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Sunday, June 29, 2008

Day +172 Eternal Vigilance One Can Only Hope For?

Last Sunday my Dad and I attended a seminar/celebration at Scripps. It was the 21st Annual National Cancer Survivors Day. The event was held in a nice sized amphitheater at Scripps Green hospital. It was attended by over 300 people, including 3 speakers, a musical entertainer and the San Diego Union newspaper. This wasn't so much of a 'support' gathering as it was a celebration for cancer survivors. 2 of the 3 speakers were cancer survivors, the other was my doctor, Jeffrey Andrey. I want to write about Dr. Andreys presentation and mention that the musical entertainment was really good. The lone performer was Steve White. He played blues guitar, harmonica, vocals and foot drums. Everyone was stomping their feet to the music. He was very good.
Dr. Andrey's presentation was very interesting to me in terms of understanding cancer. His topic was the increasing use of SCT (stem cell transplantation) for the treatment of tumorous cancers. I've always thought of SCT for the treatment of bone marrow cancers, which are non-tumorous. A traditional SCT is meant to replace defective marrow stem cells with a donor's good marrow stem cells. With the new tumorous SCT therapy, there is presumably nothing wrong with the patients marrow stem cells. Instead, tumors elsewhere in the body are the target. How could this be?
The answer may be surprising. Replacing bad stem cells with good ones make sense, but this cannot be done without the necessary side effect of a cold 'reboot' of the entire immune system. For people with bad stem cells, they would love to not have a cold reboot. The results of an immune system reboot is unpredictable. What will the new immune system attack? The liver? The heart? The lungs? Nothing? Most people, like me, are extremely happy if the new immune system attack nothing except for invading pathogens, bugs, and other usual suspects. For SCTs done to tumorous cancer patients whose stem cells were fine to start with, they *want* their new immune system to function better than their old immune system. In other words, they want an immune system transplant. Why?
This is the intriguing part. A cancer patient's old immune system somehow became lazy. Their immune system allowed itself to be duped by line of cells that were 'not right'. In other words, the tumorous cancer cells established themselves in their body and their immune system allowed it to happen. This is how cancer gets established. Errant cells, randomly created by faulty cell divisions, are supposed to be detected and killed by the immune system. Cancer is an immune system failure. With traditional SCT's like mine, some Graft Vs. Host (GVH) reaction is expected. It is expected that the new immune system may target good organs by mistake. But the immune system may target cancer tumors just as well! They call this side effect Graft vs. Tumor (GVT). It is hoped that the new immune system will not find fault with healthy, desired, organs; but it *will* find fault with any tumor cells it finds. Dr. Andrey produced slides during his presentation that demonstrated lung tumors clearing out in one SCT survivor. This is an important frontier in cancer research. But how can we direct a (new) immune system to attack only things we want it to attack?
Eternal vigilance. One thing I've come to realize from all this is that our immune systems are the key to a healthy, cancer free, disease free life. What is it that causes an immune system to give a free pass to a new line of mal-organized cells? What happens early on when there are only a few malignant cells? Why does the immune system let down it's guard? How does it get duped? The immune system must remain eternally vigilant. Is this something we can only hope for or are there things we can do to help?

God bless!

1 comments:

Unknown said...

Wow, that is a different way to think about things. I never thought of it helping like that. Good deal they are researching this stuff and finding what helps. Hopefully they will be able to find out more and more and cure it before it happens.