Meditations of an oncology geek

New Publication, Dissertation Approved, and Histology

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18 February 2014

It’s been a busy month! Well, most months are busy, but this one has been especially so, and I have some good news to show for it:

1) I am pleased to announce that my review article “Caspase-8 as a Regulartor of Tumor Cell Motility” has been published in Current Molecular Medicine and is available on PubMed.

2) About a week ago I had my pre-thesis defense meeting with my Thesis Committee. After a grueling two hour meeting my Committee Chair gave their verdict: “We are pleased with your progress, we accept your proposed graduation timeline and would like a draft of your dissertation in six weeks’ time.” Looks like I’ll be defending my thesis in the spring! I have not yet set a date, but it’s most likely going to be mid-May.

3) On top of all of that excitement I have been in the midst of my Med Into Grad program. It’s hard to appreciate the nuances and challenges of clinical oncology from the lab bench, and there are so many things that I see on a daily basis that could be aided with new technology. Often, the applications are not groundbreaking or miraculous or ideas that come down from the sky on sunbeams with chariots of angels singing a chorus; they are often subtle, but the sum of all of small innovations will aid modern oncology.

For instance, today I heard a surgeon describe being mid-surgery deep in the peritoneal cavity, his patient open on the operating table. He came across a lesion that looked very much like fibrosis, but was later revealed to be tumor after analysis of biopsy that he sampled just to be sure. A team of physicians then discussed how to move forward on the patient, who was still recovering from surgery with residual tumor cells remaining.

In another instance, a minor stir almost ensued when a patient was staged (via histology) as having a low-grade primary ovarian tumor, when it was more low-ish. The distinction matters tremendously, as the high grade (and more common) tumors will receive systemic, and sometimes preoperative, chemotherapy along with surgery, while the low grade tumors will be treated with surgery alone. The decision to give systemic chemotherapy is not taken lightly by clinical oncologists, and they absolutely need the most un-ambiguous information possible to do be the most effective with the least amount of harm.

I want to find out how subjective and reproducible the measures are that are currently used for diagnosis and guidance of treatment. I want to find means for emerging technology to help remove ambiguity in diagnosis and aid treatment. Could the emerging sequencing technologies and avenues like liquid biopsy provide a better means to asses tumor burden, extent of vascular invasion and prognostic response to existing and emerging therapies? Could this provide a more precise means of who needs what therapy?

In less than a week I’ll be starting my clinical rotations with histology. I’ll be observing how pathologists grade tumors and what sort of clinically relevant information is gleaned from microscopic observation of tumor samples, and how precise and / or subjective such measures are. It should be fun!

Ryon

Written by Ryon

February 18th, 2014 at 6:26 pm

Posted in Science Blog

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