FIGHT BACK against OVARIAN CANCER: 2013

Wednesday, December 18, 2013

BLOGGER RECESS

http://ljb-quiltcutie.blogspot.com/2013/12/blogger-recess.html

I will never figure this out. This blog Google's robot allowed me to post on Myrl'sBlog. I am a bit of seaweed tossed about in a roiling ocean of technology.

Monday, December 16, 2013

FORCE vs USPSTF: An important tussle.

Linda in Christmas Pageant, at 11.

With Halo

Joseph seems rather young for the part

This seems more than usually idiotic. You may remember our old friend, the U.S. Preventative Services Task Force (USPSTF). As I understand it, USPFTF is an all-volunteer, all expert panel recognized (but not supported) by the Feds. ObamaCare is taking cognizance of it, though, to the extent of ruling that procedures not rated A or B by USPSTF will not be covered. Can that be right? I’ll have to check*. Anyway, the USPFTF has ruled that cancer survivors be deemed not eligible for genetic testing. Here is why I think that is a mistake. Ovarian cancer and breast cancer are both influenced by mutations in the genes named BRCA1 and 2. So, let’s say you survive one of those cancers or the other. Neither cancer REQUIRES those mutations; they only increase a woman’s odds of contracting them So, it seems to me, if you have survived breast cancer (for instance) it is of considerable importance to determine whether you are carrying the BRCA mutations, because if you are your chances of getting ovarian cancer are unusually high.

To be fair, I should read the actual USPSTF decision, but right now I don’t feel like being fair. FORCE (I’ve written about that, too) – Facing Our Risk of Cancer Empowered – is up in arms. Read this link. Maybe you will want to sign the petition. I did.

https://bay172.mail.live.com/default.aspx?id=64855&owa=1&owasuffix=owa%2f#n=1960078976&fid=1&mid=66d7fec5-667e-11e3-b570-00215ad856c0&fv=1

*No, that isn’t exactly right. Obamacare only approves plans that offer coverage for procedures that USPFTF rate A or B. The problem is that this panel of experts is completely ignoring the needs of cancer survivors. FORCE is righteously enraged.

Friday, December 13, 2013

THE BECK FAMILY CHRISTMAS LETTER, 2013

To paraphrase Ramses II:

She for whom the Christmas tree shines its brightest.

Well, heck, it’s Christmas time again. This is the third Christmas without Linda, and I seem to be missing her more all the time. She loved the holidays, and her enthusiasm transmitted itself to all around her, making things special. It won’t be that much fun this year, but I know she would want me to give it a try, and I am. I spent Thanksgiving with Carolyn (and stayed on for her birthday), and in a few days I am going to Cordova for Christmas and New Year’s. There I will meet my two great grandbabies, Seamus and Evelyn, for the first time, and also enjoy the company of my three granddaughters, one daughter – and, of course, their various male support staff. It should be a blast. Still, Linda’s little ornaments will spend another year in their box. I urge you all to consider making an end-of-year contribution to cancer research. Go to

http://getinvolved.fhcrc.org/site/TR?pg=fund&fr_id=1050&pxfid=2861

and do it to honor Linda. Write something in the “guest book”, too.

I am planning to cover the back of this page with pictures, so let me use the rest of this side to tell you what I’ve been doing, and what the immediate future holds. I did get away from Bellingham some during 2013, but not to anywhere exotic. I did the usual rain-avoidance stint in Borrego Springs; and I also had a great week in Flagstaff with Kristen and Joe. I like that country (the Colorado Plateau and the Big Rez), and I hope to return frequently. I have spent a considerable amount of time and energy in Seattle, trying to help out with ovarian cancer research. As all of you probably already know, I am a volunteer with the Marsha Rivkin Center for Ovarian Cancer Research (where I am trying to help Dr. Rivkin himself with various writing projects), and also a “research advocate” with the ovarian program at Fred Hutchinson Cancer Research Center. Other than that I just hang out in Bellingham, trying to keep the house livable and the cats fed. So far I have succeeded – with the help of Molly for the first task, and Bunny and David for the second. When I am in Seattle I stay with Karen, and we explore the café and movie scene. And that’s about it. Not very exciting? Heck, I’m 80 – a weekly beer with the boys fills all my social needs, darned near.

As for the future, well, gnutz, I get to have another joint replaced. January 10^th is the date, and the weeks before that are filling up with things I need to do – joint replacement class, stop medications, start other ones, see the doctor, see the nurse, make out my will, etc., etc. When I got my first tin hip, maybe 20 years ago, I don’t recall all this fuss. I’m sure it all is helpful – and of course it also helps guarantee full employment in the medical professions. So, anyway, recovery time for an OF is of the order of six weeks, so I may not be able to spend much (or any) time in Borrego Springs this winter. I should be recovered enough for Karen and me to take our planned trip: visit Kristen and Joe in Flag, then tour Indian Country. I will wear my bola tie and Navajo silver belt buckle and fit right in. (Hosteen Beck, I will be.) After that – no clue. Continue to help out in Seattle. Keep adding to my blog*. Keep drinking beer with the boys. Keep the house passable until Linda and Paul buy it and I can move into a nice mobile home with no stairs. And make sure my fat cats are healthy. Pretty exciting, don’t you think?

· http://www.blogger.com/blogger.g?blogID=6665628846095491748#overview/src=dashboard

So anyway, HAPPY HOLIDAYS!

Blogger won't let me post the second page. Grinch!

Wednesday, December 11, 2013

IMMUNOTHERAPY and other stuff

A Michigan Fall

When I am home alone, which is most of the time, I have an evening routine. I ride my stationary bike for 30 minutes, thus pretending to stay in shape. Then I watch the BBC news, while imbibing a vodka and tonic. Next I fix dinner, then sit down to eat it. While eating I like to watch a TV program from On Demand, which – as most of you probably know – records certain popular shows for watching later. Until recently this has worked out well, because it takes me about 44 minutes to eat dinner and that happens to be the length of an hour-long TV show – divested of commercials. Lately, however, they have been fixing the shows I like to watch so that you HAVE to watch the ads – Fast Forward disabled. Thus the show lasts a full hour, and I rarely stick around for the conclusion. It follows that, since I usually watch cop dramas, I never find out who done it. A small thing, but irritating.

The worst of the ads I am forced to walk features a well-known black movie star, whose name escapes me at the moment, urging me to use the Capital One credit card. So why is this important? Because, when I tried to watch the video that accompanies the link I am about to describe to you, I first had to watch that same damned commercial! So, click on the link given below, but skip the video.

http://www.cnn.com/2013/12/07/health/cohen-cancer-study/?c&page=4

The article concerns a boy who entered a clinical trial studying an immunotherapy response to a type of leukemia that was killing him. The trial, conducted at the University of Pennsylvania, studies the effects of removing T cells from the patient’s body and somehow “re-programing” them to attack cancer cells. So far it seems to be successful. T-cells are a part of the immune arsenal, and I have written about this kind of therapy before. It holds excellent promise for the future. Let’s all hope the poor kid doesn’t relapse.

I was alerted to this article by faithful reader Parkfriend. Parkfriend lives in Canada, and has done so for many years. She is an American by birth and education, but has taken on a Canadian persona to the extent that she now wastes vowels in such words as honorable, and (no doubt) pronounces “strength” as if it rhymes with “tenth”. Strong medicine, that Canadian culture – don’t visit too often!

Sorry, Parkfriend – just kidding.

Monday, December 9, 2013

TO WALK IN BEAUTY

Our Mexico trip, 2010

This isn’t really about ovarian cancer at all, nor is it an attempt to be funny. I have been studying Navajo culture for a few months, ever since I returned from Kristen’s place in Flagstaff. “Studying” so far consists of re-reading all the Tony Hillerman Leaphorn-Chee novels. I have ordered a few more serious books; they lie there on the coffee table looking at me accusingly. When I finish Hillerman I promise to give them a try. But, I am lazy. It’s my right; I’m an old fart.

The purpose of this blog is to share something I have gradually come to realize. Hillerman relates how the Navajo Way consist of “walking in beauty”. I don’t pretend to understand that; all my life I have “walked” in a constant state of competitiveness and inner turmoil. But last night I realized that “walking in beauty” exactly describes Linda. I’m not going to try to elaborate: you who knew her well will understand. Even when she contracted ovarian cancer she continued on, in beauty. There wasn’t a Sing that could save her, nor any trick of modern medicine. But she continued. The world really is a darker place, now that she is gone.

Sunday, December 8, 2013

BACK AT WORK

Looks like an anniversary

In our little Cowgill house

The purpose of this blog is to re-kindle your interest. I have been away for over a week, and so nothing new has been posted. The result is that my “hits” dropped from about 150/week – to 6! And all of them from Moldova! (Not really.) So here are some articles I found in the NY Time, which you might want to read. Well, I doubt if you'll really WANT to read them, but you should, anyway.

The first concerns the availability of new drugs or treatments to end-stage patients, without FDA approval. Apparently there really is an avenue to do this (without going to Mexico), but it has its limits. One seems to be not knowing (or not caring) about possible “deleterious side effects.” I’ve always felt that if nothing approved will work and the patient is going to die, something unapproved could be administered without violating any ethical guidelines, No doubt it isn't that simple. Anyway, here it is:

http://www.nytimes.com/2013/12/04/business/rare-cancer-treatments-cleared-by-fda-but-not-subject-to-scrutiny.html?pagewanted=1&_r=0&ref=science

The second item of interest is a blog published in the Times, written by an extremely articulate woman who has advanced ovarian cancer. Heaven forfend that any of you should ever experience what she is going through, but it might be a useful exercise to promote understanding. Linda went through this, and I didn’t help her enough. Now I’m trying to make it up to her, when it’s too late. Anyway, here is the latest blog:

http://well.blogs.nytimes.com/2013/12/05/living-with-cancer-nude-mice/?ref=health

Sunday, November 24, 2013

THE FORCES OF DIGITAL CONFUSION HAVE DEFEATED ME: temporarily!

Galapagos, 1989

She liked to snorkel

Me? I hate cold water

I can’t get the blogging robot that governs “Myrl’sBlog” to relent an allow me to publish any more pictures. Perhaps, at 172 blogs and nearly 10,000 hits it feels that I’ve used up my welcome. However, the “Fight Back against Ovarian Cancer” blog robot still is willing to cooperate. So this pathetic entry is to inform you that, for the immediate future at any rate, I will be posting new stuff to the “Fight” address. For those of you who follow me directly, you can bookmark www.quiltcutie.blogspot.com and go directly to the site. For those of you who follow me on Facebook, nothing will change. And for those of you who don’t follow me at all: shame on you.

Also, I am going to be away for the next ten days or so, so re-read old blogs and give me some feedback. Thanks. Myrl

Thursday, November 21, 2013

Nuts, aspirin, coffee. All good for us. Why?

Certainly a birthday

Probably early 80s

I had more hair and less stomach than I do now.

She was as beautiful as ever

Amazing how quickly some news items get around! There is a new paper by Dr. Ying Bao (and six others) in the New England Journal of Medicine. It is about nuts: apparently they help you stay alive.

In the last 24 hours I have heard about this study on TV (once), radio (twice), and read about it in two newspapers. Contrast this with the cancer-sniffing-dogs story that broke in early September on “Sixty Minutes”, of all places, but has just now made it to the NY Times. Maybe the Times was saving it for a slow-news day? Anyway:

The nut result falls out of two massive studies, conducted on medical professionals, which lasted for a long time. After “controlling” for potential confounding factors, nut-eaters appeared to die less (at any given age, of course; we all die eventually) than do non nut-eaters. Die of things like cancer and heart disease, that is – people who only eat nuts while driving at high speeds on the freeway probably gain no overall benefit. The question of “why” doesn’t seem to have a definite answer as yet; there was some mention of reducing cholesterol (heart) and inflammation (cancer), but a detailed explanation was lacking. The result apparently is robust statistically; although maybe we should get Dr. Ioannidis involved. Moreover, it was reassuringly dose-dependent: the more nuts you ate, the less likely you were to die. So, pass the nut bowl.

As you can imagine, there are many “confounding factors”. That is, maybe the cause and effect chain only carries nuts along for the ride. To make up a stupid example: When I drink beer with my buddies I often eat nuts. I don’t doubt that there are many more beer-drinkers like me. So, maybe it is the beer that reduces mortality. Or, to make it even more absurd, note that many people who drink beer drink too much, get a headache, then take aspirin. It has been shown that aspirin is effective against some cancers, and also thins the blood, hence helps with stroke. So maybe it’s the aspirin that goes along with the beer and accompanies the nuts that deserves the credit. These are the sort of things that need to be "controlled" for. Again, calling Dr. Ioannidis.

One disturbing aspect of this study is that it was partially funded by the United Nut Pickers of the World, or some such body. It is stated that they had no hand in the design of the experiment nor interpretation of the results. I’m sure that’s true – isn’t it?

Here are the links:

The paper itself: http://www.nejm.org/doi/full/10.1056/NEJMoa1307352

My references to Dr. Ioannidis: http://ljb-quiltcutie.blogspot.com/2013/11/beware-greeks-bearing-manuscripts.html

Saturday, September 28, 2013

OF CANCER, STEM CELLS, AND SHMOOS

Saturday, August 31, 2013

of CANCER STEM CELLS, MICE, AND SHMOOS

Linda and lobster pots

Newfoundland, , 2001

Are you old enough to remember the cartoon strip Li’l Abner? It was drawn by Al Capp and was one of the funniest things around; often it was the only compelling reason to open the Sunday Riverside Enterprise of my youth. Anyway, for a time it featured the most benign creature ever conceived – the Shmoo. The Shmoo was a small, round, smiling creature that existed only to ascertain the wishes of humans (seemingly by mental telepathy), then happily turning into whatever was wanted. If you were hungry, for instance, the Shmoo would suddenly become a hamburger. Presumably if you were vegan it would become a vegi-burger, with a certified organic, gluten-free, whole wheat bun.

Well, there aren’t any Shmoos in this world, but there ARE laboratory mice. The laboratory mouse has given its life to benefit humans for many decades. More have just died to give us important information about cancer stem cells. They may not have died gladly, but no doubt they went straight to mouse heaven with no pause to clear purgatory.

So, anyway, the British journal Nature has published an important paper about the role of stem-like cells in epithelial ovarian cancer. The principal author appears to be A. Nikitin to whom the Marsha Rivkin Center gave a nice grant in 2011. The gist of the matter is that his research team seems to have shown that there are stem-like cells lurking in “niches” in the epithelium of ovaries. They have a positive role; they repair small tears caused by ovulation. However, this research also points out that they are particularly susceptible to cancer-causing mutations. (This may account for the fact, that the more you ovulate, they greater your chance of contracting ovarian cancer.) They investigated this hypothesis by first detecting and then isolating mouse epithelial cells with stem-like properties, then injecting them into eight lady mice that previously had several tumor-suppressor genes “knocked out”. (How this is done is just as much a mystery to me as it is to you, of course.) Anyway, seven of these unlucky mice developed ovarian cancer.

I can’t actually discern any immediate applicability of this discovery to human OVCA, but the more we know about the enemy, the sooner we can defeat him. I got that quotation from The Art of War. Not really, but I’m sure it’s in there somewhere.

I previously blogged about cancer stem cells on 8/22/12 and again on 8/26/12

Do you want to read more about ovarian cancer stem cells?

http://www.medicalnewstoday.com/articles/257367.php

Do you want to know more about Dr. Nikitin?

http://www.vet.cornell.edu/BioSci/faculty/Nikitin/

Do you want to learn more about Shmoos?

http://deniskitchen.com/Merchant2/merchant.mv?Screen=CTGY&Category_Code=bios.shmoo

Tuesday, August 6, 2013

MRC GRANTS FOR OVARIAN CANCER RESEARCH

Thursday, February 7, 2013

MRC RESEARCH GRANTS

Why I married here: she could do anything. 1967
Most likely a car load of college boys came by 12 seconds later.
I know I would have stopped

Encouraged by the Comment of my granddaughter Amanda, from time to time I am going to “profile” one or another of the cancer researchers we at the Marsha Rivkin Center help support. We (MRC) offer support in three categories, but it is clear that each emphasizes innovation. We try to identify people who may have spied an incipient crack in the armour (of ovarian cancer), and then help them pry it open. Once they are inside, we leave it to the far deeper pockets of the NIH to fight the war. To me – I had no part in the design of any of our programs – this seems to be a remarkably promising approach. I wish I were 30 again and a biochemist; I’d rather be one of those smart young people than simply an old guy writing about them. But, you do what you can with what you’ve got.

Rather than jumping right in, I will describe the kinds of grants we award. In ascending order of dollars available, and – probably – difficulty in getting funded: we award Scientific Scholar Awards, Pilot Study Grants, and Challenge Grants.

Scientific Scholar Awards: These go to young, bright, early-career scientists. The purpose is to enable them to try out new ideas (which the young have in profusion, I am told – I can't remember.) Needless to say, the ideas chosen have relevance to ovarian cancer. A grant amounts to $60,000 for one year, which isn’t much these days but may make the difference between trying out an idea and shrugging it off. This year (2012, actually) we gave out three of these, to young women in England, Canada, and the United States.

Pilot Studies: These are worth $75,000 for one year. In 2012 we awarded ten of them. I gather that the successful applicants tend to be better established in their field, but need help and encouragement in developing some novel approach to ovarian cancer. One of these awards went to a scientist in Helsinki.

Challenge Grants: I don’t precisely understand the nature of this award, so I will simply quote what is said in the MRC Website: “Challenge grants in scientific research revolve around posing a grand scientific question to the research community and asking researchers to submit their best ideas for meeting the challenge with creative solutions. With help from our Scientific Advisory Board, the Rivkin Center will identify areas in ovarian cancer research in which the greatest strides can be made today and offer a 2-year, $150,000 Challenge Grant to the research group that proposes the best solution.”

The 2011-2013 MRC Challenge Grant was awarded to Dr. David Bowtell, who works in Melbourne, Australia. Dr. Bowtell is testing the hypothesis that ovarian tumors, especially of the most lethal type – serous – leak pieces of DNA into the blood-stream in quantities sufficient to serve as an early marker of the disease. Specifically, he is looking at a mutated version of the gene TP53, which apparently is associated with numerous kinds of cancer. Incidentally, it appears that serous “ovarian” cancer originates in the fallopian tubes.

Regarding Dr. Bowtell’s very important work: as an Aussie friend of mine was fond of saying, “Goodonyah”!

Wednesday, July 3, 2013

DISCOURAGED (but temporarily)

Linda and her Mom, on the latter's wedding day

Both gone now, alas.

The world is a sadder place

One must not become discouraged. The fight must go on until victory is achieved. Be of good cheer. Or, as Linda would have said “Buck up, Buck!”

No, I’m not talking about General Eisenhower during the Battle of the Bulge. I am talking to myself, after reading a depressing news article.

If you read these blogs instead of just looking at the pictures you will be aware that one of the hot topics in cancer research is “targeted therapy”. Targeted therapy consists of using genomics to determine which mutation (or mutations) is driving the uncontrolled cell division that is at the heart of cancer, then developing a specific treatment to cancel its evil activities. Expensive for sure, but effective. Well, maybe not.

Dick Ingwall alerts me to an article in the NYTimes: Studying Tumors Differently, in Hopes of Outsmarting Them. (http://nyti.ms/1cnNE8n). The opening paragraphs are what brought on my depression. They relate the story of an unfortunate man who was covered with melanoma blotches, with only weeks to live. His oncologist treated him with a new targeted therapy drug, vemurafenib. Like magic his melanoma blotches disappeared, all of them. Unfortunately, 16 weeks later they all returned, every single one. He died a few weeks later.

The problem, clearly, is that vemurafenib didn’t get all the mutated cells. There are literally billions of cells in a solid tumor, so if you kill 99.999% of them you still leave of the order of a million cells to mount a counter-attack. Why didn’t you get them all? That’s because, as I keep reading everywhere, tumors are “heterogeneous”. Because they are tumors they divide rapidly. The chance for a spontaneous mutation occurring is greatest at cell division, when the DNA is duplicated. Errors occur, and although most are repaired right away and many that aren’t fixed are harmless – still, some bad ones may get through. Thus a tumor caused by a single mutation may spawn other deleterious mutations as it grows. This puts us in a pickle.

The way out of the pickle, this article implies, is to give two (or more?) targeted drugs simultaneously. This means even more genomics, and more messing around in the laboratory to create the drugs. And, of course, more money.

We were meant to be born, grow up, reproduce – and then, shortly - die. If we all died at 40 cancer wouldn’t be much of a problem. But the problem is that we don’t WANT to die at 40. I sure as hell didn’t. So we keep on wrestling with cancer. Maybe targeted therapy will someday be feasible, reliable, and cheap. Maybe immunotherapy will experience a break-through. Maybe epigenetics is the way to go. Damned if I know. But I still think that early detection is the most immediately promising avenue of research. That’s what my group does.

By the way, another gentle reminder. Summerun North 2013 is only 25 days away – and only 13 people have signed up, and seven of them can’t be here! Don’t make me drink all that beer by myself! To sign up, go to http://community.swedish.org/page.aspx?pid=608&tab=0&frtid=1183. Recommended donation is $20, but feel free to give anything you want. Of course, you always can give me money, checks or stolen property on the 28^th,, but if you want your name on the web site you must use the link. Big deal, of course.

Even more imminent is the deadline for signing up to purchase a Linda’s Team T-shirt – only five more days.. If you want one of these elegant shirts, go immediately to http://www.customink.com/signup/3a9v6j52.

As ever, I hope to see you on the 28th.

Sunday, June 30, 2013

CROWDSOURCING

CROWDSOURCING: A new tool.

In an English tavern.

No, that's not Guiness. It's her coke.

Perhaps inspired by various TV reality shows, the NCI has instituted a program wherein a cancer-related “problem” is defined and “teams” from around the globe invited to work on it. Then, after the lapse of some time, NCI (or somebody) decides who came up with the best solution and rewards them – hold your breath – with a trip to San Francisco and a chance to publish a peer-reviewed paper in a prestigious medical journal. It may seem like I'm scoffing, but I'm not: I think it is a very good idea.

The projects I just read about are part of a larger program called DREAM: Dialog for Reverse Engineering, Assessments and Methods. DREAM engages in “crowdsourcing”, which means taking advantage of expertise and knowledge across the research community to attack specific problems. NCI-DREAM is a subset focused on several aspects of breast cancer. Apparently 52 teams elected to participate. They were given a standard genome, then invited to: (1) using the genomic data and, I guess, anything else they could drum up, predict the response of 18 breast cancer “lines” to 31 previously untested drugs, and (2) predict the activity of pairs of compounds on diffuse large B-cell lymphoma (again using a standard cell line.) The value of this sort of research to individualized cancer treatment is pretty obvious.

A team from Helsinki won sub-challenge (1); a team from Texas . #2.

There also is another challenge afoot, one to predict breast cancer survival rates. It uses something called “computational biology”. Around every corner in a cancer research institution one bumps into a statistician, a computer programmer, or this thing called a computational biologist. And to think I used to look down on biologists as hopelessly non-quantitative! Like, geology uses higher math?

P.S. I am back from Borrego Springs until after Christmas.
P.P.S. I have used 88 pictures so far, and I am beginning to forget which. If you catch me doubling up, please let me know - I have many I want to use. For those who don't know: myrlbeck@msn.com.

FIGHT BACK against OVARIAN CANCER