DiversityNursing Blog

By Sarah Buhr

Detecting cancer could be as easy as popping a pill in the near future. Google’s head of life sciences, Andrew Conrad, took to the stage at the Wall Street Journal Digital conference to reveal that the tech giant’s secretive Google[x] lab has been working on a wearable device that couples with nanotechnology to detect disease within the body.

“We’re passionate about switching from reactive to proactive and we’re trying to provide the tools that make that feasible,” explained Conrad. This is a third project in a series of health initiatives for Google[x]. The team has already developed a smart contact lens that detects glucose levels for diabetics and utensils that help manage hand tremors in Parkinson’s patients.

The plan is to test whether tiny particles coated “magnetized” with antibodies can catch disease in its nascent stages. The tiny particles are essentially programmed to spread throughout the body via pill and then latch on to the abnormal cells. The wearable device then “calls” the nanoparticles back to ask them what’s going on with the body and to find out if the person who swallowed the pill has cancer or other diseases.

“Think of it as sort of like a mini self-driving car,” Conrad simplified with a clear reference to Google[x]‘s vehicular project. “We can make it park where we want it to.” Conrad went on with the car theme, saying the body is more important than a car and comparing our present healthcare system as something that basically only tries to change our oil after we’ve broken down. “We wouldn’t do that with a car,” he added.

Bikanta’s tiny diamonds luminesce cells in the body.

Similar to Y Combinator-backed Bikanta, the cells can also fluoresce with certain materials within the nanoparticles, helping cancer cells to show up on an MRI scan much earlier than has been possible before.

This has all sorts of implications in medicine. According to a separately released statement from Google today, “Maybe there could be a test for the enzymes given off by arterial plaques that are about to rupture and cause a heart attack or stroke. Perhaps someone could develop a diagnostic for post-surgery or post-chemo cancer patients – that’s a lot of anxious people right there (note: we’d leave this ‘product development’ work to companies we’d license the tech to; they’d develop specific diagnostics and test them for efficacy and safety in clinical trials.”

We essentially wouldn’t need to go into the doctor and give urine and blood samples anymore. According to Conrad, we’d simply swallow a pill and monitor for disease on a daily basis. We’d also be able to upload that data into the cloud and send it to our doctor. “So your doctor could say well for 312 days of this year everything looks good but these past couple of months we’re detecting disease,” Conrad said.

Privacy and security, particularly in health care is essential. Google came under fire in the last couple of years for handing over information to the U.S. government. Conrad was quick to mention that a partner, not Google would be handling individual data. “It’d be like saying GE is in control of your x-ray. We are the creators of the tech and they are the disseminators,” Conrad clarified.

The U.S. government has an active interest in this space, as well. It’s invested over $20 billion in nanotechnology research since 2013.

This project is in the exploratory phases but Conrad was hopeful that we’d be seeing this technology in the hands of every doctor within the next decade. He also mentioned that his team has explored ways of not just detecting abnormal cells but also delivering medicine at the same time. “That’s certainly been discussed,” he said, but cautioned that this was something that needed to be carefully developed so that the nanoparticles had a chance to show what was happening in the body before destroying the cells.

So far 100 Google employees with expertise in astrophysics, chemistry and electrical engineering have taken part in the nanoparticle project. “We’re trying to stave off death by preventing disease. Our foe is unnecessary death,” Conrad added.

Source: www.msn.com

By JESSICA FIRGER

When Donna Tookes learned she had breast cancer last winter, the 59-year-old thought she had no choice but to accept one of the most dreaded side-effects of chemotherapy: losing her mane of silver hair, a feature that strangers young and old frequently stopped to admire.

"I had resigned myself," Tookes told CBS News. "I had purchased an array of scarves, about 10. And I actually practiced tying them."

Tookes was diagnosed with breast cancer in January after her annual mammogram, when her doctors detected some mild calcifications in her right breast. These clusters of white flecks visible on her scan indicated there might be something seriously wrong. After a few subsequent tests, Tookes learned she had HER2 breast cancer, an especially aggressive form that can be difficult to treat. Though her doctors caught the cancer early, they wanted to be certain it would never return, which meant a unilateral mastectomy followed by 12 rounds of punishing chemotherapy.

"You have a consultation before you start chemotherapy," said Tookes, who lives with her husband and children in Stamford, Connecticut, and has worked for more than three decades as a flight attendant. "I was told I would lose my hair. And then the nurse assured me, she told me 'you're beautiful,' and that I was one of the only ones who could carry the bald look because I have that bone structure."

But her family could see that losing her hair would take a serious toll on her psyche. Tookes had heard about some treatment in Europe that helps prevent chemo-related hair loss, though she didn't know many details. Secretly, her husband began to conduct research. He wrote to friends in Sweden, who were able to obtain information about a new and innovative therapy called a scalp cooling cap. He soon found out that Mount Sinai Beth Israel in New York City was involved in a clinical trial on the device, known as the DigniCap System, which is worn by a patient during chemotherapy transfusions.

The snug cap is secured onto a patient's head each time she undergoes chemotherapy. It chills the scalp down to 5 degrees Celsius so that the blood vessels surrounding the hair roots contract, meaning that less of the toxins from chemo enter the hair follicle. This minimizes -- and in some cases completely stops -- a patient's hair from falling out.

At first, Tookes was slightly skeptical, but her family finally convinced her to move her cancer treatment from her hospital in Connecticut to Mount Sinai Beth Israel in New York City.

Dr. Paula Klein, assistant professor of medicine, hematology and medical oncology at the Icahn School of Medicine at Mount Sinai and principal investigator for the clinical trial, told CBS News the device has been effective at limiting hair loss in nearly all of her patients enrolled.

"Unfortunately, in breast cancer the two most active agents are associated with significant hair loss," said Klein. "For many women with early stage breast cancer, they are getting chemotherapy for prevention of recurrence."

Klein said overall, women who use the cap lose just 25 percent of their hair. There are some patients who lose more and a lucky handful who lost no hair at all.

The clinical trial is now in its final phase. The company behind the cap, Dignitana, will be submitting results to the U.S. Food and Drug Administration by the end of November, and hope to win FDA approval for the cap in 2015.

For women struggling through a difficult medical ordeal, the benefit is significant. Research published in 2008 in the journal Psycho-Oncology looked at 38 existing studies on breast cancer treatment and quality of life issues, and found hair loss consistently ranked the most troubling side effect of treatment for women. "Significant alopecia [hair loss] is problematic," said Klein. "Every time you look in the mirror, you remember you're getting cancer treatment."

Many breast cancer survivors report that even when their hair finally grows back after chemotherapy it is often different in color or texture than the hair they had before, due to the period of time it takes the hair follicles to recover from the damage caused by the drugs.

Moreover, the feelings associated with hair loss impact nearly every aspect of a breast cancer patient's life -- from her self-image and sexuality to whether or not she is comfortable at work or even walking into the supermarket to buy a quart of milk.

When she first prepared for treatment, Tookes worried how people would react to her appearance if she lost all of her hair. But it didn't happen. Seven weeks into chemo, she finally felt confident enough to return the unused wardrobe of scarves. She still had a full head of hair. Because the cooling therapy was used only on her scalp, Tookes did still lose her eyebrows and "everything south of there."

Tookes is now cancer-free and says the therapy helped her stay optimistic about her prognosis. "My mother used to say, you just comb your hair and get yourself together and you'll get through hard times," she said.

Source: www.cbsnews.com

By Eun Kyung Kim

It takes nerves of steel to win World Cup, World Championship and Olympic titles like Mikaela Shiffrin. Yet, the alpine skier melted into a pool of tears after hearing from a young Swedish girl she has called her “little lucky charm.”

Shiffrin met 11-year-old Emma Lundell two years ago in Are, Switzerland, after winning her first World Cup title, NBC Sports reported. Emma was battling leukemia at the time and had asked Shiffrin for a photograph.

“That was the biggest wake up call," Shiffrin recalled for Swedish publication SPORT-Expressen, which surprised her with a video update from Emma, who is now 13 and has finished chemotherapy treatments. Emma, whose hair has grown back, says she's even healthy enough to resume cross-country skiing.

“I’m so honored that you have thought of me. To be mentioned as your lucky charm is the nicest and greatest thing ever,” she said in her message to Shiffrin, who repeatedly wiped away tears while watching.

“Wow,” Shiffrin said. “She looks so good. Oh my gosh, that makes me so happy. I wonder about her a lot actually.”

And the skier's reply to her young fan was equally moving. 

"Emma, I’m so glad that you’re healthy, and that your chemo is done, and your hair is beautiful,” she said.

“I hope I see you again, maybe in Are. I think about you a lot and I’m very glad that I met you because you keep me grounded when I get arrogant. And I think about how tough it must have been for you, and I’m so glad to have met you and I wish you the best.”

Source: www.today.com

By Catharine Paddock PhD

At present, diagnosis of lung cancer relies on an invasive biopsy that is only effective after tumors are bigger than 3 cm or even metastatic. Earlier detection would vastly improve patients' chances of survival. Now a team of researchers is developing a "lab-on-a-chip" that promises to detect lung cancer - and possibly other deadly cancers - much earlier, using only a small drop of a patient's blood.

In the Royal Society of Chemistry journal, Yong Zeng, assistant professor of chemistry at the University of Kansas, and colleagues report a breakthrough study describing their invention.

For some time, scientists have been excited by the idea of testing for disease biomarkers in "exosomes" - tiny vesicles or bags of molecules that cells, including cancer cells - release now and again. When they first spotted them, researchers thought exosomes were just for getting rid of cell waste, but now they know they also do other important things such as carry messages to other cells near and far.

The challenge, however, is developing a technology that is small enough to target and analyze the contents of exosomes - mostly nucleic acids and proteins - to find unique biomarkers of disease. This is because exosomes are tiny - around 30 to 150 nanometers (nm) in diameter - much smaller, for example, than red blood cells.

Current methods for separating out and testing exosomes require several steps of ultracentrifugation - a lengthy and inefficient lab procedure, as Prof. Zeng explains:

"There aren't many technologies out there that are suitable for efficient isolation and sensitive molecular profiling of exosomes. First, current exosome isolation protocols are time-consuming and difficult to standardize. Second, conventional downstream analyses on collected exosomes are slow and require large samples, which is a key setback in clinical development of exosomal biomarkers."

Now, using microfluid technology, he and his colleagues have developed a lab-on-a-chip that can analyze the contents of targeted exosomes and spot the early signs of deadly cancer. They have already successfully tested it on lung cancer.

Lab-on-a-chip device uses smaller samples, is faster, cheaper and more sensitive

The new device, which uses much smaller samples, promises to produce results faster, more cheaply, with better sensitivity compared to conventional benchtop instruments, as Prof. Zeng continues to explain:

"A lab-on-a-chip shrinks the pipettes, test tubes and analysis instruments of a modern chemistry lab onto a microchip-sized wafer."

The technology behind the device - known as microfluidics - came out of new semiconductor electronics and has been under intensive development since the 1990s, he adds:

"Essentially, it allows precise manipulation of minuscule fluid volumes down to one trillionth of a liter or less to carry out multiple laboratory functions, such as sample purification, running of chemical and biological reactions, and analytical measurement."

Unlike breast and colon cancer, there is no widely accepted screening tool for lung cancer, which in most cases is first diagnosed based on symptoms that normally indicate lung function is already impaired.

To diagnose lung cancer, doctors have to perform a biopsy - remove a piece of tissue from the lung and send it to a lab for molecular analysis. It is rarely possible to do this in the early stages as tumors are too small to be spotted on scans.

"In contrast, our blood-based test is minimally invasive, inexpensive, and more sensitive, thus suitable for large population screening to detect early-stage tumors," says Prof. Zeng, adding that the technique offers a general platform for detecting exosomes from cancer cells. The team has already used the device to test for ovarian cancer, and in theory, says Prof. Zeng, it should also be applicable to other cancer types.

"Our long-term goal is to translate this technology into clinical investigation of the pathological implication of exosomes in tumor development. Such knowledge would help develop better predictive biomarkers and more efficient targeted therapy to improve the clinical outcome," he adds.

The team has received further funding from the National Cancer Institute at the National Institutes of Health to further develop the lab-on-a-chip.

In March 2013, Medical News Today learned how another team of scientists is developing a lab-on-a-chip that is implanted under the skin to track levels of substances in the blood and transmit the results wirelessly to a smartphone or other receiving device.

Source: www.medicalnewstoday.com

By Brittany Maynard

Editor's note: Brittany Maynard is a volunteer advocate for the nation's leading end-of-life choice organization, Compassion and Choices. She lives in Portland, Oregon, with her husband, Dan Diaz, and mother, Debbie Ziegler. Watch Brittany and her family tell her story at www.thebrittanyfund.org. The opinions expressed in this commentary are solely those of the author.

(CNN) -- On New Year's Day, after months of suffering from debilitating headaches, I learned that I had brain cancer.

I was 29 years old. I'd been married for just over a year. My husband and I were trying for a family.

Our lives devolved into hospital stays, doctor consultations and medical research. Nine days after my initial diagnoses, I had a partial craniotomy and a partial resection of my temporal lobe. Both surgeries were an effort to stop the growth of my tumor.

In April, I learned that not only had my tumor come back, but it was more aggressive. Doctors gave me a prognosis of six months to live.

Because my tumor is so large, doctors prescribed full brain radiation. I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone.

After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.

I considered passing away in hospice care at my San Francisco Bay-area home. But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind.

Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.

I did not want this nightmare scenario for my family, so I started researching death with dignity. It is an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live. It would enable me to use the medical practice of aid in dying: I could request and receive a prescription from a physician for medication that I could self-ingest to end my dying process if it becomes unbearable.

I quickly decided that death with dignity was the best option for me and my family.

We had to uproot from California to Oregon, because Oregon is one of only five states where death with dignity is authorized.

I met the criteria for death with dignity in Oregon, but establishing residency in the state to make use of the law required a monumental number of changes. I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver's license, change my voter registration and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job. The vast majority of families do not have the flexibility, resources and time to make all these changes.

I've had the medication for weeks. I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms.

I would not tell anyone else that he or she should choose death with dignity. My question is: Who has the right to tell me that I don't deserve this choice? That I deserve to suffer for weeks or months in tremendous amounts of physical and emotional pain? Why should anyone have the right to make that choice for me?

Now that I've had the prescription filled and it's in my possession, I have experienced a tremendous sense of relief. And if I decide to change my mind about taking the medication, I will not take it.

Having this choice at the end of my life has become incredibly important. It has given me a sense of peace during a tumultuous time that otherwise would be dominated by fear, uncertainty and pain.

Now, I'm able to move forward in my remaining days or weeks I have on this beautiful Earth, to seek joy and love and to spend time traveling to outdoor wonders of nature with those I love. And I know that I have a safety net.

I hope for the sake of my fellow American citizens that I'll never meet that this option is available to you. If you ever find yourself walking a mile in my shoes, I hope that you would at least be given the same choice and that no one tries to take it from you.

When my suffering becomes too great, I can say to all those I love, "I love you; come be by my side, and come say goodbye as I pass into whatever's next." I will die upstairs in my bedroom with my husband, mother, stepfather and best friend by my side and pass peacefully. I can't imagine trying to rob anyone else of that choice.

What are your thoughts about "death with dignity"?

Source: CNN

Source:http://www.inquisitr.com

By Nicole Scobie

Here's a light-hearted look at cancer treatment from the point of view of my son Elliot, who was only 4 1/2 when he was diagnosed. I know many of the adults I am in touch with who have cancer or who are helping a person with cancer through this journey, will relate!

Advice to adults with cancer from a 5-year-old:

1. It is perfectly acceptable to have a complete tantrum and throw your shoes around just before leaving for the hospital.

2. You always deserve a present after chemo.

3. If you feel like showing more respect and politeness to the hospital clown than your oncologist, that's OK.

4. If you manage to grab the syringe of medicine from the nurse, it's their loss and you are then allowed to squirt its entire content around the room.

5. You are allowed to complain loudly about any smells like perfume, but you are also allowed to fart freely whenever and wherever you want.

6. Anyone who says "this one tastes like syrup" better be not be lying or they can expect to catch some spit.

7. You are allowed to worry about life and death, but only to the same extent that you worry about whether Santa Claus will be able enter your home if you don't have a chimney.

8. Speaking of worry, you are not allowed to worry about anything that is not going to happen today or tomorrow.

9. Any bad thing that happened in the past should be quickly erased from your mind using ice cream.

10. It's OK to throw up directly on your caregiver instead of into the bucket they are holding. It will create warm and funny memories for them once this is all over.

11. Good friends may stare when they first see you without any hair, but they are quickly more interested in all your new toys. So make sure you have lots of new toys around all the time.

12. It is the right thing to do to jump off the examining table if the doctor's hands are too cold.

13. A popsicle for breakfast is a good idea and goes well with bacon.

14. If someone rubs your bald head and says you're cute, you should stare at them in complete boredom until they stop.

15. Always believe that scars are badges of courage and make you look like a pirate or a superhero.

16. Jumping on the bed is a perfectly acceptable form of exercise.

17. Someone should always be available to carry you if you don't feel like walking anymore and they will be grateful if you look at them lovingly and say, "You're walking too slowly."

18. It's a good idea to frequently press the little button next to the bed that makes the nurse come running, because she might be lonely and bored and enjoys picking your crayon up from the floor.

19. The only part of hospital food you should eat is the dessert. The rest is not really food, anyway.

20. Make having fun your priority all the time, no matter where you are or what's going to happen next.

Source: http://www.huffingtonpost.com

By Alice Gomstyn

How do you pass the time when cancer treatment means you're largely confined to your hospital room for weeks on end?

Tom Gillin, a 19-year-old college student, chose a less-than-obvious choice: He filmed a funny rap video channeling Jay-Z via the cancer ward.

"Some of the other videos I've seen about cancer patients are somewhat depressing," said Gillin, who was diagnosed with the pediatric cancer acute myeloid leukemia in April. "We wanted to flip the switch and do something that was the opposite of that."

Gillin teamed with several staffers at The Children's Hospital of Philadelphia to create "Bald So Hard." The video's title refers to Gillin's chemotherapy-related hair loss but is also a play on the phrase "ball so hard" featured prominently in a hit song by Jay-Z and Kanye West. The song is parodied in Gillin's video, as is Jay-Z's "Empire State of Mind."

The rollicking video — promoted on Twitter with the hashtag #BaldSoHard — is full of swagger. Gillin is seen mouthing lyrics such as "bald so hard my head got shiny" while dancing with his oncologist, playing basketball and even steering a "boat," a cardboard cutout made by hospital art therapist Abbien Crowley. (The actual rap was performed, mostly off camera, by University of Pennsylvania medical student David Blitzer.)

But Gillin didn't shy away from the fatigue and boredom confronting hospital cancer patients. It took him and his hospital pals some two months to complete the three-minute video since chemotherapy treatments often left him too weak to shoot.

The song's lyrics, written by Gillin and CHOP music therapist Mike Mahoney, manage to make light of it: "They gave me sleeping meds all day and I was dozing/When I got up I was so bored that I watched 'Frozen.'"

Gillin said his main motivation for making the video was to raise awareness of pediatric cancer, though he'd also appreciate it if Jay-Z — one of the teen's favorite rappers — took note of the unusual homage and paid the hospital a visit.

But don't expect Gillin to use the video to launch his own hip hop career. "I'm not that musically inclined," he insists.

Instead, he's looking forward to completing his final round of chemotherapy in a couple of weeks and ultimately returning to student life at the University of California, Los Angeles, where he's studying civil engineering.

For now, he's enjoying the happy reactions to his video, which has generated more than 20,000 views on YouTube since it debuted late last month. The Jigga Man himself hasn't yet weighed in but plenty of others say they love Gillin's jam, with one YouTube user dubbing it "best medicine in the world."

Source: http://www.today.com

By JOSHUA A. KRISCH

McBaine, a bouncy black and white springer spaniel, perks up and begins his hunt at the Penn Vet Working Dog Center. His nose skims 12 tiny arms that protrude from the edges of a table-size wheel, each holding samples of blood plasma, only one of which is spiked with a drop of cancerous tissue.

The dog makes one focused revolution around the wheel before halting, steely-eyed and confident, in front of sample No. 11. A trainer tosses him his reward, a tennis ball, which he giddily chases around the room, sliding across the floor and bumping into walls like a clumsy puppy.

McBaine is one of four highly trained cancer detection dogs at the center, which trains purebreds to put their superior sense of smell to work in search of the early signs of ovarian cancer. Now, Penn Vet, part of the University of Pennsylvania’s School of Veterinary Medicine, is teaming with chemists and physicists to isolate cancer chemicals that only dogs can smell. They hope this will lead to the manufacture of nanotechnology sensors that are capable of detecting bits of cancerous tissue 1/100,000th the thickness of a sheet of paper.

“We don’t ever anticipate our dogs walking through a clinic,” said the veterinarian Dr. Cindy Otto, the founder and executive director of the Working Dog Center. “But we do hope that they will help refine chemical and nanosensing techniques for cancer detection.”

Since 2004, research has begun to accumulate suggesting that dogs may be able to smell the subtle chemical differences between healthy and cancerous tissue, including bladder cancer, melanomaand cancers of the lung, breast and prostate. But scientists debate whether the research will result in useful medical applications.

Dogs have already been trained to respond to diabetic emergencies, or alert passers-by if an owner is about to have a seizure. And on the cancer front, nonprofit organizations like the In Situ Foundation, based in California, and the Medical Detection Dogs charity in Britain are among a growing number of independent groups sponsoring research into the area.

A study presented at the American Urological Association’s annual meeting in May reported that two German shepherds trained at the Italian Ministry of Defense’s Military Veterinary Center in Grosseto were able to detect prostate cancer in urine with about 98 percent accuracy, far better than the prostate-specific antigen (PSA) test. But in another recent study of prostate-cancer-sniffing dogs, British researchers reported that promising initial results did not hold up in rigorous double-blind follow-up trials.

Dr. Otto first conceived of a center to train and study working dogs when, as a member of the Federal Emergency Management Agency’s Urban Search and Rescue Team, she was deployed to ground zero in the hours after the Sept. 11 attacks.

“I remember walking past three firemen sitting on an I-beam, stone-faced, dejected,” she says. “But when a handler walked by with one of the rescue dogs, they lit up. There was hope.”

Today, the Working Dog Center trains dogs for police work, search and rescue and bomb detection. Their newest canine curriculum, started last summer after the center received a grant from the Kaleidoscope of Hope Foundation, focuses on sniffing out a different kind of threat: ovarian cancer.

“Ovarian cancer is a silent killer,” Dr. Otto said. “But if we can help detect it early, that would save lives like nothing else.”

Dr. Otto’s dogs are descended from illustrious lines of hunting hounds and police dogs, with noses and instincts that have been refined by generations of selective breeding. Labradors and German shepherds dominate the center, but the occasional golden retriever or springer spaniel — like McBaine — manages to make the cut.

The dogs, raised in the homes of volunteer foster families, start with basic obedience classes when they are eight weeks old. They then begin their training in earnest, with the goal of teaching them that sniffing everything — from ticking bombs to malignant tumors — is rewarding.

“Everything we do is about positive reinforcement,” Dr. Otto said. “Sniff the right odor, earn a toy or treat. It’s all one big game.”

Trainers from the center typically notice early on that certain dogs have natural talents that make them better suited for specific kinds of work. Search and rescue dogs must be tireless hunters, unperturbed by distracting environments and unwilling to give up on a scent – the equivalent of high-energy athletes. The best cancer-detection dogs, on the other hand, tend to be precise, methodical, quiet and even a bit aloof — more the introverted scientists.

“Some dogs declare early, but our late bloomers frequently switch majors,” Dr. Otto said.

Handlers begin training dogs selected for cancer detection by holding two vials of fluid in front of each dog, one cancerous and one benign. The dogs initially sniff both but are rewarded only when they sniff the one containing cancer tissue. In time, the dogs learn to recognize a unique “cancer smell” before moving on to more complex tests.

What exactly are the dogs sensing? George Preti, a chemist at the Monell Chemical Senses Center in Philadelphia, has spent much of his career trying to isolate the volatile chemicals behind cancer’s unique odor. “We have known for a long time that dogs are very sensitive detectors,” Dr. Preti says. “When the opportunity arose to collaborate with Dr. Otto at the Working Dog Center, I jumped on it.”

Dr. Preti is working to isolate unique chemical biomarkers responsible for ovarian cancer’s subtle smell using high-tech spectrometers and chromatographs. Once he identifies a promising compound, he tests whether the dogs respond to that chemical in the same way that they respond to actual ovarian cancer tissue.

“I’m not embarrassed to say that a dog is better than my instruments,” Dr. Preti says.

The next step will be to build a mechanical, hand-held sensor that can detect that cancer chemical in the clinic. That’s where Charlie Johnson a professor at Penn who specializes in experimental nanophysics, the study of molecular interactions between microscopic materials, comes in.

He is developing what he calls Cyborg sensors, which include biological and mechanical components – a combination of carbon nanotubes and single-stranded DNA that preferentially bond with one specific chemical compound. These precise sensors, in theory, could be programmed to bind to, and detect, the isolated compounds that Dr. Otto’s dogs are singling out.

“We are effectively building an electronic nose,” said Dr. Johnson, who added that a prototype for his ovarian cancer sensor will probably be ready in the next five years.

Some experts remain skeptical.

“While I applaud any effort to detect ovarian cancer, I’m uncertain that this research will have any value,” said Dr. David Fishman, a gynecologic oncologist at Mount Sinai Hospital in New York City. One challenge, he notes, is that any cancer sensor would need to be able to detect volatile chemicals that are specific to one particular type of cancer.

“Nonspecificity is where a lot of these sort of tests fail,” Dr. Fishman said. “If there is an overlap in volatile chemicals — between colon, breast, pancreatic, ovarian cancer — we’ll have to ask, ‘What does this mean?’ ”

And even if sensors could be developed that detect ovarian cancer in the clinic, Dr. Fishman says, he doubts that they would be able to catch ovarian cancer in its earliest, potentially more treatable, stages.

“The lesions that we are discussing are only millimeters in size, and almost imperceptible on imaging studies,” Dr. Fishman says. “I don’t believe that the resolution of the canine ability will translate into value for these lesions.”

McBaine remains unaware of the debate. After correctly identifying yet another cancerous plasma sample, he pranced around the Working Dog Center with regal flair, showing off his tennis ball to anyone who would pay attention. In an industry saturated with hundreds of corporations and thousands of scientists all hunting for the earliest clues to cancer, working dogs are just another set of (slightly furrier) researchers.

Source: http://well.blogs.nytimes.com

By JANE E. BRODY

The teenage years can be tough enough under the best of circumstances. But when cancer invades an adolescent’s life, the challenges grow exponentially.

When the prospects for treatment are uncertain, there’s the fear of dying at so young an age. Even with an excellent chance of being cured, teenagers with cancer face myriad emotional, educational and social concerns, especially missing out on activities and losing friends who can’t cope with cancer in a contemporary.

Added to that are the challenges of trying to keep up with schoolwork even as cancer treatment steals time and energy, and may cause long-lasting physical, cognitive or psychological side effects.

Sophie, who asked that her last name be withheld, was told at 15 that she had osteosarcoma, bone cancer. After a bout of how-can-this-be-happening-to-me, she forged ahead, determined to stay at her prestigious New York high school and graduate with her class.

Although most of her sophomore year was spent in the hospital having surgery and exhausting chemotherapy, she went to school on crutches whenever possible. She managed to stay on track, get good grades — and SAT scores high enough to get into Cornell University.

Now 20, Sophie is about to start her junior year and is majoring in biology and genetics with a minor in computer science. She plans to go to medical school, so this summer she has been studying for the MCATs and volunteering at a hospital.

Her main concern now is that people meet and get to know her as a whole, normal person, not someone who has had cancer, which is why she asked that I not identify her further.

“I’m pretty healthy, and I don’t want people to think I’m weak and need special care,” she said in an interview.

“Having cancer puts other issues into perspective,” she added. “I feel like I have to do as much as I can. I’ve gotten involved in so much. I try to enjoy myself more. And I don’t regret for a minute how I’ve been spending my time.”

Sophie’s determination to do the most she can and her desire for normalcy are hardly unusual, said Aura Kuperberg, who directs an extraordinary program for teenagers with cancer and their families at Children’s Hospital Los Angeles. Dr. Kuperberg, who has a doctorate in social work, started the program, called Teen Impact, in 1988. It operates with the support of donations and grants and deserves to be replicated at hospitals elsewhere.

“The greatest challenge teens with cancer face is social isolation,” she said in an interview. “Many of their peers are uncomfortable with illness, and many teens with cancer may withdraw from their friends because they feel they are so different and don’t fit in.”

In the popular young adult novel “The Fault in Our Stars,” a teenager with advanced cancer says, “That was the worst part of having cancer, sometimes: The physical evidence of disease separates you from other people.”

Within the family, too, teenagers can feel isolated, Dr. Kuperberg said. “Patients and parents want to protect one another. They keep up a facade that everything will be O.K., and feelings of depression and anxiety go unexpressed.”

Teen Impact holds group therapy sessions for young patients, parents and siblings so they “don’t feel alone and realize that their feelings are normal,” Dr. Kuperberg said. The goal of the program, which also sponsors social activities, is to help young cancer patients — some still in treatment, others finished — live as normally as possible.

“For many, cancer is a chronic illness, with echoes that last long after treatment ends,” Dr. Kuperberg said. “There are emotional side effects — a sense of vulnerability, a fear of relapse and death, and an uncertainty about the future that can get in the way of pursuing their hopes and dreams. And there can be physical and cognitive side effects when treatment leaves behind physical limitations and learning difficulties.”

But, she added, there is often “post-traumatic growth that motivates teens in a very positive way.”

“There’s a lot of altruism,” she said, “a desire to give back, and empathy, a sensitivity to what others are going through and a desire to help them.”

Sophie, for example, took notes for a classmate with hearing loss caused by chemotherapy. She recalled her gratitude for the friend “who was there for me the whole time I was in treatment, who would come over after school and sit on the couch and do puzzles while I slept.”

One frequent side effect of cancer treatment now receiving more attention is the threat to a young patient’s future reproductive potential.

In an opinion issued this month, The American College of Obstetricians and Gynecologists urged doctors to address the effects of cancer treatment on puberty, ovarian function, menstrual bleeding, sexuality, contraceptive choice, breast and cervical cancer screening, and fertility.

“With survival rates pretty high now for childhood cancers, we should do what we can to preserve future fertility,” said Dr. Julie Strickland, the chairwoman of the college’s committee on adolescent health care. “We’re seeing more and more cooperation between oncologists and gynecologists to preplan for fertility preservation before starting cancer treatment.”

The committee suggested that, when appropriate, young cancer patients be referred to a reproductive endocrinologist, who can explore the “full range of reproductive options,” including the freezing of eggs and embryos.

For boys who have been through puberty, it has long been possible to freeze sperm before cancer treatment.

Although some female patients may be unwilling to delay treatment, even for a month, to facilitate fertility preservation, at the very least they should be offered the option, Dr. Strickland said in an interview.

She described experimental but promising possibilities, like freezing part or all of an ovary and then implanting it after cancer treatment ends. It is already possible to move ovaries out of harm’s way for girls who need pelvic radiation.

Source: http://well.blogs.nytimes.com