The Brand New Mindset for Cancer Series: Part 3.0 Boosting our body’s own defense system to eliminate cancer Expecting a groundbreaking in cancer immunology

(Key points: Cancer immunology is not only very important for our body’s own defense system to fight and eliminate cancer, but also play an essential role in developing cancer vaccine. A groundbreaking progress will become possible only when scientists change their mindset and the way how they think, and start to turn around untouched stones.)

In a large conference room in the sprawling Orange County Convention Center the audience packed fully into the space to listen the seminar given by one of the most respected immunologists, Dr. Steven Rosenberg. He showed one slide after another, most of them were jaw-dropping pictures of excellent results: after a certain period of treatment lung cancer lesions in patients disappeared, completely disappeared.

 

That’s an unmistakable message: if scientists and doctors can find effective way to use our body’s own defense system to against cancer, the result will be astonishing. Years ago when I had several projects to use animal models to mimic cancer metastasis, one result is always very reproducible and predictable. That was don’t matter how many cancer cells were injected into animal blood, only very few can survive the forceful attacks by immune system, even in Severe Combined Immunodeficiency mouse. Every cancer researcher knows it is almost impossible to use a healthy mouse do any metastasis study. You may think there are many great studies to give a clear and satisfying explanation why this happen and how to apply it to fight cancer.

No. No one knows for sure why this happens. Since Drs. Michael Heidelberger, Frank Burnet and Jacques Miller established the modern immunology, one of the most important questions on how a healthy body can defeat cancer still remains as a big mystery.

It is time to change this situation. It is time to ask why so many treatments have failed to use our body’s own defense system to fight cancer. Are all of us focusing on the wrong side of the question and ignoring the most important aspect of cancer immunology? When I had a clue and think one immunology-related molecule may be very important in cancer immunology. Among seven varieties of very similar but clear different proteins in a protein family the only protein having no any antibody available is the one I am looking for.  

To get a groundbreaking progress in cancer immunology is not only critical for cancer therapy, but also for cancer prevention and cancer vaccine development. When I chatted with one senior scientist in the immunology field about how important dendritic cell for immunology and may be one day the scientists in Rockefeller University who had this great discovery become a Nobel Prize laureate. The scientist said that only when someone can show that those cells can actually be used in vaccine, like a vaccine against cancer.

To overcome the current struggle in cancer immunology study the researchers and scientists really need to think in a totally different way and start to look around for target proteins or genes few have touched. It is also critical for immunologist to have deep experience and knowledge about solid tumor, not limit the focus on T cell or B cell or dendritic cells only. Meanwhile cancer scientists really need to have deep knowledge in immunology. It is a big obstacle for any progress in cancer immunology as long as scientists in those two fields are working in total different settings. It should be firmly unacceptable if a preeminent scientist gives an overview on cancer progress with many words like “oncogene” and “mutation” but barely mention immunology.

After several decades of struggle a victory in cancer immunology is finally within our reach. The day when cancer immunology get a great boost is also the day when many other most challenging questions in cancer be solved. They are really the two sides of the same coin. When I ask in his excellent results what was the targeted tumor antigen, Dr. Rosenberg wished a good luck for anyone who dares to try finding out.

(This article is the third in a series of “the Brand New Mindset for Cancer” essays. It was published on 8/31/2011.)

The Brand New Mindset for Cancer Series: Part 2.0 The most important tumor cells are not cancer stem cells the scientists and researchers are studying now and talking about

(Key points: The most important tumor cells with an amazing feature (“X” cell?) are very difficult to get. It is certainly not the cancer stem cells people in the town are talking about. If we can successfully get those cells it will be a truly big scientific breakthrough and worthy to be on the cover page of the Scientific American or National Geographic or the New York Times.)

After several most influential media started a review of the results of forty years war on cancer, a professional journal joined the reflection as well. Because cancer stem cell is a white hot topic so it is nature for the professionals to talk about any progress in the field. Everyone agrees if the cancer stem cells exist and are properly targeted, then the chemotherapy may be dramatically approved and many nasty problems such as drug resistance, cancer recurrence, failure in designing new effective drug etc may be easily solved. Nowadays, there are many thousand research papers having been published. But in the past when some top scientists in the field tried to reproduce some other’s results, it was always disappointed. When the top professional journey tried to review the topic is not satisfied neither. According to the journey the cancer stem cells were defined as cells with enhanced tumor-initiating potential relative to other cancer cells within a tumor as well as displaying self-renewal potential and producing non-cancer stem cell progeny.

This is a problem, a very big problem. You can easily image what consequence would be if the basic definition gets incorrect or totally wrong. If nobody so far has shown a convincing evidence what exactly those cancer stem cells look like, the very reason may be because no one has idea what a correct definition is. What’s the enhanced tumor-initialing potential? By a limited dilution method scientists and doctors have established hundred tumor cell lines. Are all those cell lines counted as cancer stem cells, just as some already claimed? In those dozens of thousands research articles which one can clearly show the characteristic of this “self-renewal potential”?

If researchers really want to have a brand new mindset for cancer, and truly want to solve the mystery surrounding those all important tumor cells, all needed are to think the way the mass are not thinking now. Those tumor cells are certainly not the cancer stem cells the scientists and researchers are studying now and talking about.

There will be beautiful tumor cells, let’s call it as X cell (or named after any one whom generosity makes it possible), which is worthy appearing in the cover page of New York Times or the Scientific American or National Geographic because of some very unusual features and its critical roles in cancer. To extensively and thoroughly study and better understand those cells are keys to answer the following wide range questions:

Why there is hair loss after chemotherapy and how to prevent it?

Why drug resistance happens and how to overcome it?

How cancer occurs in the first place and how to prevent it from the very beginning?

Why there is no any drug so far can cure cancer, how to get multiple drugs to do just that?

(You can ask some questions, then see how the particular question be affected by finding and targeting those X cells.)

Of course, it is not impossible to get those cells. However, to pick up a right one from billions and billions of tumor cells among a tumor mass is not easy task, neither. When someone tells you that he/she is already getting those simply by sitting beside some machines for few hours. You know he/she must get some cheap stuff, too cheap to be true. Let’s remember the history how Mrs. Marie Curie got the first radioisotope radium and polonium. That is how hard and how difficult before you can truly see the face of those beautiful X cells.

(This article is the second in a series of “the brand new mindset for cancer” essays. It was published on 8/30/2011.)

The Brand New Mindset for Cancer Series: Part 1.0 Solving cancer mysteries by combining holistic and analytic approaches

In our society the way doctors treat patient is very similar to the way mechanics fix a broken car. When your car is broken down, a mechanic opens the hood and connects to a computer or checks by himself. Ouch, problem is found. Then he either fixes the problem or simply replaces the bad one.  Since Sir Isaac Newton our living body is simply regarded as a physical and chemical process. The disease is treated as a problem of dysfunctional molecules or proteins. For cancer it is a problem of mutation being a culprit. That is why scientists and doctors have spent billion dollars to pinpoint those pretended ultimate causes.

After forty years and more than $200 billion the results now set in: there is no such pinpoint you can deal with. Someone insists that we need to spend even much more  funds and resources to widen the hunting in every patient and every kind of cancers.

It is time to turn around and think a totally different approach. It is time to ask a daunting question:  is anything fundamentally wrong in the way we deal with cancer and do the related research and development, and did we rely on too much on analytic thinking meanwhile we have badly ignored a more important part of a effective solution: the holistic approach?

From the very beginning the students were taught how to solve a problem by tearing it apart and get a answer piece by piece. It is widely believed that there is no effective way the holistic thinking can be taught in school. As a result the scientists are thinking generation by generation in a lopsided way, relying on analytic approach and only on analytic approach. 

Of course, in the past decades scientific knowledge is accumulated in an accelerated speed, and enormous volume of literatures have been generated by this strategy. The more we accumulate the more we confuse: why all those brightest scientists are failed. The answer may be quite simple: we need a brand new mindset and new approach.

The new approach is to combine the strengths of holistic and analytic methods.

If we don’t have tool to help and learn holistic thinking before, now there are more and more tools just on our finger tips that is ready to serve us. The terabyte scale of information data is calling us to deploy a holistic view to interpret its meaning. The cancer patients dying daily are badly needed we think in a novel way so that we can face and overcome such most difficult challenges.

Indeed, some of human societies on this planet have already applied holistic thinking for several thousand years. In such a society our body is not seen as a physical process, but is considered to constantly interacts with environment in a mutual and dynamic fashion. The medicine developed based on such theory and belief has successfully served the medical need for several thousand years. It is time to use all those tools such as supercomputer and algorithm, as well as large scale screening and molecular methods to invent new treatment regimens for cancer and other diseases.

(This article is the first of a series of “the Brand New Mindset for Cancer” essays. It was published on 8/29/2011.)

To be trivial or to be grand

Do you feel we are living in a post-idea world? An interesting and insightful opinion appeared in the section of Sunday Review of the New York Times on 8/14/2011 by Neal Gabler tried to answer why there is no more deep thinker and big idea (see link http://www.nytimes.com/2011/08/14/opinion/sunday/the-elusive-big-idea.html?_r=1). Of course, some great products from novel ideas like iPad, Kindle and Twitter already changed this world. But let’s be clear that Mr. Gabler defines the big idea as grand as ones generated by Charles Drew, John Keynes, Albert Einstein, Marie Curie etc. The idea should ignite debates and cause revolution. In a social networking era people care more about what their friends are doing at a particular moment. So many people are busy to update the status of their Facebook page. We have become information narcissists, so uninterested in anything outside ourselves and our friendship circle or in any tidbit we cannot share with them. The daily life becomes increasingly trivial and bold ideas are almost passé. Interestingly, when an investigative report on why we lost the war on cancer published in the Fortune magazine few years ago, one scientist blamed a “lack of good idea” as a possible reason. How possible this happen when you think that we are a most informed generation with trillions upon trillions of bytes information just a click away, why is there no big idea and good idea?

To make thing worse we not only lack those ideas, we are also badly lacking of imagination. Not long time ago one issue of a scientific journal elusively dedicated to prospect the future of science 50 or 100 years down the road. The reading really made me scratch my head. Why those articles, many written by prominent scientists just talk some things probably will happen next year or within few years. You will conclude that those authors are totally lack of imagination. I still remember the exciting when I saw “20000 Leagues Under the Sea”. Where are those people who can have such an exotic imagination and enrich our thinking?

As Neal Gabler rightly pointed out one reason is that people are drowning in information, with no time or desire to process it. All grand ideas need hard work and extensive study. They have to go through many cycles of hypothesizing and grand argument. It is true that this ocean of information drown many people. But it is also true the same powerful tools and information, not available short time ago, empower the deep thinker to do thing unimaginable before. In the same issue of Sunday Review the columnist Thomas Friedman said that the globalization/IT revolution is “super-empowering” individuals , enabling them to challenge hierarchies and traditional authority figures, from business to science to government.  Sometimes the big idea is exciting and dangerous because it will overthrow the conventional wisdom. A truly good and big idea will certainly energize and elevate the whole play field. In addition, grand ideas most often open new fields and create new industries.

To effectively use those powerful tools one need to have a brand new mindset and totally different thinking. The most important thing we desperately need now is to liberate our imagination and think grand and boldly, like how to completely overcome cancer and find multiple ways to treat and prevent cancer.

We may look like living in a post-idea world, at least from the view of most people for their daily life, but we are truly living in a pre-dawn era because many grand ideas will appear, and appear rather sooner.

(This article is to response to “the Elusive Big Idea” by Neal Gabler in Sunday Review section of the New York Times on August 14, 2011.  Published on 8/18/2011, First update on 8/19/2011, second update on 8/22/2011)