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Nobel Prize in Medicine

This year’s Nobel Prize in Medicine or Physiology has been announced and the joint winners are literal life-savers.

Dr. Jim Allison is currently the Chair of Immunology and the Executive Director of the Immunotherapy Platform at the University of Texas MD Anderson Cancer Center. He is being recognized for work he conducted while at the University of California at Berkeley and the Memorial Sloan Kettering Cancer Center in New York.

Dr. Tasuku Honjo is being honored for work conducted at Kyoto University, where he is still a professor. He has also worked at Osaka University, the University of Tokyo, and the National Institutes of Health in Washington.

Although Dr. Honjo is a medical doctor, Dr. Allison is not. Both men have had long, successful research careers in the field of immunology. Each independently discovered ways of helping the immune system attack cancerous tumors in the 1990’s. They, and other researchers and medical doctors, then used the discoveries to develop immunotherapy drugs. It wasn’t long before at least one recipient previously considered terminal was declared cancer-free.

Immunotherapy was an old idea, even in the 1990’s, but no one had succeeded in turning the immune system against cancer, and the prospect that anyone might have had success in this approach had come to seem very dim. Dr. Honjo and Dr. Allison each found a way while researching one particular aspect of the immune system, the T-cell.

T-cells are are a class of blood cells that are part of the adaptive immune system. But excessive production of T-cells, or excessive T-cell activity, is bad for the body, so there are various mechanisms or “checkpoints” that inhibit them. Unfortunately, some types of cancer can deliberately activate those mechanisms and turn the T-cells off. Others simply take advantage of the system’s natural limitations. Dr. Honjo discovered one such mechanism, and how to block it. Dr. Allison discovered and blocked another. By blocking one or the other mechanism, the new immunotherapy treatments dramatically increase the chance that the T-cells will successfully attack the cancer.

No one treatment works on all cancers, nor do all types of cancer have their own form of immunotherapy yet. The list of cancers that can be treated with one or another of the newly-developed drugs includes melanoma, Hodgkin’s lymphoma, and cancers of the lung, kidney, bladder, liver, cervix, digestive system, head, and neck. Immunotherapies have the potential to cure at least some forms of metastatic cancer, a stage otherwise considered incurable.

Still, while immunotherapy offers hope to some who previously had none, not everyone responds to the new drugs, which can also have serious side effects. Dr. Allison acknowledges the problem, explaining that “One challenge is that the clinical success has outrun our scientific knowledge of how these drugs work and how they might best be combined with other therapies to improve treatment and reduce unwanted side effects. We need more basic science research to do that.”

Dr. Allison is continuing to work, both as a researcher and in a leadership capacity, on that needed research, developing new possibilities for cancer treatments and an increasingly better understanding of the immune system.

In a press conference after the announcement, Dr. Allison expressed shock and gratitude, thanked the students and colleagues who had assisted his research, and gave a “shout out” to current cancer patients, reminding them that more treatments are being developed. He also explained that cancer is a very personal issue for him, since several members of his family have had cancer, and his mother died of it while he was still very young.

He did not get into immunology in order to cure cancer, he explained. He was simply doing research in order to better understand how the human body works. However, he was always aware that there could be a practical application, and would often stop to review his work and consider whether anything he discovered could be applied to fighting cancer. Eventually, of course, the answer turned out to be yes.

“It’s a great, emotional privilege to meet cancer patients who’ve been successfully treated with immune checkpoint blockade,” Dr. Allison said. “They are living proof of the power of basic science, of following our urge to learn and to understand how things work.”

Dr. Honjo expressed a similar sentiment, saying at his own press conference at Kyoto University, “It is really, really an honor,” and that he hopes his winning the Nobel “will give encouragement to many researchers in basic studies.”

That basic science—research conducted for the sake of knowledge, without an obvious practical objective—can become the key to a major advance in medicine is an important part of the story for both men.

Dr. Honjo, like Dr. Allison, did not set out to work on cancer. He, too, was simply curious as to the functioning of T-cells, especially the process by which the cells die. His insight was that what he called “programmed cell death” is a control mechanism or checkpoint that can be turned off. Curiously, drugs developed based on his work have milder side effects than those that use Dr. Allison’s checkpoint blockade.

Dr. Honjo, too, is now focused on further developing the potential of his work.

“I want to continue this research so that in the future, this therapy will contribute to curing as many patients as possible,” Honjo explained. “We need to determine why this immune therapy does not work in certain cases.” As regards the future of immunotherapy, he is optimistic, saying “I believe this disease will be cured by the end of this century.”

Both men are highly decorated and well-respected scientists, with the duo also sharing in the Tang Prize in 2014 for their work with T-cells. But awards are not the most important thing.

Dr. Honjo told the story of being approached by someone at his golf club.

“He told me, ‘Thanks to you I can play golf again.’ That was a blissful moment. A comment like that makes me happier than any prize.”

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Mesothelioma Awareness Day

September 26 marks an important day in the lives of mesothelioma survivors, their families and caregivers, and those still in treatment; Mesothelioma Awareness Day.

Mesothelioma is an incurable cancer caused by exposure to asbestos. It is aggressive and deadly and has different types based on which part of a patient’s mesothelium is affected. Presently, there is no safe amount of asbestos to be exposed to and there is no cure for this disease which can take up to 20 years to develop in a person’s lungs or pleura.

This Thursday, many will take a moment to consider the impact this disease has had on their lives and the lives of their loved ones. Some have banded together to form groups to spread awareness of this horrible disease and provide information on how to prevent it for future generations while others still are working to make sure asbestos, the cause of mesothelioma itself, is not allowed back into the United States on construction sites or in automotive plants by signing petitions to be delivered to the EPA. No matter the course of action you choose to promote awareness, both are positive and informational in fighting the spread of this horrific disease. One such organization inviting individuals and their families to get involved is the Asbestos Disease Awareness Organization. They are currently gathering signatures for a petition to present to the EPA to ban asbestos with no loopholes nor exemptions including children’s crayons and women’s makeup. ADAO’s petition can be found here: https://www.change.org/p/u-s-environmental-protection-agency-ban-asbestos-in-the-us-now-without-loopholes-or-exemptions.

There will be many events held on social media for users to meaningfully participate as well. A #ENDMeso Twitter Chat from 12 – 1 p.m. EST as well as infographics and a Facebook frame from the Mesothelioma Applied Research Foundation. Allowing users to share ideas and virtually show their support to others in their communities.

Many may also choose to wear “Meso Blue” shirts and wristbands on the day to begin conversations with those seeking knowledge about this vitally important topic. Or volunteering their time at local hospitals or hospice facilities to hear the stories of those suffering or to help the families who have lost a cherished member. We encourage readers to find ways to help in their own communities because all voices and efforts lent to this cause are tremendously helpful.

Thankfully, there are many ways to share information and gain information, no matter which arena you choose.

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Mesothelioma Treatment Pioneer, Dr. David Sugarbaker Passes Away at Age 65

Incredibly rare, malignant mesothelioma (pronounced: me-zoe-thee-lee-O-muh), is an uncommon type of cancer impeding the thin outer layer of tissue (mesothelium) covering most of your internal organs.

Cancer of the mesothelium is caused by exposure to an industrial agent called asbestos and is both aggressive and deadly, and while treatments are available, cure is not typically possible.

The Loss Of A Great Medical Visionary

For nearly three decades thoracic surgeon Dr. David Sugarbaker led the way in advancing the way we medically approach and treat pleural mesothelioma.

We regret to report that at the young age of 65, Dr. Sugarbaker has departed this world and the world of medicine that he devoted his life’s work to.

Among a long list of accolades and accomplishments, Sugarbaker served proudly as the director of the Lung Institute at the Baylor College of Medicine in Houston, Texas.

A Storied Past

For 26 years Dr. Sugarbaker proudly and expertly served at Brigham and Women’s Hospital in Boston. Dr. Sugarbaker worked diligently and with purpose, spearheading and establishing the most noteworthy and prestigious mesothelioma cancer treatment program in America.

While in Boston Sugarbaker invented and perfected surgical techniques that resulted in lowered mortality rates and extend the lives of countless patients diagnosed with this debilitating and ultimately fatal cancer from which there is no cure.

His findings and treatment modifications earned him the respect and admiration of his colleagues and won the hearts of patients, many of which traveled across the country to work with him.

In 2014, Sugarbaker proudly joined the Baylor College of Medicine in Texas.

A Teacher and a Mentor

Dr. Sugarbaker wasn’t just a highly experienced and innovative surgeon, he was also a respected mentor and facilitator of knowledge. The teachings and impact he had on countless prominent thoracic surgeons trained under his watch will keep his legacy alive for decades to come.

Dr. Jacques Fontaine, a thoracic surgeon who started the Mesothelioma Research and Treatment Center at Moffitt Cancer Center in Tampa, remembers Dr. Sugarbaker as a “mentor of mentors”. Fontaine holds that “His vision, focus and dedication to advancing the treatment of mesothelioma have influenced an entire generation of thoracic surgeons.”

Steadfast and Unwavering Dedication to His Patients

Dr. Sugarbaker was full of ambition to help change the world for the better. He joined Baylor College of Medicine with the intent to develop the Lung Institute, and the ambitious program he had hoped would surpass even that which he had established in Boston.

His following within the mesothelioma community was unmatched by any other in his field, with word of patient success stories spreading far and wide. A small group of his patients that had passed the 10-year mark after surgery continued to see him regularly even if that meant traveling long distances to his new base of operations. A following of patients that lived for five years beyond their prescribed life expectancy only aided in furthering his notoriety.

Another thoracic surgeon trained under Sugarbaker, Dr. Abraham Lebenthal, noted that, “In the field [of mesothelioma], he is the gold standard.”

Gone But Never Forgotten

One thing is certain, while the world lost a great man and a highly respected clinician, his patients, their families and the surgeons he has trained will never forget the gift of life and knowledge he gave them.

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