Tuesday, December 30, 2014

HAPPY NEW YEAR! (now for a little biology)

Patches tries to smother Linda in loose fur.
 

Okay, enough pussy-footing around.  We need to tackle PARP Inhibitors head on, wrestle them to the earth, and stomp on them.  What, you don’t have any idea what a PARP Inhibitor is, and furthermore you don’t give a damn?  Shame on you, and who cares about you, anyway?  I’m mainly writing this thing in the fervent hope that “PARP Inhibitor”, which I have looked up at least a dozen times, finally will stick in my head.”
First, definitions:  PARP code for “poly ADP ribose polymerase”.  Does that help?  Of course not.  “poly   you understand.  Polymerase is something that causes rapid duplication of a biochemical thing to occur. The term "ribose" refers to the structure of the molecule and is of no earthly significance here.  It turns out that ADP stands for adenosine diphosphate.   ADP is essential in the transfer of energy within cells, and so PARP refers to the mass production of something that is essential to life.  Add “Inhibitor” and you are referring to something that Inhibits life.  Now, why in heaven’s name would you want to do that?
Well, cancer cells are “life”, so we should inhibit the hell out of them.   The problem, of course, is to target cancer cells without shutting down all the rest of the organism at the same time.  Part of the answer lies in the fact that cancer cells divide and multiply much faster than normal cells, and thus toss up more potentially fatal DNA-replication errors to “inhibit”.  Also, many kinds of cancers have defective “repair” proteins, such as the well-known BRCA1 and 2 that are so important in ovarian and breast cancer, hence can’t fix the damage, whereas normal cells with normal BRCA can.  Ah, but something is missing so far.  The protein PARP1 fixes single-strand breaks in DNA, and if these breaks are not repaired double-stranded errors can ensue WHICH, in the absence of functional repair proteins, will cause the cell to croak.      
It appears that the complete activity of PARP proteins is not fully understood.  Many trials are underway.  Several drugs already have been tested – and failed.  Clovis Oncology has three PARP Inhibitor drugs in clinical trial right now, and other drug companies are in the hunt.  Can we allow ourselves to be optimistic?    Well, maybe.
 

Saturday, December 27, 2014

THE RICHEST GUY IN L.A.. And possibly the most valuable


Leaving a swank floating restaurant on the Nile
No, she is not holding me up.  It costs too much to get drunk in Egypt


The richest guy in Los Angeles also may well be the smartest, is possibly the most hard working and – using my criteria – almost certainly the most valuable.  His name is Patrick Soon-Shiong and he is – you guessed it – a cancer researcher.  By training he is a medical doctor.  He made billions developing drugs.  He owns part of the L.A. Lakers and is on good terms with Kobe Bryant.  In short, he is not very much like you or me.  Nevertheless, I am very happy that there are such folks in the world.  We need lots more of them. I wish I were one. 
 Dr. Soon-Shiong is featured in a recent 60 Minutes episode:


which in turn  is summarized, analyzed and criticized in Forbes magazine as follows:


Dr. S-S exemplifies my take on how to make progress in the war on cancer.  He is free to follow where his training and instincts lead.  He isn’t required to dive into the pit and wrestle thousands of other supplicants for NIH money, nor does he need to worry that a jury of his scientific peers will deem his project too chancy to support.  He can use all the new technology he can lay his hands on, and to explore any avenue that HE –as an acknowledged expert in the field – regards as promising.  He can go where his instincts and training lead him.  And, not the least blessing,  he doesn't have to write grant proposals.

As pointed out in the Forbes article, little or none of the methods and concepts that Dr S-S plans to use are original with him.  What is original is that fact that he knows about all these things, how they work, what they are good for, and how they might complement each other - and has the means, the energy, and the resources – to put them to work.

We can’t reasonably expect a whole swarm of Dr. Soon-Shiongs to emerge suddenly and bring cancer to its knees, but we MIGHT be able to swing a well-supported governmental agency with someone like Dr. S in charge.  Right, Cliff?  

I would like to write more but I am using a new computer that seems determined to put me in my place.  It took me one hour, and at least 20 tries, to get this far.  Probably slower than my old typewriter. 






Wednesday, December 17, 2014

BAH! HUMBUG!

Linda, appropriately clad for the season

It is time to face facts: this computer is toast.  I have spent most of the day wrestling with it, with very little useful result.  I cannot post to Facebook, I cannot use Word, and I have to wrestle with cryptic pop-up messages of doom every few minutes.  So, Saturday I will drive to the big city and buy something newer and presumably better.  Then I may see how many times I can skip this one on the Salton Sea.  Here is all I want to say right now:

As usual, I ask that you do not give me presents for Christmas.  Cards are welcome, of course.  If you feel so inclined, give a gift to Fred Hutch, using this web  address:



As of this moment it will be matched by some anonymous benefactor, who has pledged $100K for the purpose;.  If you do donate, please remember to direct your donation to ovarian cancer research. Hell, let me get in the spirit of the thing, too:  I will match any donations from now until 12/31 - up to a total of $1K.  So, Merry Christmas, and stay sober.  This advice does not necessarily apply to me.


Sunday, December 14, 2014

HAPPY HOLIDAYS?


Linda and Ella
                                                                      In her home

It’s wonderful.  The older I grow the more I know, but the less I am certain of.  Take my political philosophy, for instance.  I have always been a small-government, free trade, laissez faire conservative.  I reasoned that this is the best, quickest way to raise the living standards of a society.  It probably is.  But now and then I run headlong onto the story of someone badly marginalized by this political philosophy – which is still in the main the modus operandi of the United States and other rich nations, despite decades of efforts by so-called “progressives” to modify it.  These stories increasingly involve health care.  Here is an example:



What to do?  Don’t ask me.  At 30 I knew.  Now I’m not so certain.

Thursday, December 11, 2014

A PITIFUL PLEA

Enjoying the Olympics
And each other

Many of you have helped keep this blog spluttering along by bringing cancer-related news to my attention.  I am hereby asking you to re-double your efforts.  For reasons that I don’t fully understand my two attempts to volunteer in cancer research seem to be dying a lingering death – at least, I rarely can find reason to journey to Seattle and get involved in something.  (Well into my ninth  decade, perhaps my skill set is beginning to become obsolete.  You think?)  But, anyway, I can still read news articles, use Google Scholar to dig deeper – and summarize the stuff I learn, to accompany yet another nice picture of my beautiful wife.  I want to keep at it, so – please – if you run on something you think I might like, hesitate not, but drop me an immediate email.  All these addresses will work:
Thanks.


Friday, November 21, 2014

SOME REALLY NICE PICTURES

The World's Cutest picture
 The World's most beautiful picture
 
 Almost the World's cutest picture
 
A picture that makes me kind of sad
 
Trapped inside by foul weather and gloom, I have been passing time by actually reading all of the ridiculously expensive Wall Street Journal that appears in my driveway each morning.   Normally I just read the front section, then search for a sports story – and then quickly cast the whole thing in my recycle box while feeling vaguely guilty for wasting so much money and so many trees.  However, today I discovered something that may be of interest to many of you, especially those among you who are certain that Big Pharma is ripping us off.  It is a Journal  blog, named “Pharmalot”, which deals with all manner of stuff regarding big drug companies.  Today’s column is a discussion of why some people say it cost an average of $2.7 billion to bring new drugs o market, and why lots of people feel that’s baloney.  It’s worth reading, if you have time to burn.  To read Pharmalot, just request it under that name on Google.
The main reason for this blog is to post some nice pictures to tide you over while I’m in transit.


Saturday, November 15, 2014

SOME ENJOYABLE BIOLOGY

Reading to Simon Hunsinger
 
Last week’s paper edition of The Economist contained three bio-related articles that you might enjoy.  The first is a painless discussion of how simple prokaryote cells (e.g., bacteria) may have evolved into the more complex eukaryotic cells that make up us and nearly everything else.  The second asks you to review your heartfelt but perhaps unreasoning distrust of GMO foods, and the third answers that age-old human question: “Which is more complicated the brain or the testicle?”  You may have to “join” the Economist to see these articles but don’t despair – it is easy, and free.
Here are the web addresses:
It is very cold in Bellingham these days, and my shingles give me an excuse to stay inside and watch football.
 


Friday, November 14, 2014

SAGE ADVICE FROM THE AARP (of all places)

Where the heck is this?
Looks like the Appalachians, but was she ever there?
 
From time to time over the last several years I have mulled over the collateral problems that arise from attempts to detect various cancers in their early – usually most curable – stage.  At first glance, early detection would seem to be an unmitigated blessing - it saves lives.  And it would be an unmitigated blessing if these “early warning” tests were 100% reliable, but of course they’re not.  False positives are inevitable (these are human procedures, after all), and false positives almost inevitably give rise to needless worry and expense.  Sometimes these collateral difficulties can be so severe that august bodies like the USPSTF recommend against the procedure except under special circumstances (see my first prostate cancer blog:
 and a good many – probably too many – follow-ups).  Because of these cautions, any advice that can lower costs and reduce anxiety is welcome.  So – AARP brings you this piece of wisdom, courtesy of Linda’s sister Carolyn.   All women should read it; you never know when it will come in handy.
8. Follow-up ultrasounds for small ovarian cysts
Many women receive repeated ultrasounds to verify that ovarian cysts have not become cancerous, but current research says that these tests aren't necessary. For one thing, premenopausal women have harmless ovarian cysts regularly. For another, about 20 percent of postmenopausal women also develop harmless cysts.
"The likelihood of these small simple cysts ever becoming cancer is exceedingly low," says Deborah Levine, chair of the American College of Radiology Commission on Ultrasound and a professor of radiology at Harvard Medical School.
In postmenopausal women, only cysts larger than 1 centimeter in diameter need a follow-up ultrasound. For premenopausal women, who typically have benign cysts every month when they ovulate, cysts smaller than 3 centimeters aren't even worth mentioning in the radiologist's report, says Levine.
The quotation above is #8 on this list, but the other 9 are worth reading, too.
My shingles are better, and the Seahawks pulled it out.


Sunday, November 9, 2014

DIET REARS ITS UGLY HEAD

Us, somewhere warm
A long time ago
As you know, I am a little skeptical about the role of diet in health, and especially in cancer prevention (& cure).  Maybe I should do some serious  reconsideration.
I say this because three articles published recently make a good case for the role of a “good” diet in the prevention of epithelial ovarian cancer.  They were “retrospective” statistical studies, based on very large data sets.  By “retrospective” is meant that a group of people are followed over many years, via questionnaires, lab tests, etc., and when they finally die (or funding for the study runs out!), the investigator traces back to see how each life was led, and what resulted.  Thus, say 100,000 women were followed for fifteen years.  Of these, 300 died of ovarian cancer.  These 300 are: “matched” with 300 women who didn’t contract the disease – “matched” in the sense of similar age, race, ethnic background, economic circumstances, etc..  Then the question is asked: “Is there a conspicuous lifestyle difference between the two groups?”  Or something like that.  Inevitably, fancy statistics are applied. 
So, what are the results?   Well, it appears that diet does matter.  The “flavonoids” in black tea come in for special commendation.  They also are found in citrus fruit.  Fats, refined grains, and alcohol are to be cast into outer darkness – except for red wine, which is good.   The advice, in a nutshell (and I quote):  “In any case, your best bet is probably to maintain a balanced diet with plenty of fruits and vegetables.  But you already knew that, didn’t you?”
Here are the articles”
Just so you know: The Seahawks are trailing, and my shingles still hurt like hell.


Tuesday, November 4, 2014

MORE TIME AND MONEY SHOT TO HELL

Cairo, central market
You could get lost in there and never be seen again!
 
Here is a depressing little article about ovarian-cancer drugs:
It is depressing because it failed, and even more so that it aimed so low.  The goal was to extend “progression-free survival” to a statistically significant degree.  No mention of overall survival, no mention of cure.  More money , time and talent  down the rat-hole.

 


Friday, October 31, 2014

PROFILES IN RESEARCH EXCELLENCE: Dr. Carol Hanchette

On Santorini, mid 80s
Man was it hot!

It is with great pleasure that I present Dr. Carol Hanchette for your admiring attention.  My enthusiasm has two sources.  First, Dr. Hanchette is an Geological Scientist, not a Biochemist or M.D.  Second, she is engaged in research that will further Clifton Leaf’s (and my own) priority – to “preempt” ovarian cancer.  Dr. Hanchette is using the techniques of Geographic Information Systems (GIS) analysis to determine whether or not proximity to pulp and paper mills is associated with an enhanced prevalence of ovarian cancer.  She is on the faculty of the University of Louisville, in the department of Geography and Geosciences.  Dr. Hanchette is one of eight successful applicants for the Marsha Rivkin Center’s Pilot Study grants.  The award is $75,000, for one year.  For many of the biological cancer studies I have followed, $75K would barely cover the cost of feeding the lab animals, but for an earth scientist it is a considerable chunk of change.  Spend it wisely, Dr. Hanchette.

Apparently Dr. Hanchette has preliminary data suggesting a spatial correlation between ovarian cancer and pulp mills.  A systematic GIS study clearly is the way to rigorously test the hypothesis that the two in fact are related.  Then harder questions arise: (1) is the correlation one of cause and effect, or is it more complicated?  For instance, it is possible (although astronomically unlikely)  that the increased ovarian-cancer incidence arises because women living near pulp mills drink unusually high quantities of hard liquor, in order to be able to ignore the smell, and the booze is to blame?   And then, of course, once the cause-and-effect is established the biochemist must step in:  (2) How does a pulp mill cause ovarian cancer, and what can be done about it.

Dr. Hanchette obtained her PhD from the University of North Carolina.  She describes herself as a Medical Geographer.  Much of her previous work seems to involve environmental effects on the prevalence of prostate cancer.  Currently she is an Associate Professor.  One hopes that, with the results of this study in print and validated, she quickly is promoted to Full Professor, with a substantial raise. 



Thursday, October 30, 2014

GOOGLE WILL RULE THE WORLD: Inside and out.


Linda, thoroughly be-catted
The malevolent beast glaring at you is Murphy.
The fuzz ball in the foreground is Whiskers.
 
I am quite resigned to the fact that Google will soon rule the entire external world of humankind.  Resigned, not enthusiastic – Now I learn that they have their eyes on our internal world as well; stuff in or bathed by our personal bloodstreams.  About this I am enthusiastic, but skeptical.  Their plan seems a bit “Pie in the Sky-ish” to me, but what do I know?  It never is prudent to bet against Google.
Here is what the purportedly are preparing to do.  They will create a nanoparticle with a magnetic core.  (I blogged about nanoparticles previously: 4/12/2012 I also know that it is possible to produce such magnetic  particles, from a talk I once heard at the Hutch.)  They will then coat this particle with some kind of antibody – say, one for gloming onto ovarian tumor cells exclusively.   Next they will package these nanoparticles in a pill, and turn them loose inside our bodies.  After a suitable time they will summon them back (to a magnet attached to the body – the wrist is mentioned), and interrogate them.  Voila!  If you have ovarian cancer the magnetic nanoparticles will drag them to the collection point, and – if properly calibrated – the presence of OVCA will become known.  Sounds good!  It also sounds like black magic.  And, of course, expensive.
Don’t expect this technology any time soon.  They (Google) are pointing for clinical trials in five to seven years.  Maybe they will lose interest and divert their attention to ending war, disease, bad weather, and traffic jams instead.  Right now I hear that they are developing a car that even an octogenarian can drive safely.
 
 


Tuesday, October 28, 2014

WHAT IS A VIRUS? - And why you should care

At Lady Astor's modest country retreat on the Thames
2007
 
The Ebola epidemic has driven all other health news underground, and my cursed shingles invasion leaves me with very little energy to chase down news of new developments in cancer research.  In desperation (I haven’t blogged for five days) I turned to my old pal, Google Scholar.  I asked for articles published in the last two years containing the phrase “ovarian cancer” in the title – and got “about” 5300 hits!  Thoroughly discouraged, I decided to use my aching stomach muscles as an excuse and fob you off on a general article about the biology of viruses.  It is reasonably interesting and accessible, and will give you a break from worrying about whether the Kansas City Royals can pull it off.  Here it is:

http://www.nytimes.com/2014/10/28/science/ebola-and-the-vast-viral-universe.html?ref=health

The author tosses in a few technical bio-chem terms, probably to appear erudite.  Most of them she explains:  here are several she doesn’t.

Interferon:  Proteins important in fighting viral infections.  They stimulate the immune system to fight back

Lipid:  fat cells

Capsid:  The protein shell of a virus

Ribosome:  A biological “machine” composed of proteins and RNA that converts DNA into protein.

Phyletic:  A fancy and obscure way to indicate an evolutionary lineage

I don’t give you these definition to appear erudite myself, but rather to save you the trouble of going to Google – which I had to do in all but two instances.


Thursday, October 23, 2014

THE FRED HUTCH NEWSLETTER

Enjoying a Michigan Autumn
With her brother Richard, niece Rebecca, and several Hunsinger boys
What looks like a bald-headed walrus surfacing in her lap actually is your faithful correspondent
 
I don’t get the Ukraine.  It is a poor country, engaged in a civil war.  Its people speak a Slavic language, written in Cyrillic script.  And yet I have more “hits” from Ukraine that fror any country other than the United States.  Twice as many Ukrainians ostensibly read my blog as do citizens of all English-speaking countries combined, again excusing the United States,.  What gives?  Obviously there aren’t dozens or hundreds of Ukrainian citizens avidly consuming my blog.  Some computer algorithm is doing the “reading”.  What ever can it be looking for?
The Fred Hutch newsletter is out, and you can read it by clicking on https://bay172.mail.live.com/?tid=cm1fAI-XxZ5BGUuWw75af65g2&fid=flinbox. 
There are several important articles in this issue.  One describes how Hutch scientists have developed a “tumor paint” which somehow will cause tumor cells to glow.  This should make it easier for surgeons to detect all the places where a spreading tumor is lodged.  The molecule that allows this was isolated from, of all things, a scorpion!
Another significant bit concerns the “Angelina Jolie effect”.  As you probably know, this prominent movie star went public about her troubles with breast cancer and urged women at elevated risk to get tested for the BRCA gene mutations.  Apparently since she did this, the number of women complying has doubled.  Good for her!
There are, of course, the usual pleas for money.
Several other articles in this edition of the Newsletter deserve mention, but my shingles hurt and I’m going to swallow two pills and take a nap.


Monday, October 20, 2014

ANOTHER DISMAL LITTLE ESSAY

Linda and the Kelly girls on Orcas Island
Impudent, but -- nice hair
A recent Wall Street Journal  raises some difficult and interesting  questions.  Here it is:
At least the questions are interesting to me.  I am writing this as a tool to clarify some issues in my head.  You are free, even encouraged, to correct or dispute my musings.
So, a hypothetical question:  What if a particular mutated gene made it inevitable that you will come down with an incurable, fatal disease?  Would you want to know if you had the mutation?  How about if the disease were curable?  Well, for me, the answers are, respectively, “no”, and “yes”.  If I’m certain to contract the disease and die, why would I want to go through life worrying about it?  There would be some small advantages to knowing, involving arranging your life to minimize the impact of your death on your family, but they would hardly repay living years or decades in a state of constant low-grade anxiety.  So, don’t tell me.
However, what if the disease were curable?  Then, of course I would want to know.  Then I could arrange close monitoring, enabling treatment to kick in in the early stages of the disease, when the chances of cure usually are greatest.  So, tell me.
These musings concern diseases that are inevitable, if you have the targeted mutation.  But what if the mutation merely predisposes you to the condition, such as the BRACA mutations in the case of breast and ovarian cancer.  In my view, the situation doesn’t change: if the disease can’t be cured I don’t want to know about it, but if it can be cured, even if there is only a forlorn hope of cure, then tell me.
God!  This is one of the bleakest and most depressing blogs I have ever written!  I apologize.  Maybe my mood is darkened by the fact that my shingles hurt, and that a power outage last night fried my cable TV connection as well as wrecking communication between my computer and printer.  I have spent most of the day working on these twin problems: the computer problem is fixed, but my TV still is on strike.
But here is something from the WSJ article that might interest you.  Apparently there is a gene (PSEN1) that, when mutated, leads inevitably to early-onset Alzheimer’s.  (Note: only 2% of Alzheimer patients have this genetic flaw, but if you have it you are up a creek.)  So, let’s say your mother died of EOA (early onset Alzheimer’s.)  If she passed the gene to you, your goose is cooked.  But suppose that you want to have children but are terrified of passing your mutation on to them.  In the case of one woman undergoing in vitro fertilization, the lab tested her eggs for the mutation, and then implanted the ones that were clean.  All this without informing the mother whether or not she was positive for the mutation.  She chose not to be told if she would get EOA, but she knew her children are safe.  What would I do, I wonder?  What would you do?
This stuff is abstruse but not hypothetical.  Gene-sequencing techniques are improving so fast (and becoming commensurately cheaper) that inevitably we will have to deal with lots more of it in the future.


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.


Carey, Nessa,  Junk DNA: A Journey Through the Dark Matter of the Genome. B+  Full of important science, but tough going.  I wish she didn't use quite so many hokey analogies. 

BUT, on a second reading things cleared up.  I still had some problems.  Revised grade: A-

Cobb, Matthew:  Life's Greatest Secrets.  C+. Really two books, the firt dull, and second exciting.  Read my review: http://ljb-quiltcutie.blogspot.com/2015/10/do-not-read-this-boookunless.html


DeVita, Vincent T. (& daughter), The death of cancer.  A-  This is a great book, both entertaining and educational.  It is a skillful telling of DeVita’s often bloody life in the trench war against cancer.  It ends with some optimistic predictions, a few of which I find improbable.  Buy it.
Francis, Richard, Epigenetics.  C+  Covers much the same ground as Carey’s first 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 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?

Parrington, John, The Deeper Genome, B-.  Another book on the true nature of "junk" DNA.  Mostly a tough slog, but with redeeming flashes of insight.
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 per patient.  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.