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Everyone is special in their own way

I have mentioned multiple times in the past how medicine will have to abandon its linear thinking in order to take full advantage of upcoming technologies. New solutions to very difficult problems will require that researchers and physicians think “out-of-the-box”. Approached from a totally new angle, treatments that were never previously considered may soon become standard therapy.

In the field of oncology, there has always been a strong push to explore alternate approaches beyond chemotherapy and radiotherapy. Over time, these effective treatments have become honed to deliver their maximal effect. In some cases, these treatments are nothing less than miraculous. But these treatments continue to have serious side effects, and it is hoped by all that they will one day be replaced by alternative treatments that are totally effective and free of side effects.

Even 40 years ago, oncologists were attempting to treat certain cancers by identifying specialized proteins [called markers] on the surface of the cancer cells. The idea was to create an antibody that would attack these surface markers and thus destroy the cancer cells. This is a therapy that is still in use and continued trials today, and at times it is effective.

The overreaching term, for these kinds of focused therapies based on the targeting of cancer cells [and nothing else], was “a magic bullet”. Even today, researchers use this term  but will be speaking about totally different technologies like nano bots that will soon be able to target cancer cells with a focused destructive force. This all sounds very much like science fiction, and that is part of the magic – that all of these dreamed of therapies are coming to light.

My own brother was a test case for anti-cancer cell antibodies. His treatment, well over 30 years ago, failed. But I knew back then that the day would come when such treatments would work. As I have also said before, my brother was simply born to soon.

In present-day medicine, doctors tend to classify cancers in a whole number of ways. But one of the most basic classifications relates to the origin of the cancer. So if a person, God forbid, develops cancer that starts in the lungs, many protocols for treatment are geared towards “lung cancer”.  This may seem obvious, but could it be that liver cancer treatments would be effective for lung cancer? In oncology research, all types of combinations of treatments are tried. And in fact, there is no law that says that each cancer will only respond in one specific way. That is why if a person fails to respond to the initial therapy, alternative protocols will be tried. It’s not all or nothing.

As it turns out, there are researchers who are approaching cancer from a new angle. Studies are now being done where patients’ cancers are being treated based on their genetic mutations, and not based on the organ from which the cancer originated. In a recent New York Times report on a cancer research trial, 18 patients with different cancers were treated with a melanoma drug that targeted a specific mutation that was in fact common to all of the diseases. This is a brilliant approach to cancer therapy. If one can identify universal mutations that are responsible for entire blocks of cancers, a single treatment that attacks the common mutation could cure a whole range of people with apparently totally unrelated diseases.

The results of this study were, definitely by oncological standards, amazing. In 14 of the patients, the cancers stopped growing, shrank or entirely disappeared. At the time of the publication of the news article, the other 4 patients had only just begun treatment. It is obviously hoped that these remaining patients will respond in a similar fashion to the previous 14.

In the next few months, the National Cancer Institute will begin to screen samples of cancers from thousands of patients. The intent is to identify a relatively small number of common mutations amongst all of these patients. Once this has been done, each group of patients with the same mutation will be treated specifically for that mutation. If the results of this upcoming study are equivalent to the small 18 person trial noted above, this will be nothing less than a revolution in cancer treatment.

Although the talk of having everyone undergo DNA sequencing of their own cells is a relatively new topic, so much has already been said about the potential benefits that one would think that this has been a topic of discussion for over a decade. Researchers need data. The more data that the public provides to researchers, the faster they will discover answers to life-and-death questions.

I apologize for repeating this for the umpteenth time, but in my opinion, the potential benefits of collecting such information and making it available in a universal but anonymized central database, trumps any concerns over a possible breach in privacy. In my opinion, the public should be begging the research community to collect as much physiological and cellular information as possible, in order to be able to dissect out normal versus pathological DNA.

I know that I would have done almost anything to save the life of my brother. If the most I would have had to risk was a potential illegal access to my personal medical file and DNA code, is there any question that it would have been worth it?

Thanks for listening

My website is at http://mtc.expert

 

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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