting in its digs, but I wouldn’t have missed it.  I urge all of you who knew Linda to re-read her Fred Hutch“tribute” (http://getinvolved.fhcrc.org/goto/lindajoycebeck) and then think about what you can do to further the fight against ovarian cancer.  And then do it.  Any of you who never knew her but wish you had – and that should include all of you  –  should do likewise.



DON'T MESS WITH OC: Get the best available.

Linda Joyce Beck, field herpetologist

Galapagos Islands, about 1985.

The tortise is Lonesome George, the last of his breed

You were supposed to kiss him on the forehead, for good luck.

She faked it.

 

 

It is approaching 90⁰ outside and is supposed to get hotter later in the week.  I just returned from Vista, near the coast, where I had a very pleasant visit with my friends John and Joan McManus.   John and I played  18 holes of golf at the Lawrence Welk resort.  Yes, that Lawrence Welk – the main drive through it is called “Champaign Boulevard” and when you hit your initial drive you are enjoined to count your backswing-forswing  rhythm by saying “ a onea twoa”.  (Only people of approximately my age will understand these references.)  John shot 75 and I handily broke 100 with a 97.  I must admit, somewhat reluctantly, that par for the course was 61 – only par 3s and par 4s.  It is what is known as an “executive course”, presumably because true executives are too busy to play the longer versions.  I played fairly well, but at one point very nearly placed my drive in the lap of a nice lady reading on her veranda.  She was kind.

Anyway, what I want to write about is an article in the NYTimes entitled “Widespread Flaws Found in Ovarian Cancer Treatment”, brought  to my attention by – you guessed it – Dick Ingwall.  The gist of the article is that a significant study has shown that far too many ovarian cancer patients receive treatment from practitioners that are, to put it politely, not quite up to speed.  The recommendation is that such patients should go to a major cancer center - think Fred Hutch – and not rely on their local gynecologist.  They are urged to rely only on gynecological oncologists  who work at hospitals that  perform more than 20 ovarian cancer debulkings per year.  Another recommendation is to use “IP (intraperitoneal)” therapy whenever possible.  IP therapy is proven to be more effective, but few non-specialists  even know about it.  It has been recommended since 2006. 

Linda had the benefit of a highly accomplished gynecological surgeon, at the best place for treatment  in the Pacific Northwest.  Even so, she did not get  complete “debulking” (which means the removal of all the tumor visible to the naked eye.)  Neither did she have IP therapy.  The reason for both lf these departures from best practice was that she had previously had major surgery – very major surgery – that had rearranged her insides.  Poor kid, she had to endure four – no, five - major operations during the last five years of her life.  Through it all she never complained.  I think she was more concerned about how Carolyn and I, and all her friends and relatives, were coping with her illness than she was about the illness itself.  I didn’t deserve her.

If you want to read the article for yourself, go to   http://nyti.ms/Y6BSZc

I will leave for Bellingham on March 26^th.





P53, APOPTOSIS, CANCER, AND BABUSHKA DOLLS

In a taverna in the old city of Rhodes

We ate a kilo of fresh-caught shrimp, washed down with water (Linda) and retsina (me).

The significance of the pink elephant is lost forever.

Probably 1987.

You will recall that back on February 24^th I recommended the book Genome: the autobiography of a species in 23 chapters, by Matt Ridley.  Well, I confess that there have been some mind-numbing moments subsequently, as I plod slowly onward toward the Epilogue.  Most of my problems arises from a lack of biological background, but part of it rests with Ridley: he cannot control his urge to be a little too cute, where straightforwardness would do a better job.  However, I still recommend the book, in large part because of Chromosome 17, the subtitle of which is Death.

Chapter 17 treats of cancer, its cause, and its potential cure.  It talks about oncogenes, tumor-suppressor genes, how they cooperate to allow cells to replenish themselves, and how when damaged they can result in cancer.  The star of the discussion is the gene TP53.  TP53 codes for the protein p53.  P53 induces apoptosis – it tells the cell when to die.  Together with several other genes – MYC, BCL-2 and RAS, TP53 sees to it that cell replication does not run wild.  To contract a cancer several  of these genes have to be disabled by mutation, in a single cell.  That would seem to be improbable, because mutations are random, and rare.  However, with trillions and trillions of cell divisions occurring during the human lifetime, it is not impossible.  Common medical wisdom apparently holds that the probability of contracting cancer roughly doubles with every decade of life - because of the accumulation of deleterious genetic mistakes.  (This is a sobering thought, in view of the fact that my 80^th birthday party is on the calendar.)

Chapter 17 is interesting and very useful for anyone trying to get a handle on cancer, such as myself.  However, it is also more than a little discouraging.  Ridley obviously was greatly excited by the potential these genetic revelations had for riding the world of cancer.  To quote:  ”There is now, for the first time in human history, a real prospect of a genuine cure for cancer…”  Your heart sings when you  read these words – until you remember that Ridley was writing in the 1990s.  As I said in some previous blog – you solve one problem, and find two more underlying it.  Babushka dolls again.      





NOT OC. MORE EXCESSIVE PRAISE OF ME. I promise not to let this become a habit.

 

England, 2007

 

 

This marks the one year anniversary of my anti-cancer blog.  According to the Google “hit counter” this blog has been viewed by 5840 people, hailing from many dozen countries – only Africa and Antarctica have not weighed in.*  I have written 112 blogs entries in the year, averaging one every 3 days, 2 hours and 22 minutes (you needed to know that, right?).    You probably wonder where I get wind of the stuff I write about.  Well, thank God for the NIH Cancer Bulletin, the Fred Hutch newsletter, and Dick Ingwall.  I only make a little of it up.   (No, really.  Would I lie to you?  Of course not.) 

In celebration of this dubious  literary event, let us take several moments to do the following:

Remember Linda.  If you never knew her, read about her.  She was wonderful.

 

Write your Congressman and tell him or her that if he/she fails to work to restore the 5.1% budget cut to NIH you will barbeque his/her  liver.  Write Obama, too, but no threats, or you will find several large men in suits, with wires coming out of their ears, knocking at your door.   
 

Trick a friend into reading this blog.  I make no pretense to literary merit, but I flatter myself by thinking that it helps keep cancer research in the public eye – which can’t help but be good. 
 

I hope you have enjoyed the pictures.  I have quite a few left.  Stay tuned for March 19^th.
 

*But, as I have said several times before, I suspect that some of the “hits” from places like Kazakhstan and Paraguay are computer algorithms, not people.



TIME TO BURN SOME SHOE LEATHER

 

LINDA AT MACHU PICCHU

Probably 1985

 

Remember awhile back when I told you that, as part of advocating for cancer research, to be ready to hold elected officials’ feet to the fire if they mess with the NIH and NCI budgets?  Probably not; I couldn’t find that particular blog myself, but I know I wrote it.  Be that as it may, it appears that the time has come to burn some shoe leather.  It has to do with this blatantly stupid thing called the “Sequester”.

No doubt you are current on the Sequester.  It arose from the fact that the ability to compromise has deserted our leaders in Washington.   To over simplify: Democrats pay lip service to the importance of controlling the budget deficit, want to do it by raising taxes, reluctantly subscribe to the notion that spending might  be trimmed a little with no serious consequences, and want to make damned sure that the Republicans are blamed for anything that goes wrong.  In contrast, Republicans obsess on the importance of controlling budget deficits, want to do it by slicing funding to select agencies (but not the Pentagon or the Border Patrol), once upon a time felt that closing tax loopholes might be a good idea (but now maintain that they’ve given enough on taxes already), and want to make damned sure that the Democrats are blamed for anything that goes wrong.  Note that the last phrases in each of these sentences are very similar.  I think they are the driving force behind what is going on. 

This needn’t have happened.  Sequester is the result of kicking the budget can down the road.  Obama appointed a bipartisan committee to provide an answer to the question: “How can we get our budget deficit under control without turning the U.S.A. into Greece, or Somalia?”  In due course the committee brought forth a recommendation that in my (admittedly uninformed)  opinion, would have worked.  Obama ignored it, presumably because he thought that it would harm the poor and downtrodden, including all the racial minorities that normally vote for Democrats.  If he had submitted it Congress the Republicans would have seen  that it failed, presumably because they thought it would slow economic growth.   Of course, most economic leaders support Republicans. 

So there you have it.  You may strongly support one side or the other, or join me in saying “a pox on both their houses.”  Whatever.  The fact is that, as of yesterday, the NIH’s budget has been cut by over 5%.  If budget’s need to be cut,  cut my Social Security, for God’s sake!  Reform the Pentagon!  Stop subsidies to wealthy agribusiness!  Ease up on throwing good money at bad ideas in the energy line!  But LEAVE THE NIH BUDGET ALONE!

All of you are computer literate.  Use Google to get the email addresses of your Congresspersons and tell them to get their butts in gear.  And don’t forget to email Obama and tell him that he, too, is acting like a jerk. Burn their boots.