Newsletter of the Hubert H. Humphrey Cancer Research Center at Boston University School of Medicine

Hubert H. Humphrey Cancer Research Center of Boston University

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Boston UniversityOpenBU http://open.bu.eduBU Publications The Humphrey Center Report / Humphrey Center News1985Humphrey Center News: Spring1985 v. 1, no. 1https://hdl.handle.net/2144/22153Boston UniversityHumphrey Center NEWS Volume 1, Number 1 Spring 1985 Taking Aim at the Cancer Threat r r Workers check pollution levels at a chemical dumpsite in Ohio. Concern about a link between chemicals and cancer has prompted a search by Humphrey Center investigators for a better understanding of the problem. A ne ighborhood resident is w a l k i n g across a vacant lot used as a play-gpound by local youngsters. She notices puddles whose surfaces are aswirl w i t h unexpected colors: purples, yellows, greens. U p close, the puddles have an acrid odor. The w o m a n calls friends. Soon, the ne ighborhood is rife w i t h rumors and speculation. Many residents are con-vinced the foul-smell ing l iquids are chemicals f r o m a nearby d u m p . The town's health inspector is called i n . She promises to get the contam-inated water tested. A week later, the results are back: Yes, there are toxic wastes on that lot. The neighborhood erupts. Residents h o l d a succession of heated meetings. Some families talk of m o v i n g out. Others demand a cleanup of the waste. A t first, polit ical leaders are slow to respond. But residents keep u p the pressure. There are marches, rallies. Media coverage of the neighborhood's pl ight mounts. Finally, a breakthrough: The governor orders a comprehensive study to f ind out whether the chemicals are harming the residents. Scenarios like this have been played out dozens of times across the nation i n recent years. For many of the residents affected, health studies are a major goal. Such studies, though, probably can't answer questions about the cancer threat involved. The reason, according to H u m p h r e y Center inves-tigator John Groopman, Ph.D., is the inherent l imits of the statistical tools used by epidemiologists, medicine's detectives. continued on page 3. The Laser in Cancer Surgery: Major New Applications W h e n Geza J. Jako, M.D. , sets out to remove a t u m o r f r o m a patient's larynx, he doesn't pick up a scalpel. What he does instead is this: Looking deeply into the patient's throat through a special instrument called a laryngoscope, he carefully focuses on a specific p o r t i o n of the tumor, and then presses a button. That but ton activates a beam f r o m a carbon dioxide laser. Almost instan-taneously, a small puff of smoke appears, signaling that the target area of the t u m o r has been vaporized. Thereupon, Dr. Jako shifts his focus slightly and prepares to fire the next carefully targeted laser burst. This type of procedure, once the province of science fiction, has n o w become routine i n treating laryngeal tumors. A n d m u c h of the credit belongs to Dr. Jako, because it was he, along w i t h H u m p h r e y Center colleague M . Stuart Strong, M.D. , w h o pioneered adaptation of the laser for use i n treating such tumors. Dr. Jako, a native of Hungary, received his medical degree f r o m the Semmelweis University i n Budapest. After the H u n -garian revolt of 1956, he came to Boston. Whi le training as an otolaryngolo-gist at Harvard, continued on page 2. A 2 HUMPHREY CENTER NEWS BEHIND THE SCENES People & Research It can't fly faster than a speeding bullet. It's not more p o w e r f u l than a locomotive. But the fluorescent-activated cell sorter (FACS) does have one amazing capability: It can sort cells w i t h astonishing speed. A n advanced FACS recently was put into operation at the H u m p h r e y Center. According to Elizabeth R. Simons, Ph.D., a professor of bio-chemistry and overseer of the device, it works like this: Tiny drops of l iquid, each containing a single cell, are dropped out of what amounts to a miniscule faucet. Each drop is given an electrical charge. Meanwhile , users of the device " label " some of the cells — for example, all the tumor cells i n a mixture of normal and cancerous cells — w i t h a fluores-cent compound. "The FACS has a laser that essen-tially acts as a detector for fluores-cence," says Dr. Simons. " W h e n it strikes a fluorescent cell, it activates an electromagnet. The magnet then deflects the fluorescent cells into a different container f r o m the n o n -fluorescent ones." The FACS, w h i c h processes up to 2,500 cells per second, can help cancer investigators i n a great number of ways, says Dr. Simons. For example, if they want to k n o w h o w rapidly leukemia is spreading i n a lab animal, they can process the animal's b lood cells t h r o u g h the device. Even if there are hundreds of mi l l ions of cells, the FACS allows the cancer's spread to be gauged w i t h i n a matter of hours. • L A S E R I N C A N C E R Continued from page 1. Dr. Jako continued to nurture an interest i n medical technology. I n the early '60s, for example, he developed a new type of endoscope and other instruments that permit ted the use of microsurgery — that is, surgery done w i t h the aid of a low-power micro-scope — i n the larynx. Then, his focus turned to the laser. The m i d '60s weren't an auspicious t ime to be experimenting w i t h medical uses of the laser. "Other laboratories had already experimented w i t h using the laser to treat cancer, and it was reported that the laser scattered t u m o r cells beyond the original site," recalls Dr. Jako. "Those reports got into the newspapers, w h i c h made the atmos-phere k i n d of di f f icul t . " The scientist's lab experiments, though, convinced h i m that a type of laser different f r o m those used i n those original experiments w o u l d do the job. He f o u n d a supporter i n Dr. Strong, head of the Department of Otolaryngology at Boston University School of Medicine. Dr. Strong invi ted Dr. Jako, then at Massachusetts Eye and Ear Inf irmary, to j o i n his department. The pair embarked on further experiments. Finally, by 1971, they were ready to try the technique o n a cancer patient. " I t was a patient w h o already had a large t u m o r and was going to have his larynx removed anyway," recalls Dr. Jako. " H e gave his permission for us to use the laser pr ior to the laryngec-t o m y . " W i t h Dr. Strong heading the surgical team, they per formed the procedure. That and succeeding operations con-f i rmed that the laser can be very effective i n treating certain types of tumors. One reason the laser works so wel l , says Dr. Jako, is that it leaves no blood, so that the surgeon, especially w h e n using an operating microscope, has an excellent v iew of the t u m o r site. (Experienced surgeons can see bits of t u m o r made up of as few as 100 to 200 cells.) A second is that there is no physical contact w i t h the tumor, and hence no risk of cancer cells being scattered beyond the site. A t h i r d is that the laser totally destroys the cells it strikes. " K n o w i n g what we k n o w now, 1 th ink cancer is one of the diseases that is most amenable to laser surgery," says Dr. Jako, w h o besides being on the Boston University School of M e d i -cine faculty maintains a practice i n Melrose, Mass. Today, the laser is used to operate on many tumors besides those of the larynx. Cancers of the skin, uterus and cervix, along w i t h brain tumors, are especially frequent targets. But Dr. Jako, a member of the presidentially appointed National Cancer Advisory Board, believes that the laser's promise has just begun to be realized. For one thing, he notes, surgeons are starting to use the laser to track d o w n hard-to-locate offshoots of tumors. Cancer cells, explains Dr. Jako, differ in color and consistency f rom n o r m a l cells, and also in the way they're vaporized by the laser. A n d today, he adds, experienced surgeons are learn-ing to identify those differences d u r i n g the course of surgery. W h y does this matter? "Most tumors do not make a neat border w i t h normal tissue," explains Dr. Jako. "They have t iny branches, called processes, that penetrate into normal areas. As we develop this approach, surgeons are f inding that they can fo l low a tumor process the way a miner fol lows a vein of coal." continued on page 4. HUMPHREY CENTER NEWS 3 T A K I N G A I M A T T H E C A N C E R T H R E A T continued from page 1. These tools, says Dr. Groopman, an assistant professor of toxicology, are very useful w h e n a large group of people have been exposed to a sus-pected cancer-causing agent over a long per iod of time. It was relatively simple to p inpoint a l ink between smoking and lung cancer. But w h e n groups are small, and exposure times brief or indeterminate, it's very hard to reach definit ive conclusions about cancer risks. N o w , though. Dr. Groopman and his associates are w o r k i n g on a technique that could revolutionize the task of p r o b i n g the health effects of toxic chemicals. The key to the technique is to identify connections between chemicals and D N A , the substance that makes u p our genes. "Most cancer-causing agents can't cause the disease unless they f o r m linkages w i t h your D N A , " explains Dr. Groopman. " I f an agent enters your body but fails to connect w i t h your D N A , it may do other bad things to y o u but it almost certainly w o n ' t cause cancer." W h e n a chemical does l ink up w i t h D N A , the resulting combination is called a D N A adduct. By injecting chemicals into rodents, the investi-gators have created a group of natural substances called antibodies that seek You Can Help For more information on the impor-tant work of the Hubert H. Humphrey Cancer Research Center, and how you can help, send this coupon to: M r . W i l l i a m J. Freeman Boston University School of Medicine H H H Cancer Research Center 80 East Concord Street - A l O l Boston, M A 02118 N A M F -A D D R F i s S OTY S T A T E Z I P out and attach themselves to adducts. The investigators have already pro-duced antibodies to a wide range of chemicals, and they continue to expand their targets. One chemical they're n o w w o r k i n g w i t h , for example, is ethylene d ibromide (EDB) — the pesticide whose discovery i n baked goods and other products t w o years ago touched off a national furor. For the technique to be usable on a mass scale, though, it has to w o r k i n sub-stances like b lood or urine, w h i c h are readily obtainable f r o m large groups of people. The technique isn't yet ready for widespread use. More tests are needed to prove that it works. However , even w h e n ful ly tested it still w o n ' t answer the question. D i d this chemical cause cancer? F inding an adduct only means that the potential for creating tumors is there, not that a tumor is inevitable. Still, the technique may help to penetrate the mystery that surrounds the question of h o w toxic chemicals affect us. "Right now, we have no way of k n o w i n g whether toxic chemicals really represent a serious cancer risk," notes Groopman. " O u r approach won' t resolve that issue, but it w i l l provide some hard evidence to use i n deciding what to do about these environmental hazards."n C A N C E R N O T E S C A N C E R N O T E : The rate of stomach cancer, a h ighly lethal f o r m of the disease, has dropped by more than 40 percent i n the Uni ted States over the past 25 years. Experts believe changes i n diet are responsible. C A N C E R N O T E : Coughing, w h i c h sometimes brings u p sputum con-taining b lood, is the most c o m m o n early sign of l u n g cancer. The second most c o m m o n sign is a persistent ache i n the chest. C A N C E R N O T E : L u n g cancer, w h i c h affects more than 100,000 people annually and is the largest cause of cancer deaths, is the most preventable f o r m of the disease. The lung-cancer rate could be cut by 80 percent or more if American smokers dropped the habit. QUESTIONS. . . Answer to question on back panel. A . The recent National Academy of Sciences' report o n diet and cancer singled out cruciferous vegetables (so called because of their cross-like patterns) as especially effective i n protecting those w h o eat them f r o m cancer. One possible reason is the certain natural chemicals these vegetables contain. These chemicals seem to st im-ulate the body to attack and break d o w n various cancer-causing sub-stances. Whi le the evidence that cruciferous vegetables help prevent cancer is strong, that doesn't mean y o u should avoid other vegetables. A l l vegetables contain vitamins and minerals that may help prevent cancer. A balanced diet that is h igh i n grain products and vegetables and l o w i n foods like butter and fatty meats appears to be the best dietary approach to cancer prevention. Q . Why is leukemia the most common form of cancer in young children? A. Leukemia, or cancer of the whi te b lood cells, affects about 22,000 people a year, roughly 2,500 of them children. Kids, though, are pr ime targets for one particular type of the disease, called acute lymphocytic leukemia. I n fact, they account for vir tual ly all the cases of that disease. The explanation lies i n one of cancer's key features: the fact that it tends to affect the most rapidly g r o w i n g cells i n the body. Since the whi te cells called lymphocytes are g r o w i n g fast i n y o u n g children, these cells more readily become cancerous than others. I n older children, meanwhile , the bone cells are g r o w i n g fast, w h i c h is w h y teenagers tend to be more prone to bone cancer than are other age groups. • C A N C E R N O T E : A breast l u m p does not necessarily mean cancer. Roughly four-fifths of the breast lumps biopsied t u r n out to be benign. C A N C E R N O T E : C h i l d h o o d cancers tend to gro w more rapidly than those in adults, but the overall cure rate is higher. The current rate is estimated to be 80 percent or more. 4 H U M P H R E Y C E N T E R N E W S L A S E R I N C A N C E R Continued from page 2. Other new uses of the laser, says Dr. Jako, may grow out of the marriage of the device w i t h innovative diagnostic technologies: the sophisti-cated new f o r m of x-ray called the CT (computerized tomography) scan; magnetic resonance imaging, i n w h i c h t iny magnetic signals f r o m i n d i v i d u a l cells are used to distinguish diseased f r o m healthy tissue; and ultrasound, i n w h i c h high-frequency sound waves help to map the shape and location of tumors. Such technologies may lead to accurate pictures of tumors that u p u n t i l recently were too small even to locate. This i n t u r n may spur progress i n dealing w i t h the frustrating prob lem of metastatic tumors. These tumors, w h i c h grow u p w h e n cells f r o m the original t u m o r break off and settle i n new sites, are often too small to be treated surgically. The new methods of diagnosis, however, may permit surgeons to operate on at least some metastatic tumors : those of 100 m i l l i o n cells or more. "Once y o u had your three-dimen-sional diagnostic picture," explains Dr. Jako, " y o u w o u l d go i n there w i t h the laser and remove these tumors. I n fact, you could probably use a computerized approach to help y o u plan exactly h o w to direct the laser so y o u could be sure to remove most of the cancer-ous cells." After that, radiation and chemotherapy could be used to attack the remnants of the tumor . These and other n e w techniques, emphasizes Dr. Jako, are still i n the formative stages. Once ready for general use, though, they w i l l offer bright promise for i m p r o v i n g cancer cure rates. • The Humphrey Cancer Center News is publ ished by the Huber t H . H u m -phrey Cancer Research Center of Boston University School of Medicine. President, John I . Sandson, M.D. , Dean of the School of Medicine; Director, Herbert H . Wotiz, Ph.D.; Deputy Direc-tor, Isaac M . Taylor, M.D. ; Editor, W i l l i a m J. Freeman. Why are cauliflower, Brussels sprouts, cabbage and broccoli considered especially good sources of protection against cancer { A N S W E R O N PAGE 3 pajsanbayi u o i p a j i o ^ ssaippv aNIDIQHW aO TOOHDS AiisaaAiNn Noisoa aaiNaD Hoavasaa aaDNVD H H H a n i aiVcI aovisoci so 81130 SSVW 'NOiSOa l a a a i s Q H O D N O D i s v a aNiDiaaw ao T O O H D S AiisaaMNn Noisoa BaiNaD HDtivasati aaDNVD AatiHdwnH H inaanH 

Humphrey Center News: Spring 1985 v. 1, no. 1

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Humphrey Center News: Spring 1985 v. 1, no. 1

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