TIME MAGAZINE CAN BE USEFUL

Linda trains for her trip to Egypt

 

 

Several times over the past year I have enjoined you to read he Economist  (and stop getting all your news from TV and the internet.  Admittedly, if you relied on the Economist exclusively you will fall behind on the Kardashians and Lady GaGa,  but that might not be such a bad thing.)  Now, I am beginning to wonder if I should recommend Time instead.  If you are vitally interested in political developments in Botswana, Time might not suffice – but if you want to keep abreast of developments in cancer research, it might be the better choice.  I say this because Linda’s sister Carolyn has again sent me a link to an article in Time Health that is interesting, important, and comprehensible.  Here is the link:

http://news.yahoo.com/no-more-chemo-doctors-not-far-fetched-094524778.html

The thrust of the article concerns the increasingly successful use of "targeted therapy”.  In an inadequate nutshell, targeted therapy consists of using cancer gene sequencing to discover precisely which mutation is causing the trouble, then developing a drug to block its effects.  In standard chemotherapy a drug is administered that is intended to kill all of the cancerous cells – a “one size fits all” approach”.  Chemo carries with it the threat of miserable side effects, as we all know too well.  Also, chemo rarely actually “cures” – eliminates the cancer once and for all.  This is because cancers, especially solid tumors, are said to be “heterogeneous” – they don’t all have the same deleterious mutation.  Thus, chemo drugs may kill 98% of the cancerous cells, but leave behind the remaining 2% to regroup and counter-attack.   If your oncologist knew just what assortment of bad actors he/she is facing – and had a gene sequencer and a world class lab and his/her disposal - -conceivably she/he could devise a cocktail of several drugs specific to the problem at hand.  In other words – real cure would be conceivable.  It seems to me, though, that we are talking about lots and lots of money.  Can we afford it?  Maybe the real heroes here are the engineers and chemists who are streamlining sequencing and drug creation, making it ever less expensive.  But don’t kid yourself, it will be damned expensive for a long time to come.

Another aspect of Time’s reportage is that it provides links to earlier articles, as well as to some of the original papers from which the material is extracted.  I clicked on one such, and almost wished I hadn’t.  It carried on about targeted therapy and how the world might soon be rid of many types of cancer.  It was two years old.

But, anyway, I must once again thank my far-flung cadre of research assistants.  Without  Dick Ingwall, scouring the NYTimes, Carolyn Joyce studying Time, Parkfriend searching the Toronto newspapers, and Joan McManus cutting clippings from the San Diego Tribune – I would have nothing to write about,  I might even have to  do my own research.  Heaven forbid! 

P.S.  There are only 24 more days to sign up for Summerun North 2013:

http://community.swedish.org/page.aspx?pid=608&tab=0&frtid=1183

and 10 more days to order a T-shirt:

http://www.customink.com/signup/3a9v6j52

 

 

 

 



THE CANADIANS STRIKE AGAIN!

Staring into a late-summer Norwegian sun

That's a quilt store in the background

Toronto, is a big, important city.  Despite the facts that it is located across the border in the Great Frozen North, has a mayor who may or may not smoke crack cocaine, and is inhabited by people who pronounce “about” and “strength” in a peculiar way – it is highly civilized.   Lately faithful reader Parkfriend has alerted me to evidence that Toronto is in the forefront of a civilized pursuit of unsurpassed importance – cancer research.  In fact, in some fields it seems to be THE  forefront.  I refer to the Princess Margaret Cancer Center, out of which lately have come two stories of important advances in cancer therapy. 

The first reports the research of Dr. Suzanne Kamel-Reid who, with her colleagues Drs. Phillipe Bedard and Lillian Sui, has used gene-sequencing techniques to craft personalized drugs specific to an individual cancer.  As you all know full well, cancer is a very heterogeneous disease.  Within a specific gene – say a tumor suppressor – there may be many separate mutations.  Some cause aggressive cancer, whereas others make no difference at all.  Of two cancers of the ovary, one may be mutated in such a way as to grow rapidly and metastasize, whereas the other may be “indolent” – poke along so slowly that it almost can be ignored.  Thus, standard therapy protocols for ALL ovarian cancers may work well for some, but not at all for others.  Dr. Kamel-Reid’s group has begun to use their knowledge of HOW a particular gene is mutated to design personalized treatments.  How they do it is beyond our pay grade, but they have been reasonably successful.  Goodon’em.

Princess Margaret CC also is the home of Dr. Tak Mak.  Together with a colleague from UCLA, Dr. Dennis Slamon, Dr. Tak Mak has crafted a drug that inhibits the growth of a wide range of cancers – including ovarian.  That is, it does so in mice.  The researchers have now applied for FDA approval to test the drug – called CFI 400945 – on humans.  It works by targeting an enzyme, PLK4, that is important in cell division.  So, get to work, FDA.

By the way:  the drug so far has cost $40 million to produce.  Also, the FDA application ran to 4000 pages.  Heck, that’s almost as long as the U.S. Tax Code. 

Sort of a PS:   Somewhere in these two articles I ran on the statement that the two most promising lines of investigation in cancer research today are targeted therapies, and immune system-based therapies.   To these I would add epigenetic studies, especially those involving the role of miRNA – and early detection.  The latter may be of the greatest immediate importance.

Here are the links:

http://www.thestar.com/news/insight/2013/06/03/toronto_oncologists_present_groundbreaking_paper_on_future_of_cancer_treatment.html.

http://www.thestar.com/life/health_wellness/2013/06/18/cancer_breakthrough_new_drug_to_prevent_cancer_growth.html   



SUMMERUN NORTH 2013, Chapter 2

On some unknown beach

When?  Where?  Any ideas?

Just a reminder that Summerun North 2013 is now only weeks away.  Thanks to generous contributions  by many people, but especially  by Paul Larson and Florence DiJulio, we are now within striking distance of our totally arbitrary goal.  (Of course, I would like to greatly exceed it.)  You still have plenty of time to sign up – but you don’t have much time left to order a T-shirt.  I will give the web addresses of the sign-up page and also the T-shirt-order page below.

To jog your memory:  The event will be held at my house, 1811 4^th St., Bellingham, starting at 10:30 the morning of July 28^th, which is a Sunday.  There will be hot dogs, chips, pop – and beer.   Other contributions – healthy or otherwise – are more than welcome.  Those who wish can walk a short route through Fairhaven, hopefully in "Linda's Team" T-shirts to attract attention; if anyone happens to ask what you are doing you will be able to give them a Symptoms card – and otherwise spread the word.  If anyone wants to run I will lay out some sort of route through Edgemore, complete with steep hills and other tests of character.  The event will end when the beer runs out or the cops come to break it up – whichever comes first.

As before:  you can come and not contribute, or you can contribute but not come – but we hope to see you all here, and all paid up!.     

To contribute:

http://community.swedish.org/page.aspx?pid=608&tab=0&frtid=1183

Do not “join” the team.  Instead “contribute” to it.  This is so Swedish doesn’t grab some of the money for expenses – which we will not incur.

To order a T-shirt:

http://www.customink.com/signup/3a9v6j52.



ANOTHER BOOK REPORT

Linda and guide, Ecuadorian Highlands

Probably late 80s

Cotopaxi in the background - behind the clouds

 

I am still trying to learn enough genetics/cancer biology to make comments at the meetings I attend.   I have gone the Teaching Company route, which is painless and has served to alleviate my initial total ignorance, but that is not enough.  I tried reading textbooks – full of information, most of which I probably don’t need – and ineffably boring.  (I apologize to all my former students; if I’d known how dreary textbooks can be I might have tried a different approach.)  So now I am reading “popular” books, ostensibly intended for the non- scientist.  I have written about several of them already.  Two books by Matt Ridley, Genome: Biography of a species in 23 chapters, and  The Agile Gene are light and frothy, amusing, and filled with interesting anecdotes – but don’t seem to lead  anywhere.  Another, by Richard Francis, Epigenetics: The ultimate mystery of inheritance, is not light and frothy, rarely amusing, and may lead somewhere, if you can get through it.  All three of these books will teach you things – but not the ultimate mystery of much of anything.  You need to forge on.

Right now I am reading The Epigenetic Revolution, by Nessa Carey.  Dr. Carey is, or recently has been, an active researcher in genetics, epi and otherwise, and cancer.  She lives in England.  Her intention presumably was to write a book for the non-scientist, and to a great extent she has done so.  However, she seems to forget her audience occasionally – in fact, a lot – and spirals off into fairly complex molecular biology.  There is a helpful Glossary, but more is needed. (If I have to look up retrotransponds one more time I will scream!)  But that aside, I think I am finally learning why there is such a big fuss being made about epigenetics.  I can’t actually encourage you to read this book: if you don’t know at least as much about biology as I do, after more than  a year of “diligent” study, you would be lost.  That is why her book went directly to the “remainder” market; you can get it from Abe books for $3.57, with free shipping.  (Amazon will charge you $18.75.)

I guess this post is to warn you that I am getting ready to try to explain epigenetics and convince you it is important.  I will of course give fair warning – Warning:  thick biology ahead – so you can skip the text and just enjoy the picture.

Reminder:  Summerun North 2013 is coming up.  Read an earlier post with the same name to recall what to do about it.



 



FORCE: May it be with you

 

The worlds cutest woman and the worlds cutest kitten

 

Linda and Patches, probably 1991

 

I am at home today, working on a project for the Marsha Rivkin Center.  Specifically, I am surfing (?) the Web, looking for ovarian cancer foundations all across the land, then extracting information from their websites – and transferring it to a spread sheet.  What we are going to do with all this information is not clear to me; maybe we will try to lay an arm on them to get some of their money, to use to support our researchers.  It is turning sunny outside and I should get out of the house, and leave this stuff ; it is getting a bit tedious.  However, I had my eyelid operated on yesterday and my appearance would frighten small children and cause their parents to glance away quickly – so I guess I’ll remain inside.

This “research” has, however, turned up one thing that is worth blogging about.  There is an organization called FORCE (Facing Our Risk of Cancer Empowered) that has branches all over the country.   They advocate for research and community education concerning ovarian and breast cancer.  They run all manner of fund raising events, bug politicians, and provide help to cancer patients/survivors.  Their web site is a source of lots of information.  Check them out at http://www.facingourrisk.org/.

Through another web site you can get a “locator” that will tell you which local chapters are nearest you.  Use http://www.ovariancancer.org/resources/partner-members/. 

So, I don’t expect all of my thousands of readers to immediately swamp the FORCE web site.  Unlike me, you all have lives – involving things like work.  But if you feel like getting deeper into the battle against cancer personally, this might be a way.

Isn’t this a neat picture?



ROUSE THE SLEEPING IMMUNE SYSTEM, and send it into battle

 

From the cat, the hat, and the background - mid 80s

 

I am running out of original photos.  Can you help?

 

 

-I apologize for delaying an entire week before  posting something new.  Most likely you weren’t too distressed – but I was.  I seem to have taken on about as much as I can handle – Fred Hutch, the Rivkin Center, and now I have agreed to do some writing for the local Cancer Center.  And this blog.   I am busier now than before I retired.  There is quite a difference, though: earlier there were lots of things I had to do; now I have an endless supply of things I want  to do.  If I decide not to do them, I can.  But so far that hasn’t happened.

Dick Ingwall again alerts me to an important article in the NYTimes.  It concerns the use of the human immune system to counter cancer.  You can read it yourself:   http://nyti.ms/10MU3rL

You know the problem.  The immune system has evolved as one way to combat foreign invaders; virus, etc.  These are recognized as “not us” ; presumably the immune cells somehow detect “foreignness”.  How?  Do they read DNA?  Do viruses have DNA? (Yes, they do.)  Heck, another thing I don’t understand.  But, anyway, cancer cells are most definitely “us”; they are not foreign – so the immune system stands by and watches them destroy the body.  Big flaw, it seems to me.

  Obviously a lot of time and money have been spent over the years to rectify this flaw.  Cancers  escape the immune system in two ways: being “self” they masquerade as good guys, and they also act to shut the immune system down.    Drugs targeted at the first problem have been tried already, with limited success.  Now three of the biggest firms in Big Pharma  (Merck, Bristol-Myers and Roche) have drugs targeted at the second piece of the flaw.  (Full disclosure; I have no shares in any of these companies.  I had a fair sized one  in Merck a few years ago and sold it  at a loss.  Don’t take financial advice from me.)  These drugs are in Phase I clinical trials, and seem effective.  However, it is a long haul from Phase I to your local oncologist's medicine chest,  But, anyway, the medical community is excited.  Commented one of my Fred Hutch scientists, “We (cancer researchers) are so used to failure, we get excited very easily.” 

These drugs are targeted on a beautifully named protein, PD-1, which codes for Programmed Death Receptor 1”.  What PD-1 kills is not obvious to me from this article, but “inhibiting” it shrinks melanoma and maybe other cancers as well.

In the end, though, I feel a bit discouraged by this article.  For the most part what is  being discussed amongst cancer researchers are  methods to shrink tumors and/or extend periods of remission.   Extending life by a few months is viewed as a victory.  Come on guys, and (increasingly) girls, don't screw around – what we want are real cures!  As I've said several times before - get cracking!