Thursday, December 27, 2018

TOO MUCH ON TALC, ALREADY!


At Crater Lake

This back-and-forth squabble over talc and ovarian cancer is becoming tedious.  I have reported on developments for years, often as “Comments” to other talc-related postings.  I have decided not to do it anymore.  My “sources” spew up talc/cancer stories almost weekly, but from now on I’m going to write about them if they are game-changing.  Here is one last link:


My bottom line remains the same:  Don’t use the stuff.

Saturday, December 22, 2018

AN IMMUNOTHERAPY PRIMER


Linda on the Thames

Have I blogged about this already?  Geeze, my brain is getting so dilapidated that I can’t remember what I did yesterday, let alone last month.  Anyway, this is a painless review of two kinds of immunotherapy: checkpoint inhibitors, and CAR T therapy.  Also a bit about another wrinkle, involving lymphocytes.  Worth reading, and it won’t take you five minutes.


Monday, December 17, 2018

SO YOU'VE GOT OVCA. WHAT THEN?


Even bald, she was beautiful

Here is a short essay on ovarian cancer treatment that most of you women should read – but, I hope, will never need.  Men could benefit from it as well.  I wish to hell I had known this stuff when Linda got her OVCA diagnosis.


Sunday, December 16, 2018

THE NEVER-ENDING TALC STORY


Linda and niece Ella
maybe ten years ago

Johnson and Johnson is one of the largest consumer-goods companies in the world.  It is a component of the Dow Industrial index.  It has been here, grinding out useful commodities since your mother was a little girl.  It makes lots of good stuff, but I’ll bet it fervently wishes that it had never made talcum powder!

Talcum powder basically is a powdered form of the mineral talc, the softest natural substance in the inorganic world.  Talc is a hydrothermal metamorphic rock that forms, often in great abundance, at many places in the world.  Talc is used in a huge number of industrial processes.  One form of talc, known as soapstone, is dear to the hearts of stone carvers.  Talc clearly is useful; the burning question obviously is: should it be used as a form of baby powder?

One suspicious problem with talc as a baby powder is that it forms under very similar conditions as does asbestos, and frequently in the same region.  Asbestos and talc have very similar structures.  Asbestos, as you know, is a nasty carcinogen.  J&J insists that its baby powder is, and has been, asbestos free.

Even occasional readers of this blog will be aware that J&J has been sued repeatedly over recent years on the charge that their baby powder causes ovarian cancer.  The charge is that it is the talc itself that is to blame, and not any accidental admixture of asbestos.  The science on this claim is indeterminate at present, but enough suspicion remains to underpin my advice:  leave the stuff on the shelf, and use corn starch instead.

J&J has stated repeatedly that there is no asbestos in their product.  Now, however, nosy newsmen have turned up evidence that this may be untrue.  J&J is calling “foul”.  My take is that if J&J officials really knew that there was even trace amounts of asbestos they all should be marched outside and shot.  The case is far from closed, however, but in the meantime: DON’T USE TALCUM POWDER!

And sell your JNJ stock.

https://www.mirror.co.uk/news/uk-news/johnson--johnson-asbestos-scandal-13735166

Thursday, December 13, 2018

A STEM CELL PRIMER


A very long time ago, in Mexico

Confused by all the chatter about stem cells?  This will help:





Sunday, December 9, 2018

DENDRITIC CELLS

On Santorini

Do you know what dendritic cells are?  Well, don’t fret; neither did I until a few weeks ago, and I read lots more of this stuff than a normal person would.  Anyway, dendritic cells are part of the mammalian immune system; the outer defenses, so to speak.  They are stationed at places where bad guys are most likely to try to get in; nose, throat, etc.  When they encounter such a bad guy they devour it, break it into pieces, and display these pieces on their surface.  These pieces, known as antigens, alert the T cells as to what to search out and destroy.
Well, people at Lund University, in Sweden, have figured out how to reprogram ordinary skin cells into functional dendritic cells.  They also have learned how to alert these new dendritic cells to specific “enemies” – possibly cancer cells.  Cancer cells are wily devils; they tend to mutate so rapidly that they can “hide” from some therapies, even immunotherapy.  Somehow this new technique can circumvent this trick.  To find out how you’ll just have to read the news release.


and then explain it to me.




Tuesday, December 4, 2018

MOONSHOT, REVISITED


Linda and her (much) younger sister Carolyn
On the occasion of the latter's birthday

When I decided to accept the offer of a faculty position at Western Washington University I had two other alternatives.  I had an offer from San Diego State University, as well as the option of returning to the U. S. Geological Survey, where I had worked for over five years.  Pay, of course, was a factor, but not in this case an important one; the Survey paid by far the most, and Western the least, by a substantial margin.  I rejected SD State on the grounds that it had a punishing teaching load, precluding the opportunity to do much research - which I particularly wanted to do.  The Survey did nothing BUT research, but required one to live in places I disliked – big cities, especially Washington, D.C.  And also, in my time with the Survey I had discovered it to be painfully and frustratingly bureaucratic.  The most important person in my Survey branch was the director of personnel – who knew how to get around the bullshit and let things get done.  Unfortunately, he retired.

But enough baloney about me.  Let’s get to the point.  However…..

Last chunk of baloney.  All that I wrote above is true – but the real reason I picked WWU was to be near the North Cascades.

So here is a progress report on the Moonshot; the Federal program to kick-start cancer research – or, rather, turbocharge it.  The initial appropriation was $1.8 billion.  So far (two years) $600 million has been spent.  The principal result, according to this progress report, seems to be to have been to establish committees to oversee the work!  That is 1/3 of the pot.  Moonshot is supposed to last seven years, so now we have five left to get results.  Shades of the U.S. Geological Survey.

Read the link given below; you will get a good summary of what Moonshot is all about.    And while you’re at it, see if you detect a note of” bureaucratise”.  After all, is there anywhere else that you might encounter a word like “operationalize”?

Saturday, December 1, 2018

EPITHELIAL OVARIAN CANCER



This is precisely the disease that took Linda away.  A novel way to attack it is described.  May it bear bountiful and beautiful fruit.




Wednesday, November 28, 2018

MORE ON EARLY DETECTION


Linda in an Indian village, northern Mexico
Probably 2010

You all know the following facts:

1    (1)      OVCA is curable if detected in stages 1 or 2.

2     (2)       It is damned hard to detect OVCA in stages 1 or 2.

At least you should know that stuff; I’ve blogged about it for the last six years.

Well, then, this is damned good news.  A lab in Australia has found a test that really seems to work. 

The trick apparently is to inject a “harmless toxin” into the patient.  Somehow or somewhy this toxin gloms onto sugars displayed on the surface of OVCA cells.  For other reasons – also not elucidated – this makes the cancer cells (in the blood stream) easier to detect.  Preliminary results gave a sensitivity of 90% for patients with stage 1 OVCA.  PDG.

So, okay, I don’t know enough about this matter to comment.  Further tests are underway.  Let us hope.


Monday, November 26, 2018

He did it!! Or did He?


A most beautiful baby
Made the old fashioned way


As we witty little smart-alecks used to say back in junior high school, a big, soft wad of it is about to hit the fan!

Designer babies!  The very thought frightens most of us, and puzzles the rest.  You all are aware of the potential for using “edited” genes to combat disease, especially cancer.  These alterations are applied to “somatic” cells, often using the CRISPR cas9 technology, about which I have written many times.  This use of DNA-modification raises no ethical problems; no potential human life is sacrificed by editing somatic cells, and any such changes cannot be passed on to the next generation.

You also are aware of the ethical battles surrounding the use of embryonic stem cells for any purpose other than to produce babies.  Such “pluripotent” cells have the capacity to turn into anything the body requires.  However, their main biological “purpose” is to turn into a human being.  Thus, some say, sacrificing a stem cell for anything else is tantamount to murder.  Many conferences have been devoted to the ethics of this sort of thing, and emotions run high.  Fortunately it now is possible to chemically coax a mature cell back to its pluripotent state, so with luck it may be possible to leave the embryonic type alone.

It is possible, however, to “edit” the DNA of an embryonic cell – and such an editing job can be inherited.  Therein rests big ethical questions, because editing heritable DNA is the road to designer babies.


In the United States experimenting on this subject is almost universally condemned – and moreover, illegal.  Not so, it appears, in China.

In a southern Chinese technical center, a researcher (they call him He) claims to have successfully added a gene to embryonic DNA that will protect against HIV.  He has yet to publish his results properly, so some skepticism exists.  His method involves processes done in vitro and thus is neither simple nor swift.  However, He says, healthy twin girls have been born with their modified DNA safely aboard.  They, and their descendants, will be resistant to HIV.

By the way, Dr. He was educated at Rice and Stanford.  He is no Chinese witch doctor prescribing ground rhino horn for erectile dysfunction.  Still, great doubt abounds, and all await the definitive publication.  Then, assuming He really did it, an ethical shit-storm inevitably will arise.  I will wait until then to wade into that particular fetid swamp.



Wednesday, November 21, 2018

Hippo, YAP, and all that jazz


Linda and the cat from Hell


Okay, here is what I got out of this:


There is a “pathway” called Hippo that regulates the size of organs in mammals.  For example, by properly screwing around with Hippo you can produce mice with testicles the size of tennis balls; a revolting image.

“Pathway” in the language of the bio-geek refers to a chain of “reactions”; something activates protein A, which in turn activates B, which sets off C –resulting, at the end of the pathway with some newly activated molecule doing something important.

“Druggable” refers to a molecule that can be rendered inactive by a “drug”.  Drugs most often work by attaching themselves to the enemy in question.  To do so requires the enemy to have an irregular external shape, into which the drug can insert itself.  A molecule with a smooth external shape is said to be “undruggable”

Well, a major player in the Hippo pathway is something called YAP.  YAP seems to be especially active in some kinds of cancers, including ovarian.  YAP is a “transcription factor”, which means it helps regulate the rate at which genes are “transcribed” into functional proteins.  If the “function” is harmful, as in promoting cancer growth, it would be nice to be able to shut it down: to zap YAP, so to speak.  Unfortunately, YAP is undruggable.

Ah, but YAP operates through its own pathway, and one step in the pathway “cascade” involves a molecule called NUAK2, which has a shape into which you can insert a “small molecule”, a drug.  Some very smart people in Boston figured this out, and even designed the appropriate drug.  They are going to try it out on mice.  Let us hope.



Sunday, November 18, 2018

NEW OVCA DRUG


Linda and Carolyn in Borrego Springs

Just now ten minutes of intense research showed me that AstraZeneca is one of those international drug companies that we so love to hate.  In other words, when we excoriate Big Pharma, as we so often do, AstraZeneca comes in, non-specifically, as one of the culprits.  I have several times said that, unfortunately, we need the bastards – stirring up a personal batch of a cancer drug in your bathtub just isn’t feasible.  There are sharp questions to be asked about their (Big Pharma’s) business practices, for sure, but by and large they are on the side of the angels.  I have written about this subject many times; here is an example:


Well, hell, AZ seems to have gone a long way toward justifying its mercenary capitalist existence by developing, getting approval for, and bringing to market a new drug they call Lynparza (Bio-name, Olaparib).  Olaparib is a PARP inhibitor, useful as a “maintenance” drug in cases of advanced ovarian cancer.  It also seems to be good for breast cancer and certain instances of prostate cancer.  It is specific to cases of defective BRCA genes, but also (unless my hurried research betrays me) can help in cases of non-BRCA OVCA as well.  Olaparib comes equipped with its own collection of side effects (bio-geeks call them AE’s, for Adverse Events), but none appear to be dangerously severe.  Olaparib is not a cure for OVCA, but it provides a good many months, even years, of life.

So, maybe AZ has done a good thing, after all.  Quick:  sell your stock – as we all know, no good deed goes unpunished.


By the way, AZ is headquartered in London, but has a big facility in Maryland.




Friday, November 16, 2018

CHECKPOINT THERAPY

Linda, Whiskers, Patches & Me

Two guys who made their names in immunological research won the 2018 Nobel Prize for Medicine and Physiology.  One is from Texas, the other from Kyoto, Japan.  They worked independently, but almost simultaneously they gave intellectual birth to our old friend, the checkpoint inhibitor.  Here is a PDF describing their work.  It is easy to follow and well worth a bit of your time.

https://www.nobelprize.org/uploads/2018/10/press-medicine2018.pdf

In case you need a refresher course in checkpoint inhibitors, you could start here:

https://ljb-quiltcutie.blogspot.com/2016/05/more-progress.html




Wednesday, November 14, 2018

REVIEW ARTICLE


Linda and her big brother Dick, who just turned (gasp!) 80

Here is a review article.  Much of this stuff you know already, but this helps tie it together.

https://www.cancerresearch.org/immunotherapy/cancer-types/ovarian-cancer

Monday, November 12, 2018

TREE ANGEL


Linda on Heron Island, Maine
Taking a break from chemotherapy

Call me an old softy, but I loved this news article.  (To see it you may have to wade through some obnoxious advertisements.)


I wish I had the talent to do something like this.


Thursday, November 8, 2018

EPIGENETICS (SORT OF) EXPLAINED


Linda on a bridge near Sitka, Alaska
Mid 1980s

I found this to be useful and interesting.

You all know what the word “epigenetic” means, right?  Simplistically, it refers to things that happen to your genome that effect your health, happiness and/or heredity that do not involve alternation of the c, g, t, a sequences of your DNA. 

One important agent of epigenetics is the attachment of a methyl group (CH3) to the DNA molecule in such a way as to “silence” a gene (prevent it from being transcribed into a protein.)  You all also know that an error (mutation) in the BRCA genes can lead to breast and/or ovarian cancer.  Well, it transpires that you can have BRCA-related trouble even though your BRCA genes are alive and well.  This can sometimes be attributed to the “methylating”  of the “promoter” region of the BRCA genes, preventing them from being properly activated.  Promoter regions are segments of DNA that are required to set the gene itself in action.

WHY some promoters get silenced while others don’t remains a profound mystery to me.

Anyway, glance at this short and simple essay.



Saturday, November 3, 2018

GRAPEFRUIT AND OVARIAN CANCER


Linda in Yorkshire

I often feel sorry for those persons visiting me in Borrego Springs, CA, who are unable to enjoy my delicious Borrego grapefruit owing to having to take statins for high cholesterol.  Now, it turns out, cancer researchers seem to have shown that there is another, offsetting benefit from statins: reduction in the probability of contracting the most deadly form of ovarian cancer.  In a case control study it was shown that statin-users were about 32% less likely to come down with epithelial OVCA than comparable non-users.  I skimmed through the original article and came away with the impression that they (the authors) had leaned over backwards to do the statistics right – although, it is well to remember, I am no statistician. 

So, maybe the use of statins should be encouraged.  I don’t know if statins have occasional nasty side effects, but from their wide use I would guess not.  Thank goodness this doesn’t apply to me: I neither have high cholesterol nor am in danger of contracting ovarian cancer, so I can continue to enjoy my delicious, incredibly inexpensive Borrego grapefruit.

Thursday, November 1, 2018

BRCA TESTS FOR ALL, Females, that is.


Linda in the mountains
A long time ago.

Is one billion dollars a lot of money?  Well, from my perspective – certainly.  I would bet that nearly all of you faithful readers would concur.  However, there are people who have dozens – even hundreds – of billions of dollars.  With all this wealth sloshing around, it seems to me that we ought to be able to afford to test every female baby for BRCA mutations, at birth.

There are about two million baby girls born each year.  Costs of a genetic screen for cancer-related mutations can range up to five thousand dollars, but simply testing BRCA can be performed for as little as one hundred dollars.  Say $500 a crack to be on the safe side, times two million tests yields a paltry one billion dollars! 

For comparison, the cost of our latest aircraft carrier is about 14 billion, and the annual budget of the NCI is around five billion.

Good God!  Our priorities are totally screwed!  Bitch to your doctors and your Congress-persons.  Forward this blog to the Trumpster.  And, you females – get yourselves tested.

Tuesday, October 30, 2018

ALL WOMEN SHOULD KNOW THEIR BRCA STATUS


Linda (in therapy) with baby
Never happier than when holding a baby

Here is some very encouraging news for women suffering from ovarian cancer, and who have a mutation in either BRCA gene.  It is not a cure, but it promises much longer remission times.  It concerns a “maintance drug”, specifically Olaparib.

Olaparib (trade name Lynparza) is a PARP inhibitor.  You know what that is, right?  It was developed in Cambridge, UK, and currently is manufactured by AstraZeneca.  A clinical trial indicates that it is very effective at prolonging PFS, which stands for Progression-Free Survival.  If Olaparib had been available in 2010 I might have had Linda for many more months, even years, more.  I say “might have had” because I still don’t know about her BRCA status.  I think it is criminal not to test every woman for BRCA.

Ask your gynecologist about it.

Thursday, October 25, 2018

ORGANIC FOOD?


Linda in Egypt
Look carefully and see Horus in the background, molesting Ramses II

Faithful readers of my blogs will know that I tend to be skeptical about most claims of miracle diets, especially when they concern cancer.  Well, what then am I to make of a massive new study in France, comparing the incidence of two kinds of cancer in people who ate an organic diet with people who didn’t?  Why don’t I admit that this settles the deal?  In other words, why don’t I recant?  Don’t worry: I’ll tell you.

First, the study:  Nearly 70,000 French people, mostly female, were asked to report on their eating habits.  Participants were sorted into categories: always ate organic; often ate organic; only ate organic by accident; never touched the stuff.  Since people who eat organic tend to be, in comparison with ordinary mortals, more health conscious, richer, more likely to get exercise, less likely to have big families, less likely to drink rot-gut red wine or Budweiser, etc., etc. , the researchers attempted to use statistical magic to account for these factors.  The 25% difference that remained, then, was assumed to be caused by diet.  Here is a description of the study:


Still, I remain unconvinced.  My principal problem with the study is that the participants “self-reported”; they simply described their diets to the researchers.  You know as well as I do that diet-health hawks often harbor a statistical propensity to  lie about their intake.  “Oh, that hot dog I scarfed down at the Mariners game really doesn’t count.”  Nobody lies about eating less organic food, except maybe me.  Thus the study has a built in bias – which, it seems, would be difficult to eliminate. 
Anyway, here are some caveats.


The notion is that certain pesticides may promote certain cancers, and that is certainly true.  It also is held that GMO food stuffs cause cancer; this is almost certainly not true.  Every expert agrees that one’s state of health is enhanced by eating more fruit and vegetables, less red meat, and cutting down on alcohol, and that includes cancer. Insofar as eating organic entails more apples, oranges and beets it may be beneficial - but because of what is eaten, not whether or not it is organic.  So, phooey!  Also - can you really trust a Frenchman?*

All that aside, I am now going to construct my dinner: chorizo burrito (carry-out), washed down with Red Hook ESB.  I’m 85, so who the heck cares?

*You know you can't always take me seriously, right?

Monday, October 22, 2018

SMALL-BATCH PHARMACEUTICALS


                     LINDA, IN THERAPY, WITH SOMEONE'S BABY

They used to make gin in the bathtub, and now lots of people make beer in the garage and/or wine in the cellar.  So, why not biopharmaceuticals on the kitchen table?

Well, some smart folks from MIT have done just that.  They have designed and assembled a three-stage process than can produce what you might call “small-batch” drugs.  They have tested it on several well-known concoctions, and found that it turns out the real thing very quickly and, I would guess, relatively economically.  The hope is that these units, which eventually may be miniaturized to a kit about the size of a standard ink-jet printer, can be used by researchers to produce experimental drugs, as well as by hospitals to create remedies for rare conditions.  It seems to me that it might also bring down the price if pharmaceuticals in general, but -  don’t hold your breath.

This is all well and good, but I can foresee problems.  For instance, the first drug the MIT team produced using their kitchen-table still was human growth hormone (hGH).  hGH has many beneficial applications, but isn’t it also a banned substance used by cheating athletes?  If you can turn it out in quantity using a gadget that can be hidden in the attic, the game is up.  You will know there is a problem when slender lasses from Lithuania start flinging the shot over 85 ft.!


Saturday, October 20, 2018

WHY CANCER? MORE TO THE POINT, WHY NOT CANCER?


Linda and Amanda, a very long time ago.
That tiny blob now is the mother of two of my ultra-cute great grand kids

We all know that cancer can be, and usually is, a result of genetic mutations.  Some glaring culprits – sometimes called oncogenes, have been known for decades.  Oncogenes cause the cell to divide without limit.  Opposing these bad actors are things we call tumor suppressor genes.  Too many of the former, or too few of the latter, can lead to active cancer growth.  Additionally, sequencing of many cancer types has shown that other (mutated) genes are involved in cancer growth, although just why or how are not always obvious.  But we have a list of these suspicious mutations in TCGA, The Cancer Genome Atlas, about  which I have blogged recently.  What?  You haven’t read it?  Well, here’s another chance:


So, anyway, a bunch of learned Brits have shown that normal, healthy, non-cancerous cells ALSO display a panoply of these same mutations, yet remain pink, rosy and harmless  So, what gives?  No clue, it seems.  Some speculation based on evolutionary theory is advanced, but sheepishly.  It appears that this may be another promising avenue of research.  Expect more, later.


You may be interested to know that, by middle-age, your esophagus is coated by colonies of "mutant clones!"  Maybe that's why Vegan food  tastes so terrible!

Wednesday, October 17, 2018

FRED HUTCH NEWSLETTER


I still can't figure out where this is.
Any suggestions?

The Fred Hutch Newsletter is out.  It contains a half-dozen interesting articles, ranging from Immunotherapy to Circadian Rhythms.  You could do worse than to spend a few minutes reading it.  Here it is:


I particularly appreciated the piece on ovarian cancer, partly because I know, or at least have met, almost everyone mentioned.   I even have blogged about one of them:


Much of this article is about a “two-minute” questionnaire designed to determine whether or not one is suffering from OVCA.  It is the product of work by Dr. Robyn Andersen, a clinical psychologist.  Back in the day I proof-read several of Robyn’s papers.  Her questionnaire is given in the article.  Make sure your primary care doc knows about it.  Don't apply it to yourself and then obsess about it, though.

Another interesting (to me, at least) article examines some of the mysterious nuts and bolts of CAR-T immunotherapy.  I learned that in making the T-cell a “chimera” they festoon it with molecules that are stuck in and penetrate the cell wall.  The outer end of these things is the “antigen receptor”; it recognizes, and gloms onto, the cancer cell.  When this happens, the inner end activates “pathways” that turn the T-cell into a lethal weapon.  How all this happens, or how they even know it happens is not explained.  Just as well.

Sunday, October 14, 2018

TCGA


The Canadian Empress
Queen of the St. Lawrence Seaway

I have just (10/12/18) returned from a delightful week touring the St. Lawrence river in a small funky boat (pictured), starting at Quebec City, visiting Montreal and other attractions, and terminating at Kingston, Ontario.  Overall, it was a blast; the scenery was very pleasant (fall colors were peaking), the food and accommodations were top-notch, the crew was a wonder to behold, and even the bar far exceeded expectations (and mine tend to be pretty high).  As to the river … it is the most impressive I have ever seen.  The Mississippi seems far smaller to me, and I have never seen the Amazon.  The Nile, Colorado, and even the Columbia are outclassed.  After all, the St. Lawrence drains the Great Lakes, as well as a vast (and soggy) swath of central North America.  Whatever: I was impressed, as you can tell.  I recommend the trip.  If you go, tell them Myrl sent you – they will give you a free liqueur. 

Oh, I should add something to my blog about travel when you’re old,

http://frivilousessays.blogspot.com/2017/12/travel-advice.html

Be sure to induce as many younger people to go with you as possible; they (being kind and overflowing with energy) will ensure that you don’t find yourself stranded on a dock or impossibly far from a wash room at a moment of urgency.  My helpers on this trip were my daughter Karen Beck, and Linda’s sister Carolyn Joyce.  It is impossible for me to thank them enough.
So, for my first blog back, I would like to turn you over to Dr. Francis Collins, Director of NIH,  for a brief summary of the history, philosophy, and promise of TCGA, The Cancer Genome Atlas,  I have written about this subject more than once over the years; the most complete (but oldest) treatment being


I would like to turn you over to Dr. Collins – but I can’t, at least not directly – when I copy the Web address of the article and then open it, I am presented with another of these inscrutable computeroid “explanations” for my failure.  So, if you really are interested, Google NIH Director’s Blog and access his latest – something about frog hair.  Over on the side will be a columnar list of other topics, the bottom of which concerns the TCGA 2018 Symposium.  Click on that and you will be presented with a 15 minute U Tube video that is mildly interesting and informative, and easy to follow.

Knowing that you won’t:  here is what I got out of it.  Cancer is a condition ultimately caused by errors in the genome.  Fundamentally, then, the way to tackle it is to determine what those mistakes are and how they operate,  Only with this knowledge is it possible to counteract the effects of those mistakes – making precision medicine and immunotherapy possible.  The only feasible way to separate signal (the causative mutations) from noise (harmless, random mutations) is – as any good exploration geophysicist knows – to analyze huge data sets.  Hence the marriage of medicine and computer science – bioinformatics – and ultimately The Cancer Genome Atlas.

Constructing this blog was so laborious that I think I will post it on Facebook.  Remember, there are lots more - better, shorter, and with better pictures - at "Myrl'sBlog".

Saturday, September 29, 2018

MORE ON THE PILL


A great photo
Two hippy chicks in the vinyl age

This must be big news, because it is being reported everywhere, even in the Malaysian Times.  A massive study of Danish women has shown that use of birth control pills containing estrogen and progesterone substantially reduces a woman’s chance of contracting ovarian cancer.  I wrote about this several years ago (http://ljb-quiltcutie.blogspot.com/2016/09/the-pill.html), but at that time it was only a “possibility”, but now you can call it a fact.  The Danish cohort was divided into three groups: those who had never taken the pill, those who had taken the original pill, and those that took a new-fangled pill with the proportions of estrogen and progesterone re-jiggered.  The results showed pretty conclusively that the older pill helped avoid ovarian cancer’ and the new formula did it even better.  Take this to heart, folks
.
I wish I had never had that vasectomy.   Think it through, guys.



and I could give you a half-dozen more

Tuesday, September 25, 2018

ASPIRIN NOT THE TOTAL MIRACLE DRUG I THOUGHT


Linda created this quilt for Margo and Phil Montague

It really seems that the grand debate about the health effects of aspirin will never end.  I have written about aspirin and cancer many times over the past few years: search of Myrl’sBlog turns up  15 references.  In general, aspirin seems to reduce the chance of developing cancers of many types. Now, however, comes some negative evidence.  A massive trial involving healthy elderly folks* turned up no overall longevity benefit from daily aspirin in small dosages/.  In fact, if anything, the non-aspirin control group had the better outcome.  There are lots of qualifiers, though, so read the NIH report.


However, as the focus of this blog is ovarian cancer, be sure to read this, too.


*Defined as over 70 for most of us, but over 65 for African Americans and Hispanics.

Monday, September 24, 2018

WHERE YOUR TAX DOLLARS GO


At my niece Florence's wedding
Linda is looking especially lovely, don't you think?
My mother is on Linda's right; my sister Susannah is on my left.

Ever wonder where your Federal tax dollars go?  Well, unless you are impossibly rich, dreadfully poor, or dead, the answer undoubtedly is yes.  No doubt a fair bit goes up in smoke, in the form of waste and/or mismanagement.  Lots, in my view, goes to fund stuff the Feds either can’t do or shouldn’t be doing.  But, of course, lots goes to things that are well worth doing.  Top of that list, again in my view, is work done by NCI, the National Cancer Institute; NCI probably is bloated, cumbersome, bureaucratic, and slow but its heart is in the right place and, by and large, it does good work.

So what? you ask.  Well, new NCI Director Dr. Norman Sharpless, has just released NCI’s Annual  Plan and Budget Proposal, aimed at Congress and the Trumpster.  It is a massive, detailed document which, if you have time to burn, you can read by clicking below.  I haven’t read it thoroughly myself as yet, so I will confine myself to reporting the grizzly fiscal highlights.  Next rainy day I will study it and report any important scientific highlights.  So…..

NCI is asking Congress for $6.522 billion for Fiscal 2020, of which $622 million is to offset inflation. This is an increase of $857 million over the current budget.

Of the current budget proposal, $195 million comes from the “Cancer Moonshot” program initiated under Obama and so far not terminated by you-know-who.  The Moonshot ends in 2023 and, if all goes according to plan, will expend $1.8 billion.

NCI both funds research at various universities and cancer centers throughout the country, and conducts research at its own laboratories.  (For a glimpse into how NCI research works, read my book review  http://ljb-quiltcutie.blogspot.com/2018/09/review-of-important-book.html)

For comparison, cost estimate of Trump's border wall - $33 billion.  For a modern aircraft carrier, $13 billion.  Cost of cigarette usage in the U.S., per year ~ $300 billion.

More, later.


Sunday, September 23, 2018

CLIFF NOTES FOR OVCA RESEARCH


TAKING A BREAK FROM CHEMOTHERAPY
I kid you not.  She was incredible.

Here is a handy summary of the state of our war against ovarian cancer, as of the moment.  Short, sweet, but not too complete.  (See, I am a poet, although you didn’t know it.)


To benefit from this blurb you  may need to be reminded of the nature and function of PARP inhibitors.  If so, give this a try:


Friday, September 21, 2018

EXOSOMES, EVOLUTION - and CANCER


Linda and a pitiful chestnut tree

How does this stuff come about?

Some new research from the University of Pennsylvania involves exosomes and their role in cancer.  Exosomes are, essentially, garbage bags tossed out of cells into the blood stream.  Or so they are usually characterized.  However, it appears that exosomes expelled from cancer cells (this research concerns melanoma) also are bristling with proteins called PD-L1, which bind to a receptor called PD-1 found on the surface of cytotoxic (cell-killing) T cells of the immune system.  This binding effectively neutralizes the T cell, thus facilitating the health and well-being of the tumor!  What a stupid situation! 

This work is only in its baby-to-toddler stage, but it promises to be a useful technique when it grows up.  But I am mystified:

How in the dickens does something like this arise?  My rudimentary understanding of evolution tells me that new traits in animals and plants arise spontaneously, and randomly, and that those modifications that survive and prosper are those that make a positive contribution to the entities’ prospects for reproduction.  But cancer cells make a profoundly negative impact on survival.  Also, the cancer itself does not reproduce in any sense of the term that I comprehend, hence any tricks that a particular cancer cell might develop to protect itself cannot be transmitted to cancer cells in another creature.  Yet here you have it: cancer cells tossing garbage sacks into the bloodstream, but sacks studded with little IEDs capable of deactivating any immune cells they might encounter that could do damage to the tumor.

Maybe there is a devil, after all.

https://www.cancer.gov/news-events/cancer-currents-blog/2018/exosomes-tumors-evade-immune-system?cid=eb_govdel

Saturday, September 15, 2018

REVIEW OF AN IMPORTANT BOOK


Linda at her mother's apartment
Friendship Village, Kalamazoo, Michigan

I dare you to read this book!  I double-dare you!  I don’t think you have the guts!

The book in question was written by Dr. Steven Rosenberg, long-time leader and resident star of the National Cancer Institute (NCI).  Steve, as we are told to call him, is about 78 years old at this writing (2018) and still working, as far as I can determine.  OId cancer researchers never retire, it seems – they just die in the saddle, riding resolutely into the unknown.  Good for them!  Steve was aided in the assembly of this book by John M. Barry, a professional science writer and author of a moderately
good book on the enormously lethal flu epidemic of the early 20th century.  I have been profiting from Barry book, but I set it aside to reread The Transformed Cell to prepare for writing this review.  I’m glad I did; I came to understand a lot of stuff the second time through that had mystified me on original encounter.  Maybe if I try it a third time I will figure out what in heck LAK cells are.

This book is largely an account of Steve’s professional development from childhood to the 1990s, when the book was written.  Steve is, to say the least, not an ordinary guy.  In addition to being smarter than the rest of us, he works a heck of a lot harder.  He also has an unprecidented ability to withstand, learn from, and rebound from a host of calamitous failures.  If I had experienced even 10% of the crushing setbacks he has endured I would have crawled under my desk, sucked my thumb for a week or so – and then taken up professional bowling.  Not Steve: he kept right at it, for decades – and finally was one of the midwives – possibly the most important midwife – at the birth of modern immunotherapy.

So, anyway, the book begins with Steve, as a young doctor working for the VA, encountering a gritty old cuss named James DeAngelo, who had once been riddled with intractable cancer and sent home to die – but didn’t.  Steve groped long and hard for an explanation that made sense within the context of 1960s medicine, but couldn’t find one.  The only possibility seemed to be that Mr. DeAngelo’s immune system had turned on the tumor, and killed it.  At the time that was considered impossible; cancer cells were “self”, and the immune system only attacked “non-self”.  Dr. Steven Rosenberg was driven to the suspicion that this wasn’t entirely true.  He spent the rest of his career working on a solution to what might be called the DeAngelo conundrum.   And, by God, he found it.

This book conducts you through the history of Rosenberg’s tussle with immunotherapy, beginning with a simple attempt to save a dying cancer victim by giving him a shot of James DeAngelo’s blood – to, decades later, experimenting with immune system cells “transformed” by modifying their DNA using retroviruses.  The trek from transfusion to “transduction” is too long and convolute to attempt to summarize here.  You should buy the book (<$5.00 at Abebooks) and spend some serious time with it.  You will learn a lot of important stuff – especially if you read it twice.

So why do I think you ain’t got the guts to stick with this book?  Well, it’s because much of the story involves people you get to know and care about – all of whom die.  For decades, they all die.  Dozens of them.  (Not to mention, of course, thousands of mice.)  It is hard on the reader.  What must it have been like on Rosenberg and his team?

I can’t help but end with a personal note.  This book was published in 1992.  Linda died of ovarian cancer in 2011 – 19 years later.  During her struggles with the disease nobody ever breathed the word “immunotherapy”, nor suggested any kind of clinical trial.  Linda would tell me to let all that go, so I will try.