Tuesday, May 29, 2018

GLIOBLASTOMA

 

The Joyce family, about 1950
Roy (center) died of brain cancer a few years later

As cancers go, glioblastoma is a particularly nasty brute.  As you almost certainly know, glioblastoma is a type of brain cancer, the most common type, and possibly the most deadly.  Senator John McCain, by far my favorite politician and a true public servant, has glioblastoma - according to some particularly despicable blob of sputum working for the Trump administration, he is dying from it.  Most people die from glioblastoma in less than two years (although the husband of a good family friend, - she is without doubt an ornament to our community - lived for 18 years after diagnosis.)  The husband of Linda’s Maid of Honor at our wedding had glioblastoma, and died from it shortly thereafter.  A valuable and esteemed colleague of mine in the geology department succumbed to glioblastoma.  It probably was responsible for the death of Linda’s father when she was a little child.

You know, when I think about it, glioblastoma is right up there near the top of things about this world that I hate.  In fact, it comes in second.  Right after ovarian cancer.

Well, if you read these blogs at all, you will be aware that immunotherapy is the modern great  hope of oncology.  Checkpoint inhibitors, CAR-T, and other high.tech  procedures of the kind give promise of cures to come, although it would be well to remember that, at present, only a fraction of patients respond to any particular IO (Immuno-oncology) treatment – and nobody as yet knows why.

Melanoma and blood cancers are the poster children of IO.  Solid tumors, and especially ovarian cancer, are within its sights.  But glioblastoma?  Not so much.

But there is hope.

A large part of the problem is the brain-blood barrier.  This is a dense layer of cells that has the responsibility to make sure that bad stuff circulating in the blood doesn’t affect the brain.  Another problem is that the immune system doesn’t seem to work the same in the brain as elsewhere; they are working on that conundrum   Anyway, to date all clinical trials testing the effectiveness of IO procedures in cases of glioblastoma have failed, but some have left interesting glimmers of hope.  The work goes on.

If you read the article referenced below – it is long, but interesting – you will need to know what is meant by dendritic cells (DC).  DC are created in the bone marrow, are shaped like very little trees, and serve as the gate-keepers of the immune system; they tell T cells, B cells, etc. what to hunt down and kill.  There are lots of DCs in skin, mucous, and similar places.  They are very important; I first heard about them only weeks ago!

For fun, Google “dendritic cells”, click on British Society if Immunology – and marvel at the barrage of obscure medical terms that leap at you off the page!

And, an impertinent  question:  how do they come up with such bazaar names for drugs?


Friday, May 25, 2018

BORN TO BE BAD


Happy times


I have written many times about the regrettable lack of a screening process that will detect ovarian cancer (and other cancers, of course) at an early stage.  Catch them early, it is said, and you have a good shot at curing them.  Well, in the last few years excellent progress has been made in the field of early detection.  I wrote about one such important development just a few weeks ago:


Well, even a fresh flat of strawberries comes complete with a few worms.  It turns out that early detection, by the nature of things, will turn up evidence of the existence of tumors that will never develop into anything worth worrying about.  Yes, in the colorful language of this article, some tumors are just “born to be bad”.  The rest aren’t.  Now, it seems, smart people are working on a way to tell the two apart.  As you might already have guessed, genetics is involved.  Read all about it:


By the way, this comes from a blog by Dr. Francis Collins, the Director of NIH.  He must be an incredible busy man, so I doubt that he actually, personally, writes these little essays – but maybe he does.  Whatever: they are well worth reading.

More proof that Dr. Collins is a remarkable man: he was appointed by Obama, and renewed by Trump

Tuesday, May 22, 2018

SEVEN YEARS AGO TODAY


Linda at work
Seven years ago today the world lost one darned good physical therapist.
And I lost the love of my life.

Seven years ago today Linda Joyce Beck, my brave, beautiful wife, was taken from us by ovarian cancer.  To mark that date I am going to post a passage written over 150 years ago by John Rawlins, a loyal friend and indispensable assistant to Ulysses. S. Grant for much of his life.  Rawlins lost his beloved wife at an early age.  Many years later he wrote of her:

Few of earth’s daughters were so fair; none in Heaven stand nearer the throne

I know just how he felt.


Friday, May 18, 2018

IMMUNOTHERAPY AND THE HUTCH


Linda in her favorite fuzzy sweater


I just now cancelled my subscription to the Bellingham Herald – and then along comes this very valuable piece on research in immunotherapy at Fred Hutch.  Maybe I made a mistake.  Naw, not likely.

Anyway, you really should read this.  It will do you good.


My thought is that if this had come along ten years ago I might still have Linda here, probably  to suggest that I get off my duff and do something in the yard.



Thursday, May 17, 2018

OVCA research helps pancreatic cancer victims


Linda encounters a cow

Did you miss me?  Sure you did. 

I haven’t posted a blog in over two weeks, owing to the happy fact that I have been scrounging a leisurely life from my daughter Linda and her husband Paul, at their splendid farm in western Wisconsin.  It was wonderful, sitting in the warm sun on their patio, watching birds, reading and just snoozing now and then – while Paul and Linda worked their butts off.  I guess being 85, which I turned while there, has its privileges.  Frankly, in a second  I would gladly trade whatever those privileges might be for another crack at 60!

But, anyway, I can now identify Holstein, Hereford, and Black Angus cows, and I know what CRP stands for.  How about you?

So, here is a little blip about PARP inhibitors and pancreatic cancer.


There is a drug, rucaparib, that has recently been approved for treating ovarian cancer in patients with BRCA1,2 mutations.  It is a PARP inhibitor – and you know what that means*  It turns out that BRCA mutations are somehow implicated in some types of  pancreatic cancer, and early trials indicate that rucaparib is helpful here as well.  Helpful – but not a cure. 

Pancreatic cancer is one of the worst afflictions God and/or nature has inflicted on us.  Past time we had some uplifting news.

*PARP is an enzyme that repairs double-stranded breaks in DNA.  As such, it is a good guy.  However, in the case of cancer – rapid growth leads to lots of breaks, but the cancer deploys its own PARP regiments to allow it continue to grow.  Hence PARPi, which inhibits the PARP molecule, thus preventing it from doing its job. 

How it does this is beyond our pay grade.