Cancer is a really bad disease

Cancer is a deadly disease that has taken many of my friends in the past couple of years-- men in the primes of their lives. Most recently our good buddy and bicycle riding companion, Moe Sullivan lost his battle to melanoma. Two years ago my neighbor, friend and colleague at UIC, Rob Costa lost his battle to pancreatic cancer. Pat Quinn who came from the same lab as me at Michigan lost his battle with lung cancer. The loss of these vital people comes at a great cost- medical expenses not the least of the burden. Their potentials had yet to be realized and then they were gone. Cancer is a really bad disease and now that I am a cancer biologist, my sense of altruism is well satisfied knowing I am working on this important disease.

As we prepare our presentations, either posters for meetings or various talks either me or one o my students might give, we say in a light-hearted way "Ovarian cancer is a really bad disease." This of course is the the devastating truth, but our statement is a synopsis, a short hand way of doling out the facts about this deadly disease. More than 24,000 women in the USA are diagnosed with ovarian cancer every year, and more than half of these women will die from their disease. Stage I ovarian cancer is curable in 95% of cases, but due to inadequate screening tools, ovarian cancer is usually detected at a late stage when the prognosis is poor. Most patients who present with ovarian cancer complain of GI problems, abdominal discomfort, feelings of being bloated an irregular-- not symptoms they would suspect were caused by ovarian cancer. Upon examination the distended abdomen is found to be due to a large accumulation of ascites fluid from the ovarian tumor. The cancer has progressed and metastasized throughout the abdominal cavity and the cancer cells are producing large volumes of the ascites fluid. After draining the fluid and surgical removal of the primary tumor and chemotherapy with taxol and carboplatin drugs, the disease will go into remission. about chemotherapy Sadly though, in more than 60% of the cases, the disease will return in a more aggressive and now chemoresistant way-- the growing tumors are no longer sensitive to the chemicals and continue to grow and spread until the women succumbs to the disease. It is indeed a very bad disease.

While there has been significant progress in curing other forms of cancer, ovarian cancer lags behind. The key to the cure is early detection-- for breast, prostate and colon cancers, early detection and treatment provide the patient with an excellent prognosis for long term cancer free survival. And certain other cancers are entirely preventable-- lung cancer is the single most preventable disease correlated to not smoking or quiting cigarette smoking. Cervical cancer is caused by human papalloma virus and vaccination against HPV is very successful in preventing the disease. Cancer biologists have exploited animal models to understand the etiology or cause of these diseases, and have been able to test therapies and perfect therapies while gaining further insight into these cancers. But ovarian cancer research has been hampered by a lack of suitable animal models. In the past ten years several important rodent models for ovarian cancer have been developed in which a tumor suppressor is knocked out and an oncogene is targeted to the ovary-- but these transgenic models are by their nature blind to the cause of the cancer. Ovarian cancer is of epithelial origin, arising from the specialized tissue that covers the ovary, the so called ovarian surface epithelium. Certain of the transgenic models have successfully targeted the surface epithelium by injection of oncogenes under the ovarian bursa, and the resulting disease closely mimics the human disease. These models provide a testing ground for therapies and enable investigation into the progression of later stage disease-- where all of the therapies are targeted. But the cause of the disease can not be determined from this approach.

With the exception of the laying hen, no other accessible animal model recapitulates the human disease. Laying hens get ovarian cancer spontaneously and it is of epithelial origin, just like in humans. The prevailing theory about the cause of ovarian cancer is the so called "incessant ovulation theory" set forth by Fathalla in 1971. The theory postulates that continuous "tear and repair" of the ovarian surface epithelium, which happens every time an egg is ovulated, provides a rich environment for the initiation of the cancer. Ovulation has long been considered to be an inflammatory process, analogous to wound healing. The mature follicle ruptures, bursting through the surface epithelium releasing the egg which is swept into the oviduct. The process is the same in chickens as in humans. In chickens, though, this happens every day-- yes every time a chicken lays an egg it was necessarily preceded by ovulation. Of course what happens to the ovulated oocyte is remarkably different in the chicken. In the oviduct the yolk is surrounded by albumin and then in the shell gland, analogous to the uterus, the hard shell is formed. The post ovulatory ovary is different too-- in the mammal a corpus luteum is formed, and if the egg gets fertilized, the corpus luteum will provide estrogen and progesterone to prepare the uterus for implantation and maintain the early embryo. Fertilized or not, the chicken's egg gets laid, or in the parlance of the poultry scientist, undergoes oviposition.

Despite the differences between the hen and women, the process at the surface of the ovary are essentially identical. Since hen's ovulate every day, by the time they've completed their second year of lay, they have approximately the same reproductive age as a menopausal woman, each having ovulated 450 to 500 times. That is a lot of tear and repair and it is a this time that both women and hens are usually afflicted with ovarian cancer. The incidence in a 2 year old hen is 4%, but in a 6 year old hen, the incidence of ovarian cancer approaches 50%. This provides a relatively short period of time in which the entire disease can be studied. We've made substantial progress already in defining the earlies steps in ovarian cancer in the hen, and them after examining surgical specimens from women, have observed very similar events. Our long term goal to is characterize these events, determine what factors and mediators are involved in driving these first early steps, and then devise a screening strategy based on our understanding of the mechanism through which normal surface epithelial cells become transformed into malignant ovarian cancer cells.

Another advantage of working with the hen, is the opportunity to do large scale interventions are relatively little cost-- compared to doing similar studies in rodents. Stay tuned for a subsequent post in where I will describe these intervention strategies based on functional food enriched diets.

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you gotta be kidding--bang bang

The conservatives in the Supreme Court have had their day and voted 5-4 to overturn the DC ban on handguns, ruling it unconstitutional based on 2nd amendment rights. Within seconds the NRA began to sue every city in the country with handgun bans. The NRA will not be happy until the world we live in is the OK corral and any cross word or lost temper could be rewarded by a slug to the brain. Or until thousands, not just hundreds of innocents are killed by incidental gun fire. Or more little children get their daddy's gun from his bedside table and blow their heads off-- accidently. It's their right to do so, eh? 75% of the homicides in Chicago were committed with handguns despite the ban on handguns. Does that mean that the ban should be repealed? should we do nothing, just stand by and watch the senseless murder of all these people? Do you really think that arming everyone is going to decrease the numbers of people killed with guns? What an absurd notion. Its like pouring gasoline on the fire. Yeah, right, if guns are illegal, then only criminals will have guns, and you're gonna have to pry my cold dead finger of the trigger of my gun to get it away from me, and this house is protected by 357 magnum, and guns don't kill people, people kill people. and on and on. So does all of this mean we should do nothing? Handguns and assault weapons the necessary complement to every hunter's aresenal. Guns were made for one purpose and one purpose only. To kill. People have guns so they can kill people with them. sure, they may say they have them for protection. But that means they will kill someone with their gun to protect themselves. Oops, I didn't mean to kill him, I thought it was a burglar robbing my house, I didn't know it was my teenage son stealing a snack from the fridge late at night. But then maybe these gun nuts would think it OK to kill someone for such a serious crime.

To Do, Be

More than 30 years ago I was a big fan of the TV series "Kung Fu" with David Carradine as Kwai Chang Caine who travels the American west in the 1870s, fugitive from Chinese assassins who are trying to revenge the murder of the emperor's nephew, who Caine killed after the nephew shot and killed Master Po. I loved this show back in the day. It planted the seeds which have blossomed into my own Buddhism. This year I started watching Kung Fu again via NetFlix and its even better this time around! The Buddhist philosophy which the series presents is packaged in a 1970s western and each show is predictably formulaic, yet the nuggets of wisdom which Master Po and Master Kan impart to young Grasshopper, and the adult Caine's application of these instructions in his western drama, are just priceless. After reading extensively in the Buddhist lore, the words of the Shaolin priest ring so true to me. And when we are watching the show, usually on Friday evenings, and the scene transitions from the American west to China, Ryder and I both yell "its Grasshopper time!". One of the last episodes we watched when Caine was at an impasse, not knowing how to deal with a particularly onry bandito, he flashed back to Grasshopper time and Master Po instructed him "To do--be." A poignant message, which embodies the essence of The Way. I call upon this message often in my journey through this life as a scientist and mentor. Faced with constant conflict and relentless struggle for funding, instead of getting caught up in the worry about how to do science, instead, I just do it. I never thought about it before, but Nike must be a Buddhist to. I am not alone in finding the philosophy of Caine applicable 30 years after its release. http://www.kungfu-guide.com/overview.html
has s a very nice compendium

Tis the season. Post traveling for nearly 6 weeks, I am now settling back into the work a day world and bicycle commuting. So I gave my Cannondale a bath yesterday, cleaned and lubed the chain, and swapped my fat tires for some skinnies. I put nearly 600 miles on my 37's this season, but now that distance riding calls, I switched to 25's. What a difference! A little stiffer and less forgiving on the ragged pavement, but they roll like a dream. Instead of gearing up for a marathon this fall, I am going to get as many long rides in as I can. Ryder and I are having a great time riding together and he is keeping up at 10-12 mph pretty well. I don't think he's quite up for a century, but he certainly could do a quarter century now. We've ridden 10-12 miles many times. He really wants to do the Apple Cider Century this fall. We will have to work up to that distance for sure. My goal is to do the century in under 6 hours-- but not with Ryder.

Aloha and Mahalo!

We have returned from our blissful 11 night stay in beautiful Keauhou Bay on the Kona coast of the Big Island of Hawaii. We celebrated our 25th anniversary, attended the SSR meeting, and enjoyed the sub-tropical paradise. The pace of life is a contrast to the cost of living in Hawaii. I was shocked to see gas at $4.25 a gallon, only to return to Chicago to see the same price here. $5 a gallon is coming to a gas station near you soon.

We arrived at the Kona airport on Thursday and it took a bit of adjustment to see the stark lava landscape and all outdoor nature of the airport. After we fetched our luggage and rental car, we fired up the Garmond Nuvi and voila, it directed us from the airport to the Shearaton Resort at Keauhou-- ah technology! By the time we found the hotel, it was pouring rain. Warm rain, it was like taking a shower. We were very tired and out of sync with the time, so we retired early. The next morning after a fabulous breakfast in the hotel we spent the morning at the pool, and immediately sunburned our pallid flesh. Multiple applications of sun screen and tanning oil saved us from getting badly burned and we all three had a nice glow within a few hours. After the clouds rolled in we headed off to explore Honalo and Kahalu'u forest in search of coffee. We found the Blue Sky Kona coffee farm and enjoying tasting the coffee-- traditional Kona and the richer Peaberry varieties, and went on a guided tour of the farm with an introduction to the local vegetation-- calabash, bread fruit, banana trees surrounding the coffee trees, the coffee fruit still green this time of the year. We bought roasted coffee beans and some green Kona coffee to take home. At $20 a pound it seemed exorbitantly expensive, but a fun indulgence. After we left we crossed paths with a flock of wild turkeys walking across the road. we headed into the village of Kailua-Kona on Alii Drive. We blended right in with the rest of the tourists and enjoyed the busy resort village atmosphere-- seeking ice cream. We found several coffee shops, all selling 100% pure Kona coffee for $45 per pound. Our purchase at the coffee farm then seemed like a wise one. There were several barkers trying to get us to bundle our "activities" with a time-share presentation at a big discount. One gent described a combination deep sea fishing, volcano helicopter tour bundle for only $930 per person! What a bargain but we passed. We watched the outriggers and waves while Ryder enjoyed his ice cream. After we strolled to the doc, we learned that the outriggers with their six person crews were racing on the Ironman swim course. I couldn't imagine swimming in that surf. Wow.

The next morning we practiced snorkeling in the pool and then headed off to Kahulu'u to go snorkeling. The tide was out and the walk across the lava rocks to the water was really tough on our feet. But once we made it into the water, amazing! Within a few feet we could see dozens of different kinds of brightly colored fish and the corral creatures. Ryder is a strong swimmer, but it took him a while to get used to snorkeling. Salt water takes getting used to. Like baby's tears we kept saying. I stayed near his side and he would occasionally thrash around and use me as a float while he adjusted his gear. Even though it was cloudy our backs got sunburned floating on the water, looking down. We saw many big sea turtles near the shore.

On Sunday old family friends wholive in Hilo, and who happened to be celebrating their 35th anniversarythe next day, picked us up a the hotel and drove us north to Kona Village Resort at Ka'upulehu near Kihola bay. This was a real treat-- old Hawaii with thatched roof huts which were modern bungalows, but a fabulous feast of Asian and American breakfast foods. We ate and ate and enjoyed the seaside serenity. We saw seas turtles when we strolled on the secluded white and black sand beach. Then in marked contrast they drove us up to Wiakialoa where the

huge Hilton resort is-- Las Vegas style "grandeur" with a gondola, a monorail, 100s of acres of lawns, pools, cliffs, waterfalls, thousands of hotel rooms, a dolphin show, and on and on. Of course Ryder thought this was great but Karen and I were repulsed by the over-the-top ostentatiousness of the place. It was fun though, the parrot in the lobbyand sheer splendor, but mostly Don and Dina's excellent company made for a most enjoyable day.

On Monday we indulged in our only paid "activity"-- a submarine excursion in to Kailua bay. I've never been on a submarine before (except at the museum) so this was really exciting for us all. Seeing the ship wrecks and sea life was great though not at all colorful. Not a lot of light penetrates 100 feet of ocean. We did see a shark which was very cool. That evening we attended the Luau at the hotel, and that too was a lot of fun. A pig roast, poi, hulu dancers, fire dancers, a reenactment of the Hawaii myth of Pele, goddess of fire. It was a lot of fun. Those hulu dancers were ripped!

On Tuesday we visited the state park at the Pu'uhonua o Honaunau historical site, the city of refuge adjacent to the lovely deep clear water of "two step" not a beach, but lava flow into the water. It was easy to get in and we had an excellent time snorkeling. The water was absolutely clear and got very deep quickly. We had invested a few dollars in reef shoes, and this made our experience on the lava much more pleasant. Alas, the meeting started Tuesday afternoon, and continued through Friday, so we mostly stayed at the resort. Ryder really enjoyed the waterslide and the vast pool, and Karen had a wonderful time relaxing while I worked the meeting. Word started to get out about SIU as the SIU, UIUC and UIC colleagues all commingled at the meeting. I had been very circumspect about my interviews and potential for moving to Carbondale as Chairman of Physiology, but within a day at the meeting, all my UIC cronies had heard. It was a relief actually, to have the word out. As is usual at SSR we drank and talked a lot, and enjoyed the state of the art in reproductive sciences in a bucolic setting. This meeting will set the standard for splendor, if not science and amenities, that is for sure. The traditional bar-b-queue followed by the big dance was also a treat-- I played two songs with the band as per usual, the high point of my year!

We had wanted to go sea kayaking but didn't have a full day to spend, so we returned to the beach at Kahulu'u to snorkel and found that the tide was in and we could walk across the sand and step into the water with out shredding our feet. After Ryder and I snorkeled and shot up all the film in our underwater camera, he returned to the shore and I swam out towards the break water. The current carried me out and as I neared the wall, the abundance of sea life was so incredible that I barely noticed how shallow the water was. As the waves crashed over the wall I was nearly swept into the reef and I noticed how cold the current was. Yikes! I oriented myself relative to shore and swam in strong fast strokes back to the beach. I had traveled nearly a half mile out into the water with out knowing it! exciting! Especially for Karen who watched me disappear into the waves.

On Saturday we drove up to Monoa Kea to the observators which was spectacular. At 14,000 feet it was clear, sunny, and rather cool. While the park service made such a big deal of the altitutde, it really didn't affect us adversely. We could see Maui and the distant steam plume coming from Kilauea. And we were treated to a home cooked meal at Don and Dina's house! Sunday we visited Volcano national park. I had just finished reading Chasing Lava by We spent the weekend on the Hilo side of the island with our friends, touring the volcano park and the Kilauea caldera. The lushness of Hilo was quite a contrast to the stark landscape of Kona.Wendell Duffield, the story of a geologist's tour of duty at Hawaii Volcano Observatory, so it was very interesting to see the Jagger museum and the caldera in person. We drove all the way to the sea following the lava flow and then hiked to see the waves crashing into the cliffs and the steam where the lava met the water. Next trip we will hike in at night to see the glowing lava.

On Monday we enjoyed one last morning at the hotel finishing off our Hawaiian tans, then checked out, drove to Captain Cook for one last meal at Senor Willies, and then made it to the airport. It was so relaxed at the airport it was almost a pleasure to go through TSA and the USDA inspections. Even though My bag was 51 pounds but they didn't charge extra. We had a direct flight from Kona to O'Hare. It took a few days to get over the travel and time lag, but we returned to much nicer weather in Chicago than when we left. Alas, our tans are fading quick-- we must get to the pool soon. Good to be back but it was so nice being there. Mahalo to Hawaii!

Change we can believe in

Last night as I was gathering my wits about me, still buzzing from 12 days on the Big Island, I listened to Barack Obama's passionate speech as he acknowledged that he had cinched the nomination for the Democratic candidate for president. Not just a historic moment, but a defining moment in our lives, as though a big light had just been turned on and we can now see. We are emerging from the darkness of the Bush years. Years of death, destruction, failure, despair, desperation, indignity, embarrassment, frustration, anger and pain. To think John McCain is championing all these failed policies of an unjust war and government for the corporate rich, not for the people. Enough! I admire Hillary and her determined campaign. The final nail came with her speech in which she referenced Bobby Kennedy's assassination as a reason to stay in the campaign, in the wake of the news of Ted Kennedy's brain cancer. That aside, her run was a milestone and a harbinger of things to come. No country for old white men is the theme of this election season. Yet we shall not be over confident or complacent. There are a whole lot of red neck bigoted conservative war mongering misogynists out there who will vote for McCain just to vote against a black man. And surely they would have voted against Hillary because she is a woman. Enough! Change we can believe in is on our doorstep. I am so excited for the future that awaits my son. As SUVs vanish from the landscape and oil is no longer the universal currency, when food is grown to eat not to fuel ego machines-- yes a better day is coming.

Change we can believe in takes on even more significance in our lives as I consider that one year from now we will be living in Carbondale and I will have assumed the mantel of the Chair of Physiology of SIU. We will have left the traffic, the population density, the pollution, the noise, and high cost of living in Chicago behind as we set up our new home in the country. So much will happen in this year of transition, this blog will be a useful device for me to help keep this in perspective. I have much to say but have traveled nearly continuously since April. Washington DC for NASA reviews of sperm in space, then the BIG trip to Carbondale and Springfield for the second interview, and then 12 blissful days in Hawaii. And now I return just two weeks before I head off to San Fransico to the Endocrine meetings with two months of work to catch up on before I go. Well, somethings never change.

Hawaii was incredible and despite the proximity to the site of the Kona Ironman, I barely worked out the whole trip, instead enjoyed the wonderful food as we indulged in tourism. We did go snorkeling, but most of my execrcise consisted of trips to the bountiful buffets. Inevitably I gained a few pounds, yes, well, somethings never change. But I have confidence, and a mechanism to not let them stick. Induction phase commencing now, P-diet and exercise. I started by riding my bike to work today, and will rejoin Pilates at noon. Having a tool to help deal with my propensity for weight gain really helps. I have relied on running for so many years, but just can't run enough now-- calories in must be less than calories out and it is the quality of the calories that count. Yes, change I can believe in.

inverted

There is something very invigorating about going upside down. It was one of my personal triumphs, some years ago, when I finally managed to kick up into a handstand. Even so, for years I relied on belting my arms to help me push my arms straight. This year I weened myself from the belt and try to do a handstand every day. Not just inverted, but the back bend you achieve in the handstand really energize. I found that post Pilates, when we do a lot of deep forward bends at the end of the session, it has a depressive effect. I learned from yoga that forward bends cause you to go inward and quiet you, while back bends cause you to go outside and energize you. So post Pilates I go against the wall and kick up into a handstand. I was struggling recently post workouts to get up and realized that doing handstands on the soft mat makes it much harder, as my palms sink below the arch of my hand. On the hard or carpeted floor, voila, right up. My break through in being able to get into a handstand came after a weekend workshop with Francoise Raul, who made the comment that elephants can do handstands and they are not strong enough to lift their bodies with their "hands". It is a matter of stacking yourself up and bearing your weight on your skeleton, not muscling your way up. The final extension, when I lift out of my shoulders to straighten my arms does require strength, but getting up into the position is just a matter of balance. I drop my head as I kick up and my body goes straight over my arms. A handstand a day keeps the doctor at bay. Handstands and pushups seem to be my weight lifting regimen these days. I heard that pushups are nearly the perfect exercise-- cardiovascular and upperbody, core and lower back all in one and they are easy to fit in, any where, any time in any clothes. As we drive cross country I do pushups at every rest area. Handstands though make all my change fall out of my pockets.

wind and knees

Finally, spring has arrived in Chicago, and we made our second trip to lake front for a long run. Ryder joined Saint Stephen and me on his bike and we arrived at Belmont Harbor before 8 on a blustery, clear blue, sunny Sunday morning. We were excited by the prospects of the run, but surprised by how cool the lake breeze made us feel. We headed north onto the path the east of the bird sanctuary and as we joined the path, we were knocked back by the strong north wind. And it was cold! Ryder was particularly unhappy with the conditions, so before we got to Waveland golf course we headed back in to run on the path, instead of along the water. The northward trek to Hollywood was a struggle and Ryder was very unhappy, yet we insisted that we make the trip all the way across the beach to Buck's Block, Ryder's Rock and Stephen's Stone. And so we did. The beach was sheltered and Ryder did not want to resume the journey, but much to his delight, he found the southward trek quite pleasant. It was like running on a different day, warm, sunny, the wind at our backs, we sailed south all the way to the North Avenue overpass, then headed back north on the zoo trail. As soon as we turned north we were back in the wind, and struggled for the last 5 miles. Ryder and Steve found a groove and motored on while it was my turn to struggle. My calves were so tight and my knees were screaming, it was all I could do to motor along at 11+ minute pace. I felt strong, but just very slow. After we were done my knees felt like giant water balloons. As the day progressed my knees ached and I got stiffer and stiffer. Combined with the previous day's yard work, pounding in 12 inch spikes with a 5 pound hammer, my back and arms were sore, and now my legs, a complete body abuse workout. This morning when I got up in the predawn gloom, I creaked and moaned my way down the stairs. I expected I would be sore. But then I mounted my trusty steed and peddled to work. All the pain and stiffness vanished. The miracle of the wheel. My regimen of using the AMT, doing Pilates, and riding my bike to work everyday seems to be helping my fitness and weight control, but it is not doing much for my running. I think if it weren't for Steve I wouldn't be running at all. Of course running once a week or every two weeks and going 10 or more miles makes it hard to get used to. I think you have to endure the pounding to be able to stand it. I love to run. When I ran track workouts, I would dig deep and kick, cranking out sub-80 quarters, flying, gaining speed as I rounded the turns, sprinting to the finish, often passing speedy smaller runners. The Bucky Burst. Ah, but now, my sprinting is limited to short jaunts across the park, chasing my dog. I just don't feel the juice in the legs now. I could tap into that below the belt energy and crank, now, I feel stiff and tied up. Plodding along mile after mile at a pleasant conversational pace is now what my running career brings me. The bike is where I get my jollies. I can ride my heart out, crank as hard and as fast and as long as I have the conditioning for, and not feel any pain. No that's not right, its pain, the burning lactic acid exploding quad blood in my mouth sweat stinging my eyes kind of pain, not that wounded crippling pain that all out running delivers.