Tag Archives: cancer

Idea Soup

Measuring a Life

stephen-sutton

“I don’t see the point in measuring life in time any more… I would rather measure it in terms of what I actually achieve. I’d rather measure it in terms of making a difference, which I think is a much more valid and pragmatic measure.”

These are the inspiring and insightful words of 19 year-old, Stephen Sutton, from Birmingham in Britain, about a week before he died from bowel cancer. His upbeat attitude and selflessness during his last days captured the hearts and minds of the nation, and he raised around $5½ million for cancer charities in the process.

From the Guardian:

Few scenarios can seem as cruel or as bleak as a 19-year-old boy dying of cancer. And yet, in the case of Stephen Sutton, who died peacefully in his sleep in the early hours of Wednesday morning, it became an inspiring, uplifting tale for millions of people.

Sutton was already something of a local hero in Birmingham, where he was being treated, but it was an extraordinary Facebook update in April that catapulted him into the national spotlight.

“It’s a final thumbs up from me,” he wrote, accompanied by a selfie of him lying in a sickbed, covered in drips, smiling cheerfully with his thumbs in the air. “I’ve done well to blag things as well as I have up till now, but unfortunately I think this is just one hurdle too far.”

It was an extraordinary moment: many would have forgiven him being full of rage and misery. And yet here was a simple, understated display of cheerful defiance.

Sutton had originally set a fundraising target of £10,000 for the Teenage Cancer Trust. But the emotional impact of that selfie was so profound that, in a matter of days, more than £3m was donated.

He made a temporary recovery that baffled doctors; he explained that he had “coughed up” a tumour. And so began an extraordinary dialogue with his well-wishers.

To his astonishment, nearly a million people liked his Facebook page and tens of thousands followed him on Twitter. It is fashionable to be downbeat about social media: to dismiss it as being riddled with the banal and the narcissistic, or for stripping human interaction of warmth as conversations shift away from the “real world” to the online sphere.

But it was difficult not to be moved by the online response to Stephen’s story: a national wave of emotion that is not normally forthcoming for those outside the world of celebrity.

His social-media updates were relentlessly upbeat, putting those of us who have tweeted moaning about a cold to shame. “Just another update to let everyone know I am still doing and feeling very well,” he reassured followers less than a week before his death. “My disease is very advanced and will get me eventually, but I will try my damn hardest to be here as long as possible.”

Sutton was diagnosed with bowel cancer in September 2010 when he was 15; tragically, he had been misdiagnosed and treated for constipation months earlier.

But his response was unabashed positivity from the very beginning, even describing his diagnosis as a “good thing” and a “kick up the backside”.

The day he began chemotherapy, he attended a party dressed as a granny – he was so thin and pale, he said, that he was “quite convincing”. He refused to take time off school, where he excelled.

When he was diagnosed as terminally ill two years later, he set up a Facebook page with a bucket list of things he wanted to achieve, including sky-diving, crowd-surfing in a rubber dinghy, and hugging an animal bigger than him (an elephant, it turned out).

But it was his fundraising for cancer research that became his passion, and his efforts will undoubtedly transform the lives of some of the 2,200 teenagers and young adults diagnosed with cancer each year.

The Teenage Cancer Trust on Wednesday said it was humbled and hugely grateful for his efforts, with donations still ticking up and reaching £3.34m by mid-afternoon .

His dream had been to become a doctor. With that ambition taken from him, he sought and found new ways to help people. “Spreading positivity” was another key aim. Four days ago, he organised a National Good Gestures Day, in Birmingham, giving out “free high-fives, hugs, handshakes and fist bumps”.

Indeed, it was not just money for cancer research that Sutton was after. He became an evangelist for a new approach to life.

“I don’t see the point in measuring life in time any more,” he told one crowd. “I would rather measure it in terms of what I actually achieve. I’d rather measure it in terms of making a difference, which I think is a much more valid and pragmatic measure.”

By such a measure, Sutton could scarcely have lived a longer, richer and more fulfilling life.

Read the entire story here.

Image: Stephen Sutton. Courtesy of Google Search.

BigBang

Vaccinia – Prototype Viral Cancer Killer

The illustrious Vaccinia virus may well have an Act Two in its future.

For Act One, over the last 150 years or so, it has been successfully used to vaccinate most of the world’s population against smallpox. This helped eradicate smallpox in the United States in the early 1970s.

Now, researchers are using it to target cancer.

First, take the Vaccinia virus — a relative of the smallpox virus. Second, re-engineer the virus to inhibit its growth in normal cells. Third, add a gene to the virus that stimulates the immune system. Fourth, set it to work on tumor cells and watch. While, such research has been going on for a couple of decades, this enhanced approach to attacking cancer cells with a viral immune system stimulant shows early promise.

[div class=attrib]From ars technica:[end-div]

For roughly 20 years, scientists have been working to engineer a virus that will attack cancer. The basic idea is sound, and every few years there have been some promising-looking results, with tumors shrinking dramatically in response to an infection. But the viruses never seem to go beyond small trials, and the companies making them always seem to focus on different things.

Over the weekend, Nature Medicine described some further promising results, this time with a somewhat different approach to ensuring that the virus leads to the death of cancer cells: if the virus doesn’t kill the cells directly, it revs up the immune system to attack them. It’s not clear this result will make it to a clinic, but it provides a good opportunity to review the general approach of treating cancer with viruses.

The basic idea is to leverage decades of work on some common viruses. This research has identified a variety of mutations keeping viruses from growing in normal cells. It means that if you inject the virus into a healthy individual, it won’t be able to infect any of their cells.

But cancer cells are different, as they carry a series of mutations of their own. In some cases, these mutations compensate for the problems in the virus. To give one example, the p53 protein normally induces aberrant cells to undergo an orderly death called apoptosis. It also helps shut down the growth of viruses in a cell, which is why some viruses encode a protein that inhibits p53. Cancer cells tend to damage or eliminate their copies of p53 so that it doesn’t cause them to undergo apoptosis.

So imagine a virus with its p53 inhibitor deleted. It can’t grow in normal cells since they have p53 around, but it can grow in cancer cells, which have eliminated their p53. The net result should be a cancer-killing virus. (A great idea, but this is one of the viruses that got dropped after preliminary trials.)

In the new trial, the virus in question takes a similar approach. The virus, vaccinia (a relative of smallpox used for vaccines), carries a gene that is essential for it to make copies of itself. Researchers have engineered a version without that gene, ensuring it can’t grow in normal cells (which have their equivalent of the gene shut down). Cancer cells need to reactivate the gene, meaning they present a hospitable environment for the mutant virus.

But the researchers added another trick by inserting a gene for a molecule that helps recruit immune cells (the awkwardly named granulocyte-macrophage colony-stimulating factor, or GM-CSF). The immune system plays an important role in controlling cancer, but it doesn’t always generate a full-scale response to cancer. By adding GM-CSF, the virus should help bring immune cells to the site of the cancer and activate them, creating a more aggressive immune response to any cells that survive viral infection.

The study here was simply checking the tolerance for two different doses of the virus. In general, the virus was tolerated well. Most subjects reported a short bout of flu-like symptoms, but only one subject out of 30 had a more severe response.

However, the tumors did respond. Based on placebo-controlled trials, the average survival time of patients like the ones in the trial would have been expected to be about two to four months. Instead, the low-dose group had a survival time of nearly seven months; for the higher dose group, that number went up to over a year. Two of those treated were still alive after more than two years. Imaging of tumors showed lots of dead cells, and tests of the immune system indicate the virus had generated a robust response.

[div class=attrib]Read the entire article after the leap.[end-div]

[div class=attrib]Image: An electron micrograph of a Vaccinia virus. Courtesy of Wikipedia.[end-div]

BigBang

Scandinavian Killer on Ice

The title could be mistaken for a dark and violent crime novel from the likes of (Stieg) Larrson, Nesbø, Sjöwall-Wahlöö, or Henning Mankell. But, this story is somewhat more mundane, though much more consequential. It’s a story about a Swedish cancer killer.

[div class=attrib]From the Telegraph:[end-div]

On the snow-clotted plains of central Sweden where Wotan and Thor, the clamorous gods of magic and death, once held sway, a young, self-deprecating gene therapist has invented a virus that eliminates the type of cancer that killed Steve Jobs.

‘Not “eliminates”! Not “invented”, no!’ interrupts Professor Magnus Essand, panicked, when I Skype him to ask about this explosive achievement.

‘Our results are only in the lab so far, not in humans, and many treatments that work in the lab can turn out to be not so effective in humans. However, adenovirus serotype 5 is a common virus in which we have achieved transcriptional targeting by replacing an endogenous viral promoter sequence by…’

It sounds too kindly of the gods to be true: a virus that eats cancer.

‘I sometimes use the phrase “an assassin who kills all the bad guys”,’ Prof Essand agrees contentedly.

Cheap to produce, the virus is exquisitely precise, with only mild, flu-like side-effects in humans. Photographs in research reports show tumours in test mice melting away.

‘It is amazing,’ Prof Essand gleams in wonder. ‘It’s better than anything else. Tumour cell lines that are resistant to every other drug, it kills them in these animals.’

Yet as things stand, Ad5[CgA-E1A-miR122]PTD – to give it the full gush of its most up-to-date scientific name – is never going to be tested to see if it might also save humans. Since 2010 it has been kept in a bedsit-sized mini freezer in a busy lobby outside Prof Essand’s office, gathering frost. (‘Would you like to see?’ He raises his laptop computer and turns, so its camera picks out a table-top Electrolux next to the lab’s main corridor.)

Two hundred metres away is the Uppsala University Hospital, a European Centre of Excellence in Neuroendocrine Tumours. Patients fly in from all over the world to be seen here, especially from America, where treatment for certain types of cancer lags five years behind Europe. Yet even when these sufferers have nothing else to hope for, have only months left to live, wave platinum credit cards and are prepared to sign papers agreeing to try anything, to hell with the side-effects, the oncologists are not permitted – would find themselves behind bars if they tried – to race down the corridors and snatch the solution out of Prof Essand’s freezer.

I found out about Prof Magnus Essand by stalking him. Two and a half years ago the friend who edits all my work – the biographer and genius transformer of rotten sentences and misdirected ideas, Dido Davies – was diagnosed with neuroendocrine tumours, the exact type of cancer that Steve Jobs had. Every three weeks she would emerge from the hospital after eight hours of chemotherapy infusion, as pale as ice but nevertheless chortling and optimistic, whereas I (having spent the day battling Dido’s brutal edits to my work, among drip tubes) would stumble back home, crack open whisky and cigarettes, and slump by the computer. Although chemotherapy shrank the tumour, it did not cure it. There had to be something better.

It was on one of those evenings that I came across a blog about a quack in Mexico who had an idea about using sub-molecular particles – nanotechnology. Quacks provide a very useful service to medical tyros such as myself, because they read all the best journals the day they appear and by the end of the week have turned the results into potions and tinctures. It’s like Tommy Lee Jones in Men in Black reading the National Enquirer to find out what aliens are up to, because that’s the only paper trashy enough to print the truth. Keep an eye on what the quacks are saying, and you have an idea of what might be promising at the Wild West frontier of medicine. This particular quack was in prison awaiting trial for the manslaughter (by quackery) of one of his patients, but his nanotechnology website led, via a chain of links, to a YouTube lecture about an astounding new therapy for neuroendocrine cancer based on pig microbes, which is currently being put through a variety of clinical trials in America.

I stopped the video and took a snapshot of the poster behind the lecturer’s podium listing useful research company addresses; on the website of one of these organisations was a reference to a scholarly article that, when I checked through the footnotes, led, via a doctoral thesis, to a Skype address – which I dialled.

‘Hey! Hey!’ Prof Magnus Essand answered.

To geneticists, the science makes perfect sense. It is a fact of human biology that healthy cells are programmed to die when they become infected by a virus, because this prevents the virus spreading to other parts of the body. But a cancerous cell is immortal; through its mutations it has somehow managed to turn off the bits of its genetic programme that enforce cell suicide. This means that, if a suitable virus infects a cancer cell, it could continue to replicate inside it uncontrollably, and causes the cell to ‘lyse’ – or, in non-technical language, tear apart. The progeny viruses then spread to cancer cells nearby and repeat the process. A virus becomes, in effect, a cancer of cancer. In Prof Essand’s laboratory studies his virus surges through the bloodstreams of test animals, rupturing cancerous cells with Viking rapacity.

[div class=attrib]Read the entire article following the jump.[end-div]

[div class=attrib]The Snowman by Jo Nesbø. Image courtesy of Barnes and Noble.[end-div]

Idea Soup

Hitchens on the Desire to Have Died

Christopher Hitchens, incisive, erudite and eloquent as ever.

Author, polemicist par-excellence, journalist, atheist, Orwellian (as in, following in George Orwell’s steps), and literary critic, Christopher Hitchens shows us how the pen truly is mightier than the sword (though me might well argue to the contrary).

Now fighting oesophageal cancer, Hitchen’s written word continues to provide clarity and insight. We excerpt below part of his recent, very personal essay for Vanity Fair, on the miracle (scientific, that is) and madness of modern medicine.

[div class=attrib]From Vanity Fair:[end-div]

Death has this much to be said for it:
You don’t have to get out of bed for it.
Wherever you happen to be
They bring it to you—free.
—Kingsley Amis

Pointed threats, they bluff with scorn
Suicide remarks are torn
From the fool’s gold mouthpiece the hollow horn
Plays wasted words, proves to warn
That he not busy being born is busy dying.
—Bob Dylan, “It’s Alright, Ma (I’m Only Bleeding)”

When it came to it, and old Kingsley suffered from a demoralizing and disorienting fall, he did take to his bed and eventually turned his face to the wall. It wasn’t all reclining and waiting for hospital room service after that—“Kill me, you fucking fool!” he once alarmingly exclaimed to his son Philip—but essentially he waited passively for the end. It duly came, without much fuss and with no charge.

Mr. Robert Zimmerman of Hibbing, Minnesota, has had at least one very close encounter with death, more than one update and revision of his relationship with the Almighty and the Four Last Things, and looks set to go on demonstrating that there are many different ways of proving that one is alive. After all, considering the alternatives …

Before I was diagnosed with esophageal cancer a year and a half ago, I rather jauntily told the readers of my memoirs that when faced with extinction I wanted to be fully conscious and awake, in order to “do” death in the active and not the passive sense. And I do, still, try to nurture that little flame of curiosity and defiance: willing to play out the string to the end and wishing to be spared nothing that properly belongs to a life span. However, one thing that grave illness does is to make you examine familiar principles and seemingly reliable sayings. And there’s one that I find I am not saying with quite the same conviction as I once used to: In particular, I have slightly stopped issuing the announcement that “Whatever doesn’t kill me makes me stronger.”

In fact, I now sometimes wonder why I ever thought it profound. It is usually attributed to Friedrich Nietzsche: Was mich nicht umbringt macht mich stärker. In German it reads and sounds more like poetry, which is why it seems probable to me that Nietzsche borrowed it from Goethe, who was writing a century earlier. But does the rhyme suggest a reason? Perhaps it does, or can, in matters of the emotions. I can remember thinking, of testing moments involving love and hate, that I had, so to speak, come out of them ahead, with some strength accrued from the experience that I couldn’t have acquired any other way. And then once or twice, walking away from a car wreck or a close encounter with mayhem while doing foreign reporting, I experienced a rather fatuous feeling of having been toughened by the encounter. But really, that’s to say no more than “There but for the grace of god go I,” which in turn is to say no more than “The grace of god has happily embraced me and skipped that unfortunate other man.”

Or take an example from an altogether different and more temperate philosopher, nearer to our own time. The late Professor Sidney Hook was a famous materialist and pragmatist, who wrote sophisticated treatises that synthesized the work of John Dewey and Karl Marx. He too was an unrelenting atheist. Toward the end of his long life he became seriously ill and began to reflect on the paradox that—based as he was in the medical mecca of Stanford, California—he was able to avail himself of a historically unprecedented level of care, while at the same time being exposed to a degree of suffering that previous generations might not have been able to afford. Reasoning on this after one especially horrible experience from which he had eventually recovered, he decided that he would after all rather have died:

I lay at the point of death. A congestive heart failure was treated for diagnostic purposes by an angiogram that triggered a stroke. Violent and painful hiccups, uninterrupted for several days and nights, prevented the ingestion of food. My left side and one of my vocal cords became paralyzed. Some form of pleurisy set in, and I felt I was drowning in a sea of slime In one of my lucid intervals during those days of agony, I asked my physician to discontinue all life-supporting services or show me how to do it.

The physician denied this plea, rather loftily assuring Hook that “someday I would appreciate the unwisdom of my request.” But the stoic philosopher, from the vantage point of continued life, still insisted that he wished he had been permitted to expire. He gave three reasons. Another agonizing stroke could hit him, forcing him to suffer it all over again. His family was being put through a hellish experience. Medical resources were being pointlessly expended. In the course of his essay, he used a potent phrase to describe the position of others who suffer like this, referring to them as lying on “mattress graves.”

If being restored to life doesn’t count as something that doesn’t kill you, then what does? And yet there seems no meaningful sense in which it made Sidney Hook “stronger.” Indeed, if anything, it seems to have concentrated his attention on the way in which each debilitation builds on its predecessor and becomes one cumulative misery with only one possible outcome. After all, if it were otherwise, then each attack, each stroke, each vile hiccup, each slime assault, would collectively build one up and strengthen resistance. And this is plainly absurd. So we are left with something quite unusual in the annals of unsentimental approaches to extinction: not the wish to die with dignity but the desire to have died.

[div class=attrib]Read the entire article here.[end-div]

[div class=attrib]Image: Christopher Hitchens, 2010. Courtesy of Wikipedia.[end-div]

BigBang

Evolved for Cancer?

[div class=attrib]From Scientific American:[end-div]

Natural selection lacks the power to erase cancer from our species and, some scientists argue, may even have provided tools that help tumors grow.

Natural selection is not natural perfection. Living creatures have evolved some remarkably complex adaptations, but we are still very vulnerable to disease. Among the most tragic of those ills–and perhaps most enigmatic–is cancer. A cancerous tumor is exquisitely well adapted for survival in its own grotesque way. Its cells continue to divide long after ordinary cells would stop. They destroy surrounding tissues to make room for themselves, and they trick the body into supplying them with energy to grow even larger. But the tumors that afflict us are not foreign parasites that have acquired sophisticated strategies for attacking our bodies. They are made of our own cells, turned against us. Nor is cancer some bizarre rarity: a woman in the U.S. has a 39 percent chance of being diagnosed with some type of cancer in her lifetime. A man has a 45 percent chance.

These facts make cancer a grim yet fascinating puzzle for evolutionary biologists. If natural selection is powerful enough to produce complex adaptations, from the eye to the immune system, why has it been unable to wipe out cancer? The answer, these investigators argue, lies in the evolutionary process itself. Natural selection has favored certain defenses against cancer but cannot eliminate it altogether. Ironically, natural selection may even inadvertently provide some of the tools that cancer cells can use to grow.

[div class=attrib]More from theSource here.[end-div]