The Imprecise Inquiries of Physicians Involved in Precision Medicine- Janaye S.

 

Chapter Nine of Richard Harris’ book Rigor Mortis  is titled, “The Challenge of Precision Medicine”. Right from the takeoff of this invigorating chapter, Mr. Harris once again delivers to us startling information on how another piece of biomedical research as a whole is incorrect or insufficient. He quotes a pathologist (Carolyn Compton) on how long the wait is to receive cancerous testing specimens for her laboratory. “A big colon gets put into a bag. It sits in the operating room until a circulating nurse gets around to putting it in the holding refrigerator in the operating room. At the end of the day, the same guy who delivers the mail at Mass General comes around and puts it into a cart. He takes it two buildings over, to the pathology department. There it goes onto another bench to get logged in by a technician and it goes into a refrigerator. If it’s a three-day weekend, the resident on call doesn’t come in until Tuesday, opens up the colon and takes a piece of the cancer and puts it into formalin.”(page 197)  Here, we are told that research specimens for cancer take days and even weeks to be observed by a physician. This is very shocking, considering the fact how urgent we make the need for a cure for cancer and cancer cell research. Shouldn’t the scientist and lab doctors working on this be more precise and timely about their research? It is very clear that Dr. Compton does not have control over how long it takes for cancerous specimens to reach her. However, if I was her, I would attempt to speed up the process by accessing the refrigerators in which the cancerous colon specimen was.

A little ways away on the next two pages, we learn about the HER2-positive breast cancer test.  HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2.

http://www.kadcyla.com/about/what-is-her2-positive-metastatic-breast-cancer

According to the FDA (Food and Drug Administration) HER2-positive tests were very accurate and reliable. Richard Harris found something very different. “… About 20 percent of the time it reported that a tissue sample lacked the HER2 trait even though it was not there… Either women who could benefit from Herceptin, a drug that targets HER2, weren’t getting it, or women were receiving an expensive drug that was not only worthless to them but also had side effects.”(page 199) I couldn’t believe this! Could our nation’s own federal health agencies be hiding the truth about cancer research from us?

While I was absolutely dumbfounded by this statement, I did some research on HER2 and how the FDA cleared it for use as cancer treatment. HERE, I was able to find when the FDA approved the clinical use of HER2. I was shocked once again to find that approximately 25% of all breast cancers are HER2-positive.

Moving further along in the chapter, Mr. Harris brings up two other physicians working with cancer research, John Quakenbush and Benjamin Haibe-Kains from the Dana-Farber Cancer Institute in Boston. These two men decided to recreate a test to compare two different results from mass cancer-treating drug trials. The drugs were designed to target and attack cancer genes in the body. Quakenbush and Haibe-Kains found fifteen drugs and about 500 cancer genes/cell lines.  What surprised me about their results was that neither were alike. Once again, another imprecise detail in precision medicine. What surprised me even more was how after receiving their results, they said the following to Mr. Harris, ” How can you ever hope to take data from these cell lines and make a prediction you can take into patients? It just doesn’t work.”(page 205) This was confusing. Quakenbush and Haibe-Kains spoke about their testing as if it were all for naught. But, later in chapter nine the two said that the error in their testing was the “analysis process”.

This chapter neglected to tell us how people were trying to change the cancer testing and results for better. Luckily, I went back to the web to do more research and found that there might be a possible breakthrough in cancer research which could lead to a cure. HERE, I read about a teen who could hold the answer to curing cancer. Seeing this brought my hopes back up and made me wonder about the whole process behind cancer research. How could a nineteen year-old come up with better drug results than larger-than-life science labs? Could drug companies doing research learn a thing or two from independent researchers?

Overall, Chapter 9 of Rigor Mortis was very intriguing.  We were once again introduced to the concept that biomedical research isn’t being done correctly and served shocking facts about what researchers do to results right under our noses. Hopefully, someday in the future, we will be able to change that.