CAR T

A classical chimera

More than likely you have brushed up against “immunotherapy” and its faithful companion (CAR T therapy) in the news.  Being the curious person you are, no doubt you have asked yourself what CAR T stands for.  Well, the CAR part stands for “chimeric antigen receptor”, and the T part refers to that part of the immune system called T cells (sometimes called “killer T cells” for their ferocious role in the body’s defense system).

Did that help?  Well, maybe not, so I here is an official explanation: “Chimeric antigen receptors are engineered receptors which graft an arbitrary specificity onto an immune receptor cell”. 

Did that do the trick?  Well, hell, of course not.  Who do these people think they’re writing for – Watson and Crick, or maybe Linus Pauling?  Here is all I know:  CAR T therapy is called “chimeric” because it grafts some new stuff onto the patient’s own T cells.  This gives it “specificity”, which means that these T cells now can recognize a particular kind of cancer cell, and gobble it up.  Two (very expensive) drugs are now approved for blood cancers.  One researcher describes these engineered T cells as Pac Men, swimming through the blood stream and zapping the bad guys.

Anyway, CAR T technology is being modified to attack solid tumors, including ovarian.  Some of this work is going on at Fred Hutch.  If you use the link below to follow up on CAR T, soon you will know more than me

Not that that’s saying much.

https://ovariancancernewstoday.com/2017/10/20/ovarian-cancer-gene-therapy-specialist-to-share-more-than-a-million-dollars-in-grants/

AMERICAN EXCEPTIONALISM

Linda with Tarahumara baby, 2009

I think she wanted to bring it home with her

They talk about “American  exceptionalism”.  There is no doubt that we are exceptional in many ways.  We are exceptionally powerful, economically as well as militarily.  We are exceptionally lucky to be situated on North America and not, for instance, West Africa.  We are exceptionally lucky to have a secular state, rather than one based on religion.  Likewise, we are fortunate enough to have the NY Yankees and the New England Patriots to hate.  So, by and large, we should be very  happy to have been born here, rather than in Yemen, for example.

But on some things it seems to me that we are exceptionally stupid.  In school I was taught that our system of government was created by very wise men, and was the best ever devised.  But why, then, do we have total gridlock in Washington and a bunch of clowns for leaders?  Is it the fault of the Founding Fathers, or are we modern voters to blame.  Possibly a bit of both, I believe. 

But one facet of life we approach in an exceptionally stupid way, for sure – our system of providing health care.  What pushed me into this tirade is the fact, which I just learned…

http://www.news.com.au/lifestyle/health/women-with-family-history-of-breast-and-ovarian-cancer-able-to-undergo-free-genetic-tests/news-story/3a2de230422fbca80c93f0ce889a72a8

that in Australia every woman with any risk factors can now get tested for BRCA mutations on the cheap, whereas in this country one actually has to  HAVE the damned disease!  How many American lives are tossed away needlessly each year, in order to save a few bucks?  We need more cancer biologists, and fewer statisticians and economists.  So say I.

I am in a bad mood this morning.

MORE ON HORMONE THERAPY

Linda and a stuffed something

Despite my somewhat ambiguous first name (Myrl), I am male and consequently know about such things as hot flashes, night sweats and sleeplessness (post-menopausal symptoms, apparently) only at second hand.  They seem to be serious enough, however, that hormone therapy – estrogen, progestin – have been prescribed to ease them.  In 1993 a massive study was undertaken to test the safety and efficacy of this drug regimen.  It was terminated prematurely in 2002 because, as I read it, taking estrogen in combination with progestin caused a statistically-significant increase in the incidence if stroke, breast cancer, and blood clots.  On the basis of this result I have advised against hormone therapy multiple times (eg., http://ljb-quiltcutie.blogspot.com/2013/09/free-medical-advice-and-worth-every.html).  So maybe I was wrong.

The massive study referred to above (the Women’s Health Initiative) was continued (after withdrawing the drugs) in the sense that the subsequent histories of the participants were studied.  Big surprise: the placebo group and the group that received the drugs had statistically-significant identical rates of mortality.  I probably know less about statistics than I know about cancer biology, if that is possible, but this sounds weird to me; if the drug-getters had more life-threatening side effects than the placebo group, how come they didn’t die more?  I have to assume that all the stats were done correctly – so what gives?  Did they mix a little Atropa belladonna into the placebo?  Or maybe GMO-enhanced polyunsaturated fructose sugar?  None of these is possible, of course, leaving me baffled.

There are some other important statistics in the article:  http://www.fredhutch.org/en/news/center-news/2017/09/death-risk-menopausal-hormone-replacement.html.  Some of them suggest to me that the culprit here is progestin, and that estrogen alone may be safe and beneficial under certain circumstances.  As always, consult someone who knows.  Maybe several.

QUAKERS AND OVARIAN CANCER

Two of my favorite people

As we all learned many months ago, if ovarian cancer is detected in stages 1 or 2, cure – it not a slam-dunk – is still quite likely.  However, in view of the fact that early stage disease has few obvious symptoms, most OVCA cases are discovered only after the disease has spread.  We also all agreed many months ago that a major new weapon – specifically, an effective test for early stage OVCA – is sorely needed.  Well, here is one, involving cancer DNA in the bloodstream.  Read this little ditty to find out how it works.

https://www.nih.gov/news-events/nih-research-matters/detecting-early-signs-cancer-blood

The catch, as always, is cost.  If a woman’s body doesn’t show obvious signs of distress, how then does one know which women to apply the test to?  Clearly, humankind would be well served if ALL women were tested periodically.  But how much would that cost?  I don’t know, but I would bet – about as much as the U.S. Navy.  And so it won’t happen, at least not soon.

Wouldn’t it be nice if the world were so ordered that we didn’t need a navy – or an army or air force, for that matter?  Think of what could be done with all that money.  The Quakers definitely have the right idea.  Just not the votes.

FREE CAR MAGNET

I ordered some more Ovarian Cancer Awareness car magnets, and to get the volume discount I ended up with a few extra.  If you want one, email me at myrlbeck@msn.com and I will send it free, gratis and for nothing.  They are 8 inches high, cling to your vehic like a barnacle, and further a good cause.  Supply severely limited, so act now.

WHAT YOUR PCP SHOULD KNOW

If you take my picture one more time I"ll whack you with this gourd!

Does your PCP (primary care physician) know all this?  Maybe not; they are busy professionals with family lives of their own.  But they should.  Read this, then give them an oral exam.

https://www.healio.com/internal-medicine/oncology/news/online/%7Bc2f9594d-5f0d-40ea-aa06-3c39774ec0c0%7D/ovarian-cancer-care-what-pcps-need-to-know?page=3

ALAN SANDERSON

Two kids in Evanston

Alan Sanderson, you’re my man!

There is a large lake, Chew Valley Lake, in the Chew Valley district of Somerset, England.  The somewhat comical name (Chew Valley) led me to read an article in the Chew Valley Gazette.  There I met Alan.

Alan lost his wife to ovarian cancer in 2014.  Since then he has devoted much of his time and energy to combatting the disease.  He is a star fundraiser for Ovacome, a leading British charity focused on ovarian cancer.  For instance, he recently organized a 13-mile walk through the Somerset countryside, to raise money for OVCA research and treatment.  In his spare time he gives talks to groups about OVCA symptoms and treatments.

Alan, I envy you the energy and mobility to do what you do.  I have somehow become so old that all I can do is sit on my duff and write this blog.  If you ever visit the Pacific Northwest, I would like to buy you a beer.  Not as good as you would get in your Local, of course, but not bad, either.

Here is the article on Alan:  http://www.chewvalleygazette.co.uk/article.cfm?id=102792&headline=Chew%20Valley%20Challenge%20tackles%20ovarian%20cancer&sectionIs=news&searchyear=2017

And here is some information about Ovacome:

http://www.ovacome.org.uk/