cancer – Page 3

Cancer research breakthrough

Assistant Professor Avi Schroeder of the Technion faculty of chemical engineering and the Technion Integrated Cancer Centre. (photo by Ashernet)

Technion researchers in Haifa have developed a new technology for determining the suitability of specific anticancer drugs to a specific patient – before treatment begins. The study, just published in Nature Communications, was led by Assistant Professor Avi Schroeder of the Technion faculty of chemical engineering and the Technion Integrated Cancer Centre. The researchers packed miniscule quantities of anticancer drugs, as well as placebo packages (which contained no drugs), inside dedicated nanoparticles they developed, which have the ability to flow in the bloodstream to the tumor. Attached synthetic DNA sequences served as barcode readers of the activity in the cancer cells. After 48 hours, a biopsy was taken and the anticancer drugs were found mainly in dead cancer cells – that is, they had killed them – while the placebos were found mainly in live cells – that is, they had not killed the cells. A comparison between various anticancer drugs also found differences in effectiveness.

Cancer makes me angry

Cancer. Now I’ve said it. Just saying it tightens up my gut. It makes me want to swallow. I look around to see if anyone can sense the anger, the blind rage that surges through me. I find myself breathing faster. The fight-or-flight chemicals prompted by fear are racing through my body. Mostly, I try not to think about it because of the instant effect it always has upon me. I don’t know about others, but I hate it. Just the thought of it makes me angry.

To me, the idea of cancer is like a living presence, dressed up in the image of death, stalking through our lives, the destroyer of health and happiness. It looks this way and that, it looks for those at whom it will swing its lethal scythe. I know it’s really like spores in the wind, poisons in the soil, air and water, or genetic predispositions hiding in our DNA, waiting for the merest provocation to flower like a deadly bloom of nightshade. I know it is like an evil charlatan that smilingly gives way to our defensive measures, only to strike back with deadly force when we have let down our guard. I know it has so many disguises and tricks that we have to learn the new ones every day that we are alive. It takes some of our best minds to keep us relevant in that battle.

I know about all the new promises, new hopes yet to be realized. We learn something new every day. But, so does cancer, reacting to counter every twist and turn we make. We are not there yet in spite of all the public promises that are made. It is not politically correct to say it, but the same promises were being made during the time cancer was a living presence in my home. So I retain the hate that I learned.

When it struck in our home, we reacted with shock. We marshaled our resources and radically changed our lifestyle. My late spouse gave up her stressful and demanding work. She was a simultaneous translation interpreter. She was the manager and creator of her own firm, one that was preeminent in Canada, but she delegated her work and ceased professional activity. She underwent a mastectomy, radiation and chemo. We changed our diet toward the completely macrobiotic and a shelf full of recommended natural products. The result – in six months all traces of the disease were eradicated! We declared victory. My spouse became a poster child, a survivor, to rally the spirits of all victims of the disease. After a year, we relaxed our guard and returned to our previous way of life.

Four or five years later, two cancer cells were discovered during the regular screening that had been maintained. The number of cells quickly multiplied and, after a time, a regular regime of chemotherapy was reintroduced, accompanied by multiple discomforts. This continued for years. No material effect on the disease’s progress was ever noted. Eventually, several metastases were discovered, until the cancer was generalized. None of the chemotherapy offered appeared to have had the least effect.

My role changed over time, as I became a full-time caregiver. Indeed, after years of feeling like a helpless bystander, there was great consolation in, at last, being able to play a useful role. I had the feeling I was witnessing hand-to-hand combat with the cancer, a living, breathing adversary. I hated the losses we were sustaining on a daily basis. The success of radiation sessions in fighting off the external manifestations of the cancer felt like victories.

At one point, the cancer prevented the kidneys from working. The doctors asked if we wanted them to intervene. Although my late wife declined, because she was suffering the effects of uremia, which impairs judgment, my resounding yes won the day. The intervention was successful. We went off on a two-week holiday in Italy. I treasure to this day the sight of her dancing to her own music on a sunny balcony in Tuscany.

The medical resort to radiation to eliminate ugly lesions that appeared, time after time, on various areas of the body, seemed like a blessing. But, the ultimate effect of these sessions was to destroy the ability of the body to produce the red and white blood cells we depend on for life. I did not understand that these were a signal that the medical profession had given up any hope of a remission, because the doctors continually talked to us of impending victory. I did not question it, full of continuing hope as I was. In effect, they were offering palliative care, while continuing to test drug combinations on my late wife.

Eventually, these blood cells could only be provided for her by external means. We learned, after a time, that these infusions of blood cells, enormously costly, were the only way to keep my late wife alive. I always assumed these would continue, but I marveled at the generosity of the system on which her life depended. The various chemotherapy combinations, with all their accompanying distress, continued to be presented by doctors as the answer and the cure. She followed every prescription faithfully in spite of the discomfort they engendered.

Suddenly, we were informed by the hospital administration that my late spouse was to be assigned to hospice care in our home. Calls to the doctors went unanswered. Any assistance I could provide was replaced by outside help. We were told that the life-giving infusions were being withdrawn. She expired after three weeks, 10 years after first contracting the disease.

I do not know if the doctors ever confided to my late wife the real state of the struggle in which we were engaged. If they did, she never shared the details with me. We never ever spoke of her impending demise.

I remain a survivor of the experience, full of anger at the caregivers, anger at my helplessness and ignorance, and full of rage against the inexorability, the implacability of the disease. Its overwhelming power in the face of our defences, even after once having been initially repulsed, gives me little faith in the happy claims of any early relief in our struggles against the disease.

I appreciate that there have been some small victories, that some conditions have become treatable instead of fatal. I am grateful for that. I appreciate that we must encourage those who are facing the challenge and the threat. I know that they, and we, have to continue fighting it like soldiers on the frontline, despite our many losses. Cancer, I hate it!

Max Roytenberg is a Vancouver-based poet, writer and blogger.

Research into psychedelics

Jordan Sloshower (photo from Jordan Sloshower)

The use of psychoactive plants and mushrooms for sacramental and religious purposes has been widespread throughout the world’s cultures for centuries. More recently, in the 1950s and 1960s, academic centres investigated the potential therapeutic uses of psychedelic compounds – primarily lysergic acid diethylamide (LSD) – to treat forms of mental illness and addictions. After producing thousands of papers, the field came to a halt in the 1970s, due to the “war on drugs” and the classification of psychedelic drugs as a Schedule 1 drug in the United States. Nonetheless, the past 10 years have seen a resurgence of interest in the field of psychedelic science.

In the last decade, research has resumed at prominent universities, such as Johns Hopkins University, University of California-Los Angeles and New York University, where clinical trials have examined the use of psilocybin (the psychoactive component of “magic mushrooms”) to treat cancer-related end-of-life anxiety, as well as addiction to alcohol and tobacco. And, a recently formed group at Yale University – the Yale Psychedelic Science Group (YPSG) – is exploring the science behind such research.

YPSG was formed with the aim of reviewing and discussing academic research in the psychedelic sciences via examining academic articles and papers, as well as hosting leading scholars in this field from across the country. The group is working to host an interdisciplinary forum in which clinicians and scholars from across Yale can learn about and discuss the reemerging field of psychedelic science and therapeutics.

One of the leaders of this resurgence is Winnipeg-born and -raised Jewish community member Jordan Sloshower, who is currently a second-year resident physician in Yale’s psychiatry program.

“I first thought I was going to do infectious disease, which is a more typical path for someone like myself interested in global health,” Sloshower told the Independent. “But I found that, clinically, I was most interested in interpersonal relationships, so social dynamics and psychiatry was feeling like a better fit.

“What actually happened was I was able to go do a psychiatry elective in Peru – both in Lima and in a smaller city in the mountains – and, for six weeks, I got to interact with different aspects of their mental health care system there. It was really my first exposure to what we call ‘global mental health,’ and I learned that this is actually a very vibrant field.”

Sloshower found that mental health was a hugely underserved area, with not only a lack of access to care, but with human rights abuses. With a lot of work needing to be done in the field, he decided to combine his interest in global health with his clinical interest in psychiatry. This led to his working in Nepal’s mental health system as well, at the end of medical school.

Regarding the field of psychedelic science, Sloshower dates its inception back to when Albert Hoffman synthesized LSD.

“Now, the way I think of it is as a broad interdisciplinary study of how these molecules act biologically, socially and economically,” he said. “I think there are also political, arts and anthropological angles. I think the term psychedelic still brings up thoughts of art and music from the ’60s. It’s a broad term.”

According to Sloshower, the term psychedelic means “minds manifesting,” which some refer to as “hallucinogen.” In context, this refers to compounds that cause perceptual alteration.

The province of Saskatchewan, as it happens, was one of the leaders investigating LSD for the treatment of alcoholism and cancer-related anxiety. In Europe, psychedelic drugs were used for psychotherapy. Thousands of papers were published on this until, Sloshower said, “things got shut down when psychedelic drugs were classified as illegal drugs.”

Psychedelic drugs went from being perceived as potential wonder drugs to something awful, and then just disappeared. Then, about 10 years ago, Dr. Rick Strassman in New Mexico did a study looking at dimethyltryptamine, a psychedelic drug found in many species of plants as well as in our own bodies.

“There’s a huge need for new treatments that work rapidly in a sustained way, and we need treatments that are not toxic,” said Sloshower. “So, it makes a lot of sense that we should look at these drugs, which actually have safety profiles that were demonstrated to be excellent back in the original wave of research and, increasingly, in controlled settings.

“There have been several trials using psilocybin, which is the active ingredient in magic mushrooms to treat cancer-related anxiety, which, again, picks up from the ’60s. There’s been a promising study with psilocybin to treat alcohol and nicotine dependence.”

While Sloshower said he is not an expert in the matter, he was willing to explain the basics of how these compounds work on the brain. He said that psychedelic drugs activate a subtype of serotonin receptor in the brain and that “serotonin is one of the key neurotransmitters in mood, attention and a range of different things.”

He said, “Typical antidepressants usually act on the serotonin system as well. One potential mechanism of how psychedelics exert peculiar effects on thought and perception is by interrupting something called ‘the default mode network,’ which is kind of like a neural correlate of the ego. It’s a network of neurons that fire together in your baseline consciousness when you’re doing self-referential thinking. In people with depression who have a lot of ruminant thoughts, you see an increased activation of the default mode network and, with both the use of psychedelics and mindfulness practice, you actually see a decrease in activation of the default mode network.”

Among the speakers YPSG has hosted is a speaker from Johns Hopkins who discussed his work using psilocybin to treat tobacco addiction. Another expert, from NYU, was part of the trial done on psilocybin for cancer-related end-of-life anxiety. The results from both studies look promising.

Sloshower anticipates that some Canadian universities will soon become more interested in researching psychedelics. “Actually, the Canadian medical journal, I noticed on the front cover a few months ago, had psychedelics on it,” he said.

When asked about any possible connection between psychedelics and the increased interest in medical marijuana, Sloshower said they are not explicitly connected, although both are part of a search for new therapeutic approaches.

“From my point of view, it’s not so much a matter of the drugs (antidepressants) being overused as much as it is that the drugs don’t work as much as we’d like,” he said. “In a lot of cases, we don’t have great treatment. In depression, for instance, the medications either work partially, take a long time to start working or have a lot of side effects.

“In these cases, the treatments we have aren’t really adequate. We need new ones. We don’t really have good drugs for substance use disorders either. Actually, something that’s been interesting with psychedelic drugs is that the model being proposed, unlike typical antidepressants, is based on a very limited number of drug exposures over a very short period of time.”

The proposed model includes providing treatment in clinics only, with people requiring only one or a handful of drug-therapy sessions linked with psychotherapy, as studies have shown both rapid-acting and prolonged effects of psychedelics.

As for the cancer anxiety research, it has shown improvement in patients’ mood six months after having received a single dose of psilocybin.

“That’s why I think there’s a lot of interest,” said Sloshower. “I don’t think it’s going to be a miracle, but another tool we’d have alongside other treatments we already have.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Summer, sun … melanoma

A public service video produced a few years ago and making the rounds again this year hits me close to home. Produced by the David Cornfield Melanoma Fund and called Dear 16-Year-Old Me, the video warns of the dangers of melanoma and the importance of sun smarts and mole checks.

When I was 21, I had just recently returned from a year living in Israel, where I attended Hebrew University. One morning in Vancouver as summer was winding down, I was flipping through the Vancouver Sun at my parents’ kitchen table and paused on a full-page feature about melanoma.

I glanced over at my right forearm. I had long had a mole there, but now I noticed the mole contained one of the warning signs of melanoma: rather than being a uniform brown, it had a darker spot on a medium-brown background. Overcoming my fear of needles and scalpels, I insisted that my family doctor remove the mole.

A week later, back in Montreal for my final year of university at McGill, I received a call from my parents that I should make an appointment with a plastic surgeon as soon as possible. The biopsy results had come back and I indeed had malignant melanoma, thankfully only to a depth of 0.4 millimetres – so far. I was more scared than I’d ever been. One of my best friends scooped me up that evening for a distracting sojourn on St. Laurent Boulevard.

A few days later, I left my flat in the McGill Ghetto and went to the Jewish General Hospital. My surgeon, the late Dr. Jack Cohen, was a much-admired member of the medical profession in Montreal. He was also an excellent amateur whistler, and I asked him to whistle through the surgery to help calm my nerves. He warmly complied before leaving me with a formidable scar: a small price to pay for saving my life.

That night, swaddled and bandaged, I walked over to the McGill Arts Building to hear Canadian author Michael Ondaatje read from his latest novel. As the evening closed, the painkillers began to wear off.

My friends and family know that because of my melanoma history, I am much less fancy-free when it comes to summer fun than many of my fellow Canadians who are desperate for sunlight after our country’s seemingly endless winters.

I take care to wear hats and sunscreen (I seek out favorite brands and stick to them). I constantly seek out shade. I don’t sunbathe. I don’t turn my face to the sun and quip about needing vitamin D; instead, I take oral supplements.

As for sun-smart clothes, this season’s “maxi dress” fashion trend has helped a little. And, with the recent development of vitiligo on parts of my body, my vanity helps me want to avoid the sun for the cosmetic goal of keeping an even skin tone, as well.

When I’m feeling sarcastic, I joke that my Zionism – given the first of three years I spent in Israel – gave me melanoma. Sometimes, I look wistfully at the last photograph of my pre-surgery arm, my near-deadly mole visible as I sport a large backpack, smiling for the camera while waiting for the Egged bus from Jerusalem to take me to kibbutz Urim, one of my favorite weekend hangouts.

When I’m feeling ironic, I think about how the religious laws of modesty that I often privately disdain are actually very prudent for protecting the body from the dangers of the sun’s rays. It is for the reason of modest dress, researchers have inferred, that Palestinian citizens of Israel develop melanoma at lower rates than that of Jewish Israelis.

When I’m feeling especially cautious – which is always, when summer comes – I’m careful to apply sunscreen to my kids each morning. No one said that the sticky, daily ritual was fun. But it’s important.

I try not to saddle my kids with more fear than they deserve to have in their innocent years. Life is scary, and we need to protect ourselves where we can.

Mira Sucharov is an associate professor of political science at Carleton University. She blogs at Haaretz and the Jewish Daily Forward. This article was originally published in the Canadian Jewish News.

Jewish Book Fest in a week

More than 30 authors are featured in this year’s Cherie Smith JCCGV Book Festival, from the time it opens on Saturday night, Nov. 22, with Israeli author Zeruya Shalev (The Remains of Love) till it closes on Thursday night, Nov. 27, with Toronto emergency physician and CBC Radio host Dr. Brian Goldman (The Secret Language of Doctors). Here’s a taste of what to expect each literary day.

Sunday: Fact Meets Fiction

Speaking twice on Sunday is writer, editor and activist Nora Gold. Her late-afternoon talk will be about jewishfiction.net, an online journal that she founded and edits. In the evening, her novel Fields of Exile will be the focus. In it, the main character, Judith, faces antisemitism in the guise of anti-Israelism on the fictional campus of Dunhill University, where she is taking a master’s in social work. Gold’s opinion on the subject comes out clearly and the novel will make many Jews who have had to endure Apartheid Weeks and anti-Israel propaganda on campus feel less alone; the frustration and fear that Judith experiences will be familiar.

Judith is a knowledgeable and critical supporter of Israel, she has lived in the country, worked for peace and on human rights projects there, and only returns to Canada because her father becomes ill. Nevertheless, with few exceptions, her opinions on Israel are discounted and dismissed by professors and students alike. Ultimately, the anti-Israel words and images turn into violence because they are never put in check by the university, each professor having their own reasons for ignoring, or not speaking out, against antisemitism.

Monday: Focus on Hungarian Jewry

Joseph Kertes shares his session with Ayelet Waldman (Love and Treasure), hosted by Janos Maté. Kertes’ The Afterlife of Stars follows the Beck family’s flight from Budapest to Paris as Russia invades Hungary in 1956. The terrifying reality of the period, the human and material losses, are tempered by the story being told by 9.8-year-old Robert Beck, whose class is in the process of reviewing decimal points when the book begins. Robert and his 13.7-year-old brother Atilla don’t necessarily understand what is happening, though Atilla is wise beyond his years, always asking questions, philosophizing, taking Robert on dangerous (though they don’t usually realize it) journeys, to see a movie, to see some statues, various adventures without their parents’ knowledge.

The wonder of the brothers and their relationship provides the energy of the story, which slows and becomes pedantic in places where historical or background information is explained, especially once the family reaches Paris. Overall, though, The Afterlife of Stars is mostly a charming tale with moments of sadness and beauty, written from a unique perspective.

Tuesday: For Book Clubs and Book Lovers

Steven Galloway’s most recent novel, The Confabulist, is, in a word: fun. This tale of Houdini, as told by Houdini and Martin Strauss, the man who killed him (twice), is perfect vacation/relaxation fare. Galloway explains some of Houdini’s greatest illusions, regales with tales of Houdini working with the secret service as a spy and captivates with Houdini’s efforts to expose spiritualists for the frauds they were perpetrating – on some very powerful and influential people. Out of all the threats facing Houdini, it was an unexpected punch in a bar that killed him … or was it?

The entertainment value of The Confabulist is enriched with ponderings on the role and purpose of magic in our lives; the fallibility and malleability of memory. Both Houdini and Strauss contemplate how they have lived and what they have accomplished, and perhaps their observations will prompt readers to think about their own pleasures and regrets. Or maybe they’ll just enjoy the show.

Wednesday: The Power to Triumph

Susan Wener has had several serious health issues in her life, including two bouts of cancer. In Resilience: A Story of Courage and Triumph in the Face of Recurrent Cancer, she matter-of-factly takes readers through her experiences and how she handled them. Already a health-care system veteran when she was first diagnosed with cancer at age 36, when her children were young, Wener hoped to live long enough to see them to adulthood – she now has several grandchildren.

There are many life lessons from such a memoir, of course. One of the most powerful in this one is that it’s OK to be angry, to breakdown, to react how you react. You are not in charge of the disease but you are in charge of everything else, what tests and treatments you undergo, what therapies you try, who you ask for help, how you live your life.

Wener writes without bravado. She kept getting up every day, but she wasn’t always a fighter or optimistic. Her illnesses, especially the last serious one – years of pain and horrible treatments before being diagnosed with a functional obstruction in the colon – pushed her to the limit, as the title of that chapter openly admits. But she did push through, she took the tests, did the research, underwent the surgeries, made the decisions.

Wener shares her thoughts about and discussions with her husband and daughters, and these moments are incredibly emotional. Readers will readily imagine such conversations with their own family and friends and, despite the lack of sentimentality with which Wener writes – or perhaps because of it – most readers will not be able to get through this memoir without getting a little choked up and teary-eyed at times.

Thursday: Fix Your Diet

In the penultimate event of the festival, Dr. Yoni Freedhoff speaks about The Diet Fix: Why Diets Fail and How to Make Yours Work, a clear, concise book that outlines the main weaknesses and myths surrounding dieting, and offers a detailed program that Freedhoff believes can result in success – i.e. long-term weight loss.

It is not a difficult program, but neither is it for the faint of heart. Be prepared to diarize, measure, goal-set and cook. And to be patient, both with the length of time it might take to lose the weight but also with yourself if you break your diet or exercise routine.

According to Freedhoff, most diets suffer from “seven deadly sins,” such as the constant need to battle hunger or resist temptation, and these sins traumatize many people, leading to depression, binge eating and other problems. His solution begins with a “10-day reset.” He does not promise you will lose a pant size or two, but, rather, the reset “is about lifting the guilt, the fear and the traumas of the past off your shoulders and giving you a brand-new relationship with your body, your weight and your health.”

The reset he lays out and the discussion of how it can be applied to any diet and in your broader life seems pragmatic. Freedhoff includes advice for people on medication that leads to weight gain, and for parents on how they can help with their children’s weight. Throughout the book, Freedhoff offers advice that makes it seem like his plan has a better chance than most of working. For example, he summarizes in the epilogue 10 points to remember, including, “If you can’t happily eat any less, you’re not going to eat any less,” and “If you can’t use food both for comfort and celebration, then you’re on a diet that you’re ultimately going to quit.”

The book ends with recipes for snacks and meals, as well as suggested reading and other resources, including smartphone apps.