Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, May 16, 2014

Treating Cancers

"It's a landmark. We've known for a long time that we can give a virus intravenously and destroy metastatic cancer in mice. Nobody's shown that you can do that in people before."
Dr. Stephen Russell, Mayo Clinic, Minneapolis


A nurse uses a syringe to prepare an injection of the combined Measles Mumps and Rubella (MMR) vaccination at an MMR drop-in clinic at Neath Port Talbot Hospital near Swansea in south Wales on April 20, 2013. Public health officials said on April 19 they were investigating the first suspected death from measles in Britain in five years, after an outbreak blamed on a campaign against vaccinations. More than 800 people have contracted the highly contagious disease in Wales in the past six months, centred around the southern city of Swansea. Marion Lyons, director of health protection for Wales, said it had now been confirmed that a 25-year-old man from Swansea who died on April 18 had measles, a full postmortem will be conducted to determine cause of death. AFP PHOTO / GEOFF CADDICK        (Photo credit should read GEOFF CADDICK/AFP/Getty Images)
 (GEOFF CADDICK/AFP/Getty Images)

We fund research in the hopes that medical investigations into new therapies and treatments of various kinds will alleviate the scourge of dread diseases like cancer in all its manifestations. Some cancers can be cured, and have a fairly high rate of success. While others are horribly grim, with far less chance of successful outcomes. Medical science has come a long way in the last fifty years in the treatment of cancers with new experimental protocols that, when successful, become standard.

Now, a new experimental procedure pioneered at the Mayo Clinic which led to a scientific paper outlining the procedure and its success, has been published in the Mayo Clinic Proceedings by its lead researcher, Dr. Stephen Russell. The example outlined was that of the success realized in treating a woman from Minnesota suffering from myeloma, cancer of the bone marrow that had spread throughout her body.

A decade of various types of treatments had proved ineffective; she was running out of time and available treatment options. And then doctors at the Mayo Clinic, administered to her 100 billion infectious units of a measles vaccine. That represents an amazingly massive dose of vaccine, enough in fact to inoculate ten million people.

What happened next must have seemed a miracle to Stacy Erholtz from Pequot Lakes, a local rural community. The cancer she had been suffering from for so intolerably long was in complete remission, nothing remained of it. The woman, 50 years of age, was selected for the trial on the basis of having experienced limited exposure to measures previously. Her immune system was sufficiently weak as a result of previous treatment and her parlous medical state not to be enabled to fight the massive viral material she was inoculated with.

She'd undergone two stem cell transplants and chemotherapy treatments with scant success. Scans showed tumours growing all over her body. One grew on her forehead, pushing on her brain by destroying a bone in her skull. Cancer had infiltrated her bone marrow. In a bit of grim humour her children had named the forehead tumour 'Evan'. When she was treated with the new therapy of oncolytic virology, the doctors felt they were entering the unknown.

The procedure the researcher undertook on this experimental basis was an hour-long process; five minutes into that process Ms. Erholtz felt a dreadful headache. Two hours afterward she began shaking and vomiting, and her temperature soared to 105 degrees.

"Thirty-six hours after the virus infusion was finished, she told me, 'Evan has started shrinking'", said Dr. Russell. It took several weeks but her forehead tumour vanished, and so, eventually, did the other tumours all over her body.

This type of therapy has been around for over fifty years. It is more commonly used with bladder cancer. Flooding the bladder with BCG , a vaccine for tuberculosis, has a high success rate to prevent bladder cancer cell recurrence. Although doctors are not quite sure how BCG works for bladder cancer, it would seem it encourages immune system cells to thrive and become active in the bladder lining.

BCG seems to work as a type of immunotherapy. These cells of the immune system probably kill off any cancer cells that might grow back or have been left behind in the bladder lining. The vaccine helps to stop or delay the regrowth of bladder cancers recurring or spreading after surgery, with the active immune system cells killing off cancer cells that may have been left in the bladder lining post-surgery.


In the instance of using measles vaccine as the research team at the Mayo Clinic did, it was held that
the viruses bind to tumours, using them as the scaffolding upon which they replicate their own genetic material, leading the cancer cells to eventually explode, releasing the virus. The therapy can be used once only on any specific patient. Once delivered, the body's natural defences will recognize it and attack the vaccine before it has the opportunity to destroy the tumours.

According to Dr. Tanios Bekail-Saab, researcher at the James Cancer Hospital and Solove Research Institute in Ohio, this method of treatment for certain cancers may eventually become a treatment standard within the next three or four years. A second patient involved in the trials responded less well. This was held to be because her cancer was different, with tumours located in her leg muscles.

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