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 28th,, 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.
 

 


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