Under the hood - 2010

Once upon a time cancer was considered a disease of cell proliferation. Chemotherapy was aimed at cellular cycle activity and its success has reached the limitations of this disease model.

New insights have led to new therapeutic directions and opportunities. Today the basic mechanisms causing cancer can be considered as alterations in a clone or "tribe" of primitive cells that develop changes supporting their survival or "immortality".

Understanding the cellular communications programs and signals that lead to cell death, known as apoptosis, has led to the understanding of how these intra-cellular pathways are altered in cancer cells.

This in turn has allowed the tailoring of biological agents targeted at one or more of these signal elements and pathways.

This personalized therapy is now applied in the day to day treatment of breast, lung, colon and Gastro-Intestinal Stromal Tumor as well as chronic myeloid leukemia. Cell signaling products are available as pharmacological products to support anemia, low white cells and platelets.

A New York Times article offered a glimpse into these endeavors, and more is to follow in the companion web site: cancer-management.com.

Navigating the cancer map

I am constructing a companion website. This introduces a more structured approach to the educational instrument I use on a daily basis. I have been using this outline in one form or another for the last four decades and it is refined as evidence and knowledge has evolved.

This blog will deal with the "softer" side of my daily interaction with patients and their family. These interactions trigger a broad array of questions and challenges that may be of interest to a wider audience.