When Hasini Jayatilaka was a sophomore at Johns Hopkins University working in a science lab, she noticed that cancer cells started spreading if they got too crowded. The usual way we have thought about cancer metastasis is that when tumors get to a certain size, bits break off and travel to other parts of the body. What Jayatilaka observed seemed contrary to the prevailing theory. Size didn’t matter; density did!
Later when she learned that bacterial cells have a similar characteristic, she decided to check out her observation in the academic literature. However, when she looked for research articles about the relationship between cell density and cancer spread, she could not find anything.
Seven years after her first observation as a college sophomore, Jayatilaka and other researchers at Johns Hopkins were able to not only validate what she had noticed, but also come up with a theory about why it happens and develop possible drugs that hold promise for preventing the spread of cancer.
This is important because cancer that stays where it starts rarely kills. A breast tumor is often not deadly until parts of it spread to the lungs, liver, or other vital organs. Understanding the process of metastasis is the key to reducing cancer deaths. The old theory that early detection saves lives has not worked out as well as scientists had hoped. About 30 per cent of breast cancer patients whose tumors are found at early stages go on to develop metastatic disease.
What the Johns Hopkins researchers have found is that when the cancer cells are packed tightly together, they secrete molecules that enable them to break away from the original tumor and look for a new home. They also found that two drugs – tocilizumab and reparixin – slow down this process. Tocilizumab, approved by the Food and Drug Administration (FDA) for other indications, is in clinical trials examining its efficacy against recurrent ovarian cancer. Reparixin, which has orphan drug status for delayed graft function, is “being evaluated for safety, tolerability, pharmacokinetics, and to detect early signs of antitumour activity in breast cancer patients,” according to the researchers.
So what use is a story about drugs that are not yet available? This story has several important implications.
Curiosity propels discovery. We need to encourage curiosity in ourselves and others. Sure, a toddler’s twelfth “Why?” In a row can be annoying, but curious children become smart children. Wanting to understand how the world works is a good thing. Jayatilaka’s curiosity led her to connect information about bacteria with her observations about cancer cells and sent her to do more reading and get more education as a doctoral student.
Education is important. I taught teenagers and adults from every income range for 44 years. Some of my brightest students had significant barriers to overcome just to show up in class. Our society needs their ideas and talents. When I hear people complain about paying taxes to support schools, I am dumbfounded. Yes, their children are grown now. Yes, they don’t have children currently in school. But every community needs educated citizens who can think critically about the complicated decisions they must make as voters.
According to the National Center for Education Statistics, more than 80 percent of full-time undergraduate students at four-year institutions receive some form of financial aid. Of course, I don’t know if Jayatilaka was one of them, but I do know that I don’t want the next cancer breakthrough to go undiscovered because a child’s school doesn’t have a good science lab or a college sophomore has to drop out for financial reasons.
Research needs support. The first thing most people think of in terms of research support is money. Universities and other scientific laboratories need funds for research. In a time of tight funding, bright young scientists with good ideas are having trouble getting research grants. Who knows what cure or breakthrough will not happen because as a country we were not willing to fund research?
But it goes beyond dollars. The very concept of research is under attack in some parts of our society today. When people choose to believe that a cancer drug developed in random-controlled clinical trials is not better than an expensive treatment their neighbor heard about from her cousin’s husband, science is undermined. We see similar anti-intellectualism in the people who choose not to believe in vaccines or climate change.
I’m alive today because in 1962, botanist Arthur Barclay was curious enough to collect some yew bark to see if it might work as an anti-cancer drug. In 1994, through the efforts of many other scientists at multiple institutions, paclitaxel, a semisynthetic form of the cancer-killing compound in yew bark, was approved by the FDA. Curious, educated researchers worked for 34 years to get this life-saving drug to my doctor’s office.
If we want more breakthroughs, we need to start with our toddlers and follow through with public policy that supports education and research.
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Phyllis Johnson is an inflammatory breast cancer (IBC) survivor diagnosed in 1998. She has written about cancer for HealthCentral since 2007. She serves on the Board of Directors for the Inflammatory Breast Cancer Research Foundation, the oldest 501(3)© organization focused on research for IBC. She is a list monitor for an online support group at www.ibcsupport.org. Phyllis attends conferences such as the National Breast Cancer Coalition’s Project LEAD® Institute. She tweets at @mrsphjohnson.