Feeds:
Posts
Comments

Archive for August 13th, 2010

Cancer Miracles

A cancer patient, given just months to live, stages a miraculous recovery. Doctors dismiss it as a fluke. Yet the mystery may offer crucial clues to fighting cancer.

Charles Burrows was given two months to live in 2005. Then, with no treatment, his liver tumor vanished. ‘I won a lottery,’ he says.

Charles Burrows noticed a strange lump on his stomach in the summer of 2005. By November the pain was so bad it felt like a knife was stabbing him in the stomach. A ct scan and a biopsy confirmed Burrows’ worst fears: He had inoperable liver cancer.

Few cancers have a worse prognosis. His tumor, the size of a baseball, was already starting to strangle the portal vein going into the liver. Doctors at the Phoenix Veterans Affairs Health Care System told Burrows, then 56 years old, there was nothing they could do. “They said, ‘Get your affairs in order because you have 30 days to live, maybe 60,'” recalls Burrows, who is divorced with three grown kids.

Buzz Burrows quit his carpentry job and spent the next two months in a fog. Then things got very strange. In February 2006 Burrows developed abdominal bloating, shaking, chills and nausea. Soon after that he noticed that the lump on his stomach was gone. By then his daughter had found a doctor in private practice willing to consider treating him. But the doctor couldn’t find a tumor. He went back to the VA, where gastroenterologist Nooman Gilani was flabbergasted when computed tomography and magnetic resonance imaging scans showed no sign of cancer. Where the tumor had once been, there was “literally empty space,” Gilani says.

Burrows remains free of cancer three years later and still seems dazed by the turn of events. “I won a lottery, and I don’t understand why,” he says. “I would like someone to explain to me what the heck happened.”

Ole Nielsen Schou also looked like a goner. In 2002 the Danish pharmaceutical production manager (now 69 and retired) found out that his melanoma had spread to his liver, abdomen, lungs, bones and ten spots in his brain. The abdominal tumor was surgically removed, but doctors at Rigshospitalet in Copenhagen had no treatment for his other tumors. He took a strange cocktail of 17 vitamins and supplements, including shark cartilage pills, and imagined the metastases were rats and he was chasing them with a club. In Depth: 6 Miracle Cancer Survivors.

Four months later he went back for a new scan and found that 90% of his tumors had melted away. Soon they were gone. Co-workers hugged and kissed him when they heard the news. Plastic surgeon Vennegaard Kalialis, who detailed his case last year in Melanoma Research, doubts it was the vitamins. “It is a complete mystery,” she says. “Nobody has seen anything like this.”

Spontaneous tumor regressions are among the rarest and most mysterious events in medicine, with only several hundred cases in the literature that can be considered well documented. Regressions have most often been reported in melanoma and in kidney cancer. But the phenomenon may, in fact, be an everyday one, taking place beyond doctors’ eyes. A recent study suggests that as many as 1 in 3 breast tumors may vanish on their own before being detected by a doctor.

Why do some patients get lucky?

Scientists are finding tantalizing evidence that the immune system, the body’s defense against disease-causing microbes, kicks in to play a critical role in combating cancer. If that’s the case, then Schou and Burrows are more than just lucky patients. They are clues to how doctors may someday save thousands of lives.

The evidence includes the fact that some unexplained remissions have occurred after infections, which may propel the immune system into high gear–possibly attacking the cancer tumor as well as the infection. Burrows’ remission seemed to begin after his strange illness. Schou’s abdominal tumor when removed was swarming with white blood cells, the lead weapon in the body’s immune system. It’s also possible that ordinary cancer survivors, people who beat the disease after getting radiation, chemotherapy or surgery, get an assist from their own immune systems.

Big drug companies, including Pfizer Bristol-Myers Squibb and Sanofi-Aventis are doggedly pursuing drugs that aim to boost the immune system to fight cancer. GlaxoSmithkline is in final-stage tests of a vaccine to prevent lung cancer from coming back after surgery. In an early trial it slashed the probability of cancer recurrence by 27%. “It is all about educating the patients’ natural defenses against cancer,” says GlaxoSmithkline’s Vincent Brichard. Easier said than done, of course. Some patients, apparently, need only a small trigger to propel a massive anticancer attack. With nearly all others, however, the cancer cells fight back successfully and even co-opt immune cells to aid their growth. Why some patients respond better than others to certain drugs is a focus of furious scrutiny.

The role of the immune system in controlling cancer has been hotly debated for decades–and indeed many scientists remain unconvinced. But Jedd D. Wolchok, an oncologist at New York’s Memorial Sloan-Kettering Cancer Center, thinks there is a connection. A spontaneous remission, he says, is “either divine intervention or the immune system.” While few researchers directly study such cases–they are far too rare–they provide hints of what the immune system might be able to do if we could harness it.

The immune system work is part of a new twist on the war on cancer. For decades cancer researchers have focused mostly on killing cancer cells with drugs and radiation, or removing them with surgery. But this is often impossible to accomplish. So scientists are studying the environment around tumors in order to invent drugs that will halt their spread. Such drugs, like Genentech ‘s Avastin, would be the medical equivalent of cutting terrorist-cell supply lines or putting up security checkpoints to stop them from getting into vital areas.

One of the first scientists to try to trigger the immune system to attack cancer was the New York surgeon William Coley. He was inspired by a patient with sarcoma who recovered after suffering an acute bacterial infection. In the 1890s Coley started vaccinating other patients with killed bacteria. He claimed that his toxins spurred the immune system to destroy tumors in a minority of cases.

In the 1980s the natural immune protein interleukin-2 was touted as a breakthrough. But it turned out to help only a small minority of cancer patients and to sport an array of nasty side effects. Over the years numerous trials of anticancer vaccines designed to train the immune system to recognize cancer have shown mostly lackluster results. None of these new therapeutic vaccines is approved in the U.S.

But intriguing data suggest that the immune system can combat cancer sometimes. “To the body, a tumor looks like the biggest bacteria it has ever seen,” says Robert Schreiber, an immunologist at Washington University School of Medicine in St. Louis. He has found that mice lacking key components of their immune system are far more likely to develop cancers. In one experiment 60% of mice missing something called the gamma interferon receptor on their cells got tumors after being exposed to a carcinogen, versus only 15% of normal mice.

Read Full Post »