charity begins online

It's possible I have a streak of hypochondria. When I suffered the Amazing Five-Day Headache from Hell last December, there was, I admit, a brief period where I genuinely feared I might have a brain tumor... until I went online and every single authoritative site informed me -- with just a hint of exasperation -- that chronic headaches are statistically very unlikely to be linked to the onset of brain cancer. I guess they get that particular Google search a lot. And of course, in my case, those sites were right -- a visit to my doctor confirmed as much (and prescription strength headache meds put an end to the pain). But let's face it: the reason so many of us fear such things is because cancer is so prevalent in our society. Every one of us knows someone who has been diagnosed, suffered through surgery and/or chemotherapy, and in some cases, has died, from some form of the disease.

It's even more distressing when the patient is a child. Which is why we're taking time out at the cocktail party from posts about communicating science and the cosmos, and promoting Talk Like a Physicist Day, in order to promote a very different sort of event: the annual St. Baldrick's head-shaving fund raiser to benefit childhood cancer research, held this year on March 14 at Fado's Irish Pub in Chicago, among several other venues. I donated last year in support of regular CPP reader Matt Dick (he rewarded me by emailing a photo of his shiny new bald head). It's a fun, rowdy time, apparently, and all for a good cause. Makes me wish I lived closer to Chicago, despite those brutally cold winters.

Matt is participating again this year as a "Shavee," and I figured, in addition to making another small donation, I could help by spreading the word in hopes that some of my readers might be moved to also contribute to the cause. It's personal for Matt: his little cousin, Nathan, lost his fight with cancer (neuroblastoma, the most common of childhood cancers) last July, at the ripe old age of 6. It's too late for Nathan, but there are lots of other children out there who could be saved by a timely breakthrough in ongoing research. So check out the site, and if you feel moved, support Matt or one of the other Shavees.

There's some genuinely fascinating science going on related to cancer research. For instance, last year I wrote about the work of David Nolte's group at Purdue University developing a new holographic technique for imaging cancer cells to determine the effects of anti-cancer drugs on living tissue. Essentially, they can now measure the motion of organelles inside cancer cells to determine if they're living or dead, before and after the administration of anti-cancer drugs. (Organelles play a key role in fostering the out-of-control cancer cell division that so often proves fatal, so they are a primary target of drug therapies.)

New, more effective treatments are desperately needed. Matt told me about one prospective treatment that ultimately failed: injecting children with a neuroblastoma with T-cells drawn from mice exposed to a certain type of rodent virus, in hopes that the T-cells would kick into hyperdrive and aggressively attack the neuroblastoma. Alas, this didn't happen. In Matt's words, "While the mouse T-cells would go find the cancer cells, they just hung out at the scene not doing anything -- the idle youth of the immune system, I suppose." (Matt clearly has a knack for creative analogy.) Now the researchers are trying a new twist: treating the mouse T-cells with radioactive elements, then injecting them into the neuroblastoma, in hopes of achieving small-dose, targeted radiation to the cancer site.

Targeted drug delivery continues to be a very hot topic, particularly for cancer research, because chemotherapy and other standard treatments quite frankly have nasty side effects. More targeted drug delivery can help reduce those side effects, because more of the drug finds its way to the cancer cells, rather than to surrounding healthy cells in the patient's body. Neurosurgeons can usually successfully remove as much as 99.5% of a brain tumor when they operate, but we're talking about brain tissue here, so they can't be as aggressive about removal as they might be in other, less sensitive areas of the body. There's always a few scattered cancer cells left over, which is where the targeted delivery of powerful anti-cancer drugs comes in.

There's been some recent exciting progress in this area with the development of "gliodel wafers" -- essentially, disc-shaped implants infused with cancer-fighting drugs that are placed at the site where a tumor used to be just before the neurosurgeon closes everything up after removing a brain tumor. This means the drugs can dissolve and diffuse slowly into the surrounding brain tissue to kill any lingering cancer cells. The trick is getting past the blood-brain barrier, which is designed to keep stuff out. That's one possible reason why pharmaceutical agents don't appear to penetrate brain tissue uniformly -- something that still puzzles researchers.

Brain cancers are  especially challenging, as I discovered a couple of months ago when I chatted with George Lewis Jr., a researcher at Cornell BME who is working on finding ways to make targeted cancer drug deliver more effective. Some of the newer drugs are pretty darned powerful, and can easily stomp out those straggling cancer cells -- provided the drug can reach them. Cancer cells are tricky: they migrate to other areas of the brain rather quickly after surgery. Sure, it's only a few millimeters to a centimeter, but it's just enough to elude the drugs, with nasty results. "In two weeks you have tumors reappearing, and in two months, the patient is dead," Lewis told me bluntly. And that's why brain cancers like neuroblastomas and neurofibromatosis are still the leading cause of cancer-related death in people under the age of 35: the few remaining cancer cells soon migrate beyond the range of the slowly diffusing drugs.

At last fall's meeting of the Acoustical Society of America, Lewis presented a paper on the use of acoustic pulses to help brain tissue absorb chemotherapy drugs faster -- hopefully before the cancer cells have a chance to migrate very far -- and also increase the range of diffusion. He and his collaborators (groups at Yale and Princeton) are using focused ultrasound  to agitate the tissue matrices, enhancing permeability and making it easier for the drug to get into the brain tissue. Basically, they're massaging the brain tissue to open up the pores, since the brain is kind of similar to a sponge. (I held a "training brain" once while visiting a lab doing Alzheimer's research. It is indeed a spongy organ.)

Initial results from experiments with a horse brain indicate that with such a technique, the drugs do indeed spread further and faster into the tissue than they would by natural diffusion alone -- a hundredfold further, in fact, which makes it very promising for future treatment of brain cancers. They're now carrying out a full study using live animals to see if they still get enhanced diffusion effects, and also to make sure a living creature can withstand the treatment.

Ironically, Lewis got the idea from an Indian study on using sono-poration for transdermal drug delivery, an older technique in which the drug is applied to the skin, and then ultrasound  is applied which breaks down the skin surface so the drug can better permeate through. The Indian leather industry uses a similar technique to help dyes diffuse into the leather, resulting in a more uniform color. One of the things they discovered is that when surgeons remove the tumor and insert a drug disc into the cavity, there's a form of interface resistance that takes place, similar to surface tension on water. "It's because there's more tightly cohesive bonding between the cells at surfaces; they lock into each other," Lewis explained. "The sono-poration effect of ultrasound breaks down the interface and allows more rapid diffusion of drugs."

They're still not entirely sure what mechanism is actually at work in the technique. Some of Lewis's collaborators suspect that acoustic cavitation from microbubbles work to bloat the pores and open them up sufficiently so the drugs can diffuse through the tissue more effectively. Lewis thinks it might be primarily a mechanical effect related to the acoustic waves: "They go through the tissue as a compression wave, which oscillates the tissue and massages it to allow the drug more readily to diffuse through it." He likens it to how dentists will often massage a patient's gum when injecting Novacaine into the nerve because it helps push the drug around a bit to reach the nerve more quickly. "We're trying to rub the brain" using ultrasonic waves.

We want folks like Lewis and Nolte and the thousands of other researchers looking for new, improved ways to fight cancer to be able to continue with their work. One place to start is writing to Congress and complaining vociferously about the draconian cuts to science funding. Another is by participating in charity fund raisers like the ones offered by St. Baldrick's. Because someday, that cancer patient in dire need of cutting-edge treatment could very well be one of us.

Comments

[Matt]

My very great thanks, Jennifer. For the donation and for the plug.

One correction, and I'm sure the error is totally mine, "medulloblastoma" is most common malignant brain tumor in children; what my cousin had is "neuroblastoma" and is a rarer cancer, is of the nervous system, and is not always brain-affecting.

But the event is amazing, and everyone should check out a local event an at least go and have a good time watching grown-ups having a good time for the benefit of sick children.

Thanks again,
Matt

[Clinton]

Great post, Jennifer.
There's so much happening in drug development and delivery it's almost impossible to cover it too much.
Your last sentence really hits home. For what it's worth, I wrote on my personal blog about my introduction to kids and neuroblastomas (http://shelookslikeme.wordpress.com/2007/02/10/projections/). Cancers are so mysterious, so elusive, but their effects, the collateral damage, is very real. Here's to the folks at St. Baldrick's.

[marvin]

It's devil's bargain. The costs of the new therapies, especially the genomics and biologicals like antiangiogenic agents(google Judah Volkman) are astronomical. For common breast cancers , especially in Jewish women, the test to see which treatments might work costs $3000.And the imaging which Jennifer pictures is very expensive.
The only way we can possibly pay for this is with universal health insurance. Most people are not sick so if they all pay a relatively small amount, there can be a fund which is big enough to stand expenses. The principle is the underlying one of insurance- we dont know if your house is going to burn down, but we know how many will burn in a given year.We dont know if you will get a heart attack, but we do know how many there will be in a given year.
Obviously we need a Democratic president, but both Clinton and Obama's plans keep for-profit insurance companies, which have to show increasing profits to stockholders every year.So they try not to pay doctor fees or patient benefits.

[Lab Lemming]

"Now the researchers are trying a new twist: treating the mouse T-cells with radioactive elements, then injecting them into the neuroblastoma, in hopes of achieving small-dose, targeted radiation to the cancer site."

Hopefully the mouse cells have a higher radiation tolerance than the cancer does...

[h2O]

Jennifer,

You would like to be closer to Chicago to participate in the fund raising event. You do not have to - by spreading the word in hopes that some of your readers might be moved to also contribute to the cause and your actions, you make a difference. This movement that you are part of ressembles what is described in a terrific book written for ordinary people who want to make connections that create extraordinary outcomes. You would no doubt enjoy this book written by Frances Westley, Brenda Zimmerman and Michael Quinn Patton (2007)- entitled: Getting to maybe.
Perfect reading for you...

[a quantum diaries survivor]

Hello Jennifer,

I took the liberty to tag you for one of those internet memes... See my blog's latest post (can't write html here!)

Cheers,
T.

[T.J. Howard]

Thanks for any help that you can provide in cancer awareness and funding. I had tranlocation gene leukemia and had chemo therapy for three years. My family was helped by the McDonald house, by providing a place to live while I was being treated away from home. Even when in my case therapy was successful in putting cancer in remission, it is still very hard on the family. Putting ones family and life on hold for three is much more than most can handle. Just think about it. Enjoyed your articles, at least the ones I can understand. Keep up the great work.
Time is motionless
People pass through it

[Tom Stern]

This is a great story, which I unfortunately share when it comes to brain cancer. Almost 15 years ago both my parents were diagnosed within 2 month of each other and died 10 days apart from this dreaded disease.

While you discuss cures and research, which is one end of the spectrum, the other end is learning how to avoid it. You might ask how? We suspect it has to do with Electro magnetic field (EMF) that is given off by electricity and electronics all around us. As it turns out there was an electric line passing close to our house right where my parents slept, right by their heads. As I looked into this all the expert suspect EMF and the conflicting financial institutions says there is no proof. Since, at this time, we need electricity and there is no other viable solution we try and hid our heads in the sand (pun intended).

Let me share a parallel story we all understand now. About 40 years ago when my father would give my older cousin the car we might go away for a weekend with some of his friends -- they all smoked, I did not. We are driving and I asked everyone to put out the cigarettes because it was unhealthy. Their response was no it is not, we debated it and they finally said there is no proof. I suffered in a smoke filled car while the whole industry protected their pocketbooks. I didn’t need all the fancy studies to know that my eyes were burning and had trouble keeping them open. I knew this is no good for me.

Let’s get back to the science of EMF. If you take a nail, wrap a wire around it, and run electricity through it it becomes magnetized. Polarizing the nail forcing positive in one direction and negative in the other causes magnetism. The brain cells need to function, which it can’t when it is stretched. What would happen if you were tied up, stretched out, and had a 3 year-old playing with an open box cutter right near you? You wouldn’t be able to protect yourself or the child. The body and cells are constantly being invaded but the cell system as well as the immune system keeps knocking it out. In the case of the cells and the immune system being stretched they can’t protect themselves.

Why is this all relevant? The various companies that their products or services produce EMF would either need to protect us or admit they are responsible will not do so because the money causes them to rationalize money above human life. We are all human and we all understand it, however we can’t and shouldn’t condone it. If they at least admitted the problem people would take steps to protect themselves. Incidentally, if the industry cared more about their customers they would realize they could protect us and still make a profit but that means making another investment.

The industry responds there is no proof “explain it to us scientifically” guess what they have a point but no one could explain gravity either but we don’t walk out of buildings unless we are planning on using gravity to help us accomplish our means.

The big problem is the legal system supports that type of thinking and to the credit of the medical industry and scientists they use statistics as a tool. So we have a conflict of interest and it is time to move cautiously and quickly to protect society.

[Matt]

A big thanks to Jennifer and CPP readers. My team is really close to our goal of $30,000! I can't thank everyone enough. If you want to contribute, you can hit the linkin Jennifer's post or go here:

https://www.stbaldricks.org/participants/shavee_info.html?ParticipantKey=2008-20743

Thanks again!

Matt

[Jennifer Ouellette]

For Tom: There is very little science to support your contentions about adverse health effects of EMFs. See the latter part of a post I wrote a year ago on the subject:
"Ghost in the Machine" http://twistedphysics.typepad.com/cocktail_party_physics/2007/01/ghost_in_the_ma.html

More generally, I would advise potential commenters not to attempt to peddle pseudoscience here.... the readership is pretty darned science-savvy, and more than capable of eviscerating poor arguments hampered by lack of data (personal anecdotes don't count as actual data). I'm just sayin'....

Congrats to Matt and his team for nearly reaching their goal! We expect pics of your newly shaved head!!

[H20]

Congratulations Matt - Great cause! Great action!

[digital radon detector]

my sister is down with brain tumor and the treatment cost is astronomical. she is at stage 3 now. the entire family has practically mortaged everyting of valuable for the treatment. Not too sure as to where else i can seek for help.