Like a dad in a drugstore: an analogy for molecular profiling

Good news to share with you today!

My molecular profiling results are IN! We don’t know what they are yet, but there’s HOPE in the air today!

What’s molecular profiling?  Well, here’s a two-minute analogy.  Imagine that your kid gets sick and you call your husband to ask him to stop by the drugstore for some medicine.

If you don’t tell him the child’s symptoms, he’d have to just stand there in front of the long shelf of children’s medicine and choose a bottle at random.  Once in a while, the random medicine would work and the child would recover.  More often than not, though, the medicine wouldn’t work, AND the child would have taken medication she doesn’t need.  Not a good idea, right?

If you tell him that the child has a cold, then he knows to choose from the array of a dozen or so cold medicines for children.  The child may get better, or not, but also he may end up taking much stronger medication than he needs.

But if you tell him exactly what kind of cold it is (cough, stuffy nose, fever), he can zero in on the right bottle and the child will get better quickly without taking unnecessary medication — and without having to wait while someone goes back to the pharmacy every couple days to try a different cold medicine at random.

Are you with me?

Okay.  So.  Cancer treatment today relies on an array of chemotherapy, hormone suppressants, and other drugs to reduce inoperable tumors and keep them from coming back.  All cancer is not the same, however, so it really helps to know what kind of cancer is at work.  Some people, like my neighbor Frank, have had cancers of unknown primary origin.  The doctors can’t tell where the cancer started, so they don’t have much help in narrowing down the specifics.  Treatment of cancer of unknown primary is in its infancy, and the choice of chemotherapy drug can be a little like choosing a random bottle off the shelf.

Those of us who are lucky enough to know where our cancer started have some clues.  We know that we have breast cancer, for example, and we know what part of the shelf to look on for the appropriate medicine.  Beyond that, we know that we have specific markers for our breast cancer — ER+, PR-, HER-2- inflammatory breast cancer, for example, which is what I have.  When my oncologist considers treatments, she’s like the father in the drugstore who knows his kid has a cold.  There are a handful of possible treatments that could work, but some won’t be effective enough, and some are overkill.

How can oncologists choose the right chemotherapy right away?  In January, researchers announced new successes in clinical trials where the patient’s cancerous tissue underwent molecular profiling in a laboratory to identify the exact targets where the cancer is vulnerable.  By knowing what the cancer really looks like, the treating oncologist can then choose a chemotherapy (drug) to treat not just cancer, and not just breast cancer, but the EXACT cancer that the patient actually HAS.  This is incredible and exciting new research, peeps.  I’ve heard over and over this year about the potential power of personalized medicine, and this is MY opportunity to try it out.

I’m excited.  I don’t know if my particular results will call for a particular treatment, but I’m so happy today that this is even a possibility.

In other news, radiation starts tomorrow. I’m not at all worried about it; we’re just going to treat it as an inconvenience until it gets all hurty and stuff.  I’ll have four fields of radiation, two in my armpit and two across my chest from different angles, so as not to irradiate my lungs or heart too much (both cause damage).  I’ll lie down for treatment, they’ll push and pull my limbs until my tattoos are lined up just exactly with the positioning light beams, and then they’ll leave the room as the machine moves into position and sends x-rays onto my skin and the tissue below. Think of it like a rather unpleasant tanning bed, where the cover doesn’t descend, but a small portion of it moves into position so that the lamp shines just on a particular part of your body at a time.  In fact, that’s what I tell my kids happens during radiation:  the light shines on my chest, and I get a sunburn.

The goal of radiation is to kill any remaining cancer cells that escaped before surgery (my pathology report showed that the cancer did escape from each of the 13 positive lymph nodes into the surrounding tissue in my armpit, but both were removed during surgery) and make the area inhospitable for cancer to return.

My latest science policy paper was accepted! Working title:  Principal investigators and project managers: insights from the Discovery line of small planetary missions.  No, it’s not bench science, but on the plus side, I don’t have to have a multi-million dollar mass spectrometer taking up space in my guest bedroom.

So there, cancer!  I’ve got the trifecta today:  treatment, possibility of new and targeted treatment, and accomplishments that have nothing to do with cancer.

Today is a win for me, not the cancer.

Advertisement