Sunday, August 19, 2007

The Way Forward

I have been doing alot of thinking about how to insure I beat this thing. Here's what I think now.

First of all, I will of course first do the prudent things recommended by my physicians to get through the initial period -- conventional radiation and chemotherapy, to fight regrowth of the tumor from those parts that could not be surgically resected. This will buy some time to pursue more innovative and promising approaches.

But then I plan to drop my role as "patient," and take up the role of "scientist/engineer." I intend not only to personally survive this cancer, but I want my case to mark the dawn of a new era in treatment of glioblastomas, in which treatment is curative, not merely palliative. I plan to devote myself and my laboratory at Caltech to achieving this goal, working in close collaboration with my medical team, especially Dr. Igor Fineman, my fantastic neurosurgeon, and a top-notch research scientist himself.

So what is required to achieve this ambitious goal? Fundamentally, it is necessary to be able to selectively destroy tumor tissue, without attacking healthy brain tissue. For GBMs, this is hard, because they are formed from diverse tissue types, and physically intertwine with healthy tissue.

A very promising approach is to use heat to destroy the tumor, if heating agents can be selectively bound to the tumor. One way to do this is to use the body's own immune system, using T-cells that bind to the tumor, and that are also attached to small metal nanoparticles. The net effect is that the tumor can be selectively coated with nanoparticles. These nanoparticles can be heated with an external AC magnetic field, or by laser irradiation at their plasmon frequency (for gold, this is near 600 nm - red light).

In my group at Caltech, we have done quite a bit of work with gold nanoparticles as heaters for other applications (micro/nanostructure formation, fluid pumping in microchannels). But other groups are already using nanoparticles to heat and destroy malignant tumors. I would be very excited to shift our focus to using gold nanoparticles to selectively heat and destroy glioblastomas. I really think this approach may offer the first possibility of curative therapy -- that is, therapy that really gets all of the residual tumor, leaving nothing for further growth!

For this reason, I not only expect to eventually be cured of this GBM, but I expect this will increasingly be the norm! We will go from the present situation, in which survival is measured in months, to one in which patients live many years, and ultimately die of something else. I see no reason to think this cannot happen - it can, should, and (given enough resources and smart people) will happen!


Verma G said...

What an amazing thing, that your work at Caltech could be used in your personal battle with this thing! This kind of collaboration could achieve wonderful things for you and others. How encouraging.

Much love,

Jeff H said...

Hi Dave! I've been reading your blog on a regular basis here and am glad you're doing so well. In fact, I'm thrilled. My mom is a cancer survivor and we just passed 5 years of being cancer free this May. Cancer has been a big problem in my family (particularly my mother's side) and when she got cancer I promised myself that I would focus my abilities to try and help defeat it. I just want to let you know that I would like to be first in line to sign up and devote my efforts to the new goal of finding a curative solution using some of the techniques we already have in place in the lab.

Additionally, I sent the blog link to my mom because she is always interested in both what is going on with me, and those around me. She is hands down the strongest person I know. She wanted me to tell you that she is impressed with your good attitude toward your journey and your sense of humor, which she says, will do wonders for your recovery. These were both qualities she possessed. She also said "now he has a good excuse if his memory fails him!" Anyway, I thought some words from a cancer survivor might be helpful. If you want her email please let me know. I know she can help as well as anyone else in my family.

Hopefully we can talk soon about the new research opportunity. I am confident that I am as passionate about the goal as you are...

Wishing you the best,