Thursday, December 11, 2014

Progress, legitimate progress

My how things have changed with respect to cancer research over the past 5 years. Cancer immunotherpaies are working. THEY ARE WORKING!  Sorry to yell, but when you are on a makeshift life raft and you see an aircraft carrier in the distance, it's a motivator to row a little faster. THE PROMISE OF GENOMICS IS BEING REALIZED. Again, pardon the enthusiasm, but we have been waiting for some real promise on this horizon for some time now, and it's happening. We have DNA in all of our cells (except red blood cells). Sometimes the DNA gets damaged, that damage can lead to cells that don't know how to die, or want to grow too fast, and in most cases, both. That's cancer in it's most minuscule nutshell right there. If we can understand fully what the underlying genetic causes of these behaviors are, we can try and target the proteins that are responsible. We've known this for a long time, and have a number of "targeted therapies" (or drugs that are designed to specifically target the problem proteins as opposed to chemotherapy, which just goes after all fast dividing cells, regardless of if they are cancer or hair follicle cells..), but for the vast majority of cancers, these targeted therapies don't lead to long-term remissions. There are a number of reasons for this. Cancers literally evolve. One mutation in DNA might lead to problems in a cells ability to correctly make more DNA. So the new cells that are "born" have even more DNA mutations. As soon as the safeguards that are built in place to faithfully copy each letter of our DNA are mutated enough, then it's a race to see which tumor cell can outgrow the rest.
Technology has reached a point where we can ask questions like, "what drives my cancer, why did I develop resistance to a targeted therapy, what combination of drugs might work best for me". And when I say it in the first person, I mean it...from the patient, for the patient. And this brings me to my favorite point with respect to progress in cancer research. THE PATIENT IS BEING LISTEN TO. I'm not even going to apologize for that one. It's the most amazing thing, and it's catching like wild fire..doctors and scientists want our opinions, they want our insights, they want to learn from us. We are moving into an era where medicine will be one giant group effort, clinicians, scientists and patients will all move this forward together. Such a stark difference from the day I was diagnosed, and so quickly. I have so much hope right now, hope that we are going to see even more significant breakthrough's in our lifetimes as long as we continue to come together.

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