Contributions of Physics To Advancing Cancer Research Have Been Profound

Human cancer (fibrosarcoma) cell studied at Johns Hopkins University Physical Sciences -Oncology Center for identifying metastatic agents.


It was two years after I received my first cancer treatment (at UCSF) using its high dose rate afterloader, see account here:

The Longest Day...And Then Some...

That I learned how advanced physics was contributing to the study of cancer and improving our understanding, mainly via PS- OC (Physical Science - Oncology  Centers) at different universities. Their origin goes back to 2009 when a dozen PS-)Cs were created by the National Cancer Institute. Their purpose was to team physical scientists with biologists and oncologists to seek a new understanding of cancer development.  This in turn could lead to new and improved treatments as well as diagnostics.  In the words of Paul Davies - a cosmologist who is the lead investigator at Arizona State University's PS-OC: (PT, Nov., 2014, p. 23)

"Cancer research is far too much money chasing far too few ideas. We need to think our way to a solution, not spend our way to a solution."

Davies then goes on to observe that both experimental and theoretical physics are useful in understanding and modeling metastasis.  At ASU one such synergistic project requires cancer cells to transition from static to slippery and motile, then squeeze through the tissue around the rumor and secrete membrane -dissolving chemicals to get into the bloodstream.

Once that occurs then other organs can be colonized and full metastasis is underway.  For example, in prostate cancer - which I have dealt with for 7 years now (latest PSA held steady at 4.8 from 6 months earlier) -   once the cancer cells get into the bloodstream they often migrate to the bones and especially the spine, where they become "mets". e.g.


PET  scan of patient with advanced prostate cancer showing extent of bone metastasis (dark spots) congregated in the spine and even brain.  These are actual prostate cancer cells that have migrated from that gland to these other, distal locations.

For the advanced prostate cancer patient the only way known to get a further lease on life is via hormone therapies. such as ADT (androgen deprivation therapy) which slows tumor growth by cutting off the cancer's primary fuel: testosterone.  Since the side effects can be horrific, i.e. constant brain fog and cognitive incapacity - memory loss, depression, gynecomastia, weight gain, diabetes, cardiac issues etc. it's regarded as a desperation, last resort option by many.   Given all of this it is easy to comprehend why figuring out the metastatic process is important in cancer treatments, diagnostics.

At ASU one project that's received attention concerns the use of atomic force microscopy to measure the degree to which cancer cells (like the fibrosarcoma cell shown at top) soften as the disease progresses. The approach entails obtaining the Young's modulus of the cancerous cells being investigated.

The Young's modulus is a dimensionless quantity in the elastic mechanics of solids defined as the tensile stress divided by the tensile strain, e.g.

Y  =  (F/A) /  (D L/  L _o )

The tensile stress then (numerator) is the ratio of the external force acting F, to the area A.  The tensile strain is the ratio of the change in length D L (the quantity Y is usually applied to wires) to the original length ( L _o ).  In terms of the ASU experiments, the researchers - to get Y-  prodded the cancerous cells with the tip of the atomic force microscope. According to lead investigator Davies:

"That change in Young's modulus is critical to the whole metastatic process, the squeezing through gaps."

The takeaway? Limit the cancer cells ability to stretch themselves and "squeeze" (e.g. keep D L  a minimum) and it might be possible to control metastasis.  As Davies adds:

"What has become abundantly clear the last few years is that the physical mircoenvironment can play a critical role in cell behavior. Just pressure forces or even shear stresses can affect gene expression."

Given all this, we certainly should expect much more cancer research funding to find its way to the physicists working at PS-OCs and now playing an equally important role to oncologists in extending our comprehension of cancer metastasis.

Cigarette Butts - The New Bane of the Planet

Let's concede that smoking cigarettes is one of the most disgusting human habits there is, not to mention one of the most unhealthy - prompting lung disease (including cancer), heart disease, strokes and sundry other problems.  Now, new research has revealed another problem: the pollution of the planet via trillions of tossed cigarette butts.

I can't speak for readers, but one of the most infuriating sights I've beheld is cigs tossed out of a car window from a moving vehicle on the open highway or even main thoroughfares in a city. Such behaviors show the people who toss them regard the planet and their own city -state as merely  a giant dumping ground.

But the problem is not confined to cities or highways. Each year, hundreds of thousands of volunteers scour beaches all over the world, picking up trash. Ocean Conservancy estimates that last year alone these Earth conscious folks picked up over two million cigarette butts among the other refuse,  By one estimate, two thirds of the six TRILLION cigarettes smoked each year worldwide end up being dropped. They amount to a total of 750,000 TONS. Dropped on beaches, dropped on city sidewalks, dropped on streets, dropped wherever the numbskulls who do it think no one is looking  - so can't hold them to account, or won't.

Now, thanks to Thomas Novotny's Cigarette Butt Pollution Project we know just how bad the situation is. Novotny's project is currently studying cigarette waste from a number of perspectives including: toxicity, accidental consumption by children and animals, and potential for adverse effects on human health via dumping.

The results so far reflect an urgent need to reduce this form of toxic waste. Some of the findings:

1) Used butts are not just pieces of non-biodegradable plastic. They also contain the  carcinogens, nicotine and toxins found in all tobacco products.

2)  Just one butt soaked in a liter of water for 96 hours leaches out enough toxins to kill HALF of the fresh or salt water fish exposed to them. Thus, there is biological plausibility to the argument that such a vast volume tossed into the environment each year will adversely affect human health.

3) Filters on cigs are no use whatsoever. They were originally designed to keep loose tobacco out of smokers' mouths - not to protect their health. The fact is that these filters do nothing, nada to filter out harmful toxins. According to the Surgeon General and the National Cancer Institute filters lack any benefit for smokers. Indeed, "cancer risks have actually increased over the past 50 years." (New Scientist, June 28, p. 26)

Thus, the tobacco industry's solution of a biodegradable filter is a non-solution. Toxins would still leach out while falsely reassuring smokers of doing justice to the environment.

It is time now for the tobacco industry itself, which is causing the monstrous problem, to give a helping hand as opposed to largely leaving the responsibility of cleanups to communities, eco-conscious activists, and individuals

It could also help by posting a message - or using adverts - to advise chronic smokers to cease and desist with their revolting habit of butt -flicking. Better, a fine of $500 each time they're caught or their license reported to a state bureau of highway (or environmental) code enforcement. After a few hits they may find it economical to stop tossing the butts from their windows.

But one of the best solutions, suggested by Novotny's group is getting rid of the filters altogether. They serve no useful purpose so why keep them? To preserve the illusion smokers are somehow protecting themselves?  The filter may reduce some tar and nicotine but the total impact on the planet is god-awful.

It is time that we help with the end objective, and get friends, family as far as we are able, to stop tossing butts.

Or better yet, stop this noisome habit altogether! I stopped cold turkey after being hurled from my bed in New Orleans 45 years ago, barely able to breathe. The doc I went to said I had two choices: keep smoking my Marlboro 100s (2 packs a day)  and end up in an early grave or with incurable lung cancer at age 70 - or stop the foolishness and chew gum instead. I opted for the latter, and sadly for many smokers a life -altering experience (or near death one) may be what it takes to get them to halt their poisoned puffing.

Obviously, none of them are going to stop out of any concern for the planet their butts are converting into a giant ash tray.

Should This Gynecologist Be Allowed to Examine, Treat Male Patients? Of Course!

Dr. Elizabeth Stier - wants to continue treating the men in her practice.


Dr. Elizabeth Stier isn't asking for much, only that she be allowed to continue examining and treating male patients  at risk for anal cancer. The disease is rare, but it can be fatal and its incidence is increasing, especially among men and women infected with H.I.V. Like cervical cancer, anal cancer is usually caused by the human papillomavirus, or HPV, which is sexually transmitted.  (One of the last major media notices put out about it was a few years ago, when Farrah Fawcett described her ordeal.)

As a New York Tmes piece described Saturday, though most of Dr. Stier's patients are women, (she works at Boston Medical Center), she also treated about 110 men last year, using techniques adapted from those developed to screen women for cervical cancer.  

But in September, the American Board of Obstetrics and Gynecology insisted that its members
treat only women, with few exceptions, and identified the procedure in which Dr. Stier has expertise as one that gynecologists are not allowed to perform on men. Doctors cannot ignore such directives from a specialty board, because most need certification to keep their jobs.  Doctor Stier expressed shock to learn that she would lose a vital credential, board certification as a gynecologist, unless she gave up this important part of her medical practice and her research: taking care of men at high risk for anal cancer.

Now Dr. Stier’s studies are in limbo, her research colleagues are irate, and her male patients are distraught. Other gynecologists who had translated their skills to help male patients are in similar straits.  Worse, this comes at a time when researchers are about to start a major clinical trial that is aimed at preventing anal cancer (increasing at new, alarming rates), with $5.6 million from the National Cancer Institute. Observers say the Dallas' board’s decision will keep some of the best qualified, most highly skilled doctors in the United States from treating male patients in the study.


Though Dr. Stier and the Director of the planned study asked the Board to reconsider their decision, they remain adamant. According to the Times article, they are convinced such practice amounts to "money making" and is "tarnishing the specialty's image. . But  Dr. Mark H. Einstein, a gynecologic oncologist at Montefiore Medical Center  said, “The board’s approach is to be rather dogmatic and to draw a line in the sand.”
 

In many ways it reminds me of a fierce debate that erupted in an Astronomy meeting some years ago when one purist decried planetary scientists calling themselves astronomers. "How can they be astronomers? " he asked, "when the very name is based on 'astro' referring to stars, not planets!"  Presumably, if this person could be transported to the present context, he'd argue "gyne" refers to females so can't be applied to males.


But he'd miss the point that many of the techniques are the same and are medically transferable. For example, the technique entails the use of Anoscopy. .  This involves using 4-5 cm long lighted tube (anuscope)  to examine the anal canal which is 4-5 cm long. A high resolution version also adds a magnifier to look for abnormal growths much the same way as is done in a colonoscopy. These growths may be cancers or precancers, with the latter requiring surgery  though doctors can burn off precancers in much the same way gastro-enterologists can excise polyps during a colonoscopy.

The point is that Dr. Stier has been an expert in the high resolution method and her patients - males especially  - have come to depend on her. Though she has been treating men for 10 years, she will now be able to see only women and this worries her.  What most concerns her is what will become of the men she's been treating. As she points out in the NY Times piece, the procedures are embarrassing and uncomfortable for patients, and it takes time for a doctor to gain their trust.  Now, they will have to seek treatments and care at other hospitals, with other medical practitioners with whom that same trust may not be possible. It is possible that they won't even bother.

Dr. Joel Palefsky, a specialist at the UCSF Medical Center in San Francisco(where I had my prostate cancer high dose treatment) said:

"We need as many trained people as possible. The assumption all along has been that many of the gynecologists we trained would participate in the study and would see both men and women.”


Sadly, however, definitional absolutism and semantics has crept into a field which can ill afford it. If we are ever to win the battle against cancer - especially against the "squeamishness-inducing, embarrassing cancers" that make people's skins crawl - we will need all hands on deck and as many different resources and high level skilled professionals as possible!

Bravo to Dr. Liz Stier for trying to do her part!