Wednesday 24 April 2013

George - Second Anniversary

One of the many doctors who treated George described him as a miracle child. And it was true. He had survived a rhabdomyosarcoma diagnosed at two and which was aggressively treated for about a year, followed by a few months in remission. When the disease recurred it was treated hard again but the last scan showed there was still evidence of disease. With no options left on the table we were sent home to prepare for the worst. George was just four years old. We refused to accept the news, and he was just a kid who wanted to play. And play he did, for the next eleven years. He really was a miracle child. But when he was fifteen he was diagnosed first with a basal cell carcinoma and then, a little later, with osteosarcoma. For us the miracle ended two years ago, when the osteosarcoma finally defeated our wonderful, lovely child, after the hard years of battle.

On this second anniversary it’s time to take stock of where we are with the Trust formed in his name. One of the things we wanted to focus when we started was on encouraging more research in Li Fraumeni Syndrome. We never imagined that we would be responsible for some of that research, but that is precisely what has happened. Over the last year I have developed a new theory about cancer initiation in LFS, one that is subtly different from the mainstream view. The first test of a new theory is to see if it can stand the peer review process and be published in a reputable peer-reviewed scientific journal. I am happy to report that the paper ‘Li Fraumeni Syndrome, cancer and senescence: a new hypothesis’ has been published in the journal ‘Cancer Cell International’. There will be more to say in the coming weeks and months about this paper, but for now it’s available for download at the journal’s website.

Friday 12 April 2013

Ablation of bone tumours

For patients with advanced cancer bone tumours, (whether from primary bone cancers like osteosarcoma or metastases from other types of cancer, such as breast or prostate), can be a cause of persistent and hard to treat pain. A standard treatment in many such situations is radiotherapy, which can have unpleasant side-effects, and, in the case of Li Fraumeni Syndrome patients, might also have long-term implications regarding further cancers. Additionally, treating cancer pain with opiate-based pain-killers, such as morphine, can also be problematic given the evidence that opioids can cause further cancer progression (though this can be reversed with the use of naltrexone).

In which case there’s some encouraging news being reported at the 29th Annual Meeting of the American Academy of Pain Medicine. A group of French clinicians have reported on treating patients with tumour pain, including bone tumours, with micro-wave ablation (MWA).

One of the doctors, Adrian Kastler of the Centre Hospitalier Universitaire, in Besançon, France, is reported as saying:
"This technique may be applied to any patient suffering from bone tumour pain, mainly in patients suffering from bone metastases, refractory to conventional therapies. The main advantage of ablation techniques is the fast pain relief obtained - immediately after the procedure - as opposed to delayed pain relief obtained with radiation therapy… Our research showed that the use of MWA in bone and soft-tissue tumours is feasible and effective concerning pain palliation. However, MWA needs to be studied in order to apply the same procedure in a curative intention." 
The last point is certainly one that needs urgent attention. Bone tumours are notoriously hard to treat, so any new treatment that shows signs of being effective needs to be researched as a matter of priority. And, given that primary bone cancers are often unresponsive to chemotherapy, any physical treatments that can be used alongside surgery are urgently needed.