Preparing for the right exam

There is probably nothing else my high school daughters detest more than those three letters. But I’m not here to give advice on how to achieve that perfect 1600 on the SAT. And what does this have to do with cancer research?

In scientific research, to study a disease, one needs to have a model of it. I don’t mean a plastic one, like a model airplane. I mean an animal model, usually, especially with cancer. The animal model allows us to study the disease process from beginning to end. The animal model allows us to re-create the disease in an experimental setting and “take it apart” to understand its intricate workings.

However, sometimes we think we can simply inject cancer cells into a mouse and as soon a tiny tumor develops, try to stop it with some drug. But that doesn’t reflect human reality, where if a cancer is discovered while the tumor is still small, then the surgeon immediately cuts it out – end of story. It hadn’t spread anywhere; it was small. No chemotherapy, just an excellent prognosis. Likewise, in this animal model, if a tumor is cut out when it’s small, the animal does equally well without any additional treatment, surviving for the rest of its life cancer-free. Most people are not dying of what has just been described, which is early-stage cancer, yet this is the animal model used in most cancer labs. If I’m enrolled in a bunch of SAT-prep courses, I must be planning to take the SAT exam, right? Therefore in a way, if scientists are using an animal model of early-stage cancer, they must be trying to discover a treatment for early-stage cancer. But we already have one, and it’s highly effective and rapid, and it’s called surgery (coming from a “unbiased” surgeon).

So what happens if the cancer is NOT caught early, as is usually the case? Eventually the tumor grows larger and begins to send out individual cancer cells to other parts of the body. Let’s refer to this as mid-stage cancer. The larger primary tumor is still able to be removed by surgery, sure, but surgery can’t remove the “invisible” cells that have gone to other parts of the body. Enter chemotherapy, to “clean up”and go where surgery cannot. Unfortunately, in many cases, several months or years later, the cancer reappears as recurrence and/or metastases, which ultimately claim the patient’s life. The majority of cancer deaths are from this mid-stage form of cancer.

In the same way that my daughters have to prepare for a specific test (SAT prep for SAT exam), we should use the right animal model for the human disease we’re trying to cure, which in this case should be mid-stage cancer, since this is where most deaths occur and where we need the most improvement. This is why, at Daniel 2:28, we intentionally wait for the tumors to reach the size where we know that “invisible” cancer cells have already started spreading to other parts of the body. This replicates and models the harder-to-treat mid-stage cancer. Only at this stage do we begin our experimental treatments. Of course surgery is always performed to remove the larger primary tumor. But if we stop there, the animal inevitably succumbs to metastatic recurrence. If a successful treatment is added, the animal survives cancer-free. As mentioned as one of our projects, we do have at least one drug-free treatment that achieves long-term survival after surgery for mid-stage cancer.

With God’s help, we will understand the mechanism, and find a way to translate this to the clinic. Stay tuned, and remember the importance of the right model for the right disease.

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