It’s a medical nightmare: a 24-year-old man endures 350 surgeries since childhood to remove growths that keep coming back in his throat and have spread to his lungs, threatening his life. Now doctors have found a way to help him by way of a scientific coup that holds promise for millions of cancer patients.
The bizarre case is the first use in a patient of a new discovery: how to keep ordinary and cancerous cells alive indefinitely in the lab.
The discovery allows doctors to grow “mini tumors” from each patient’s cancer in a lab dish, then test various drugs or combinations on them to see which works best. It takes only a few cells from a biopsy and less than two weeks to do, with materials and methods common in most hospitals.
Although the approach needs much more testing against many different types of cancer, researchers think it could offer a cheap, simple way to personalize treatment without having to analyze each patient’s genes.
“We see a lot of potential for it,” said one study leader, Dr. Richard Schlegel, pathology chief at Georgetown Lombardi Comprehensive Cancer Center in Washington. “Almost everyone could do it easily.”
An independent expert agreed.
For infections, it’s routine to grow bacteria from a patient in lab dishes to see which antibiotics work best, Dr. George Q. Daley of Children’s Hospital Boston and the Harvard Stem Cell Institute said in an email. “But this has never been possible with cancer cells because they don’t easily grow in culture,” he said.
The new technique may reveal in advance whether a person would be helped by a specific chemotherapy, without risking side effects and lost time if the drug doesn’t work. “Pretty nifty,” Daley wrote.
In the case of the 24-year-old, described in Thursday’s New England Journal of Medicine, lab-dish tests suggested that a drug used to treat a type of blood cancer and some other unrelated conditions might help.
It’s not a drug that doctors would have thought to try, because the man technically does not have cancer. But his lung tumor shrank after a few months of treatment, and he has been stable for more than a year. He still has to have operations to remove throat growths that keep coming back, but only about once every five months.
The man, an information technology specialist in suburban Washington who asked to remain anonymous to protect his privacy, has recurrent respiratory papillomatosis, or RRP. It’s usually due to infection at birth with certain types of a virus, HPV, that causes genital warts.
The condition causes wartlike growths in the throat, usually around the voice box. These growths usually are noncancerous but can turn malignant, and even benign ones can prove fatal if they spread to the lungs. The main treatment is surgery, usually with lasers to vaporize the growths and keep them from choking off the airway or making it hard to talk.
About 10,000 or more people in the U.S. have the disease, said Jennifer Woo, president of the RRP Foundation. Woo, 29, is a medical student at Georgetown and one of the researchers on the study. She also has the condition but said it is confined to her throat and has required only about 20 surgeries so far.
The man in the study has a much more serious case.
“I was diagnosed when I was 3 or 4. At first, I had to have surgery every 7 to 10 days,” the man said in a phone interview. “I get short of breath and my voice will get more hoarse.”
Two years ago, the growths to his lungs became extensive and life-threatening, and his physician, Dr. Scott Myers, described the condition at a meeting of Georgetown hospital specialists. “It’s crushing the airway,” Myers said.
Doctors suggested that the new lab method pioneered by Schlegel and others might help. It borrows an idea from stem cell researchers: adding mouse cells for nourishment, plus a chemical that prevents cell death to an ordinary lab culture medium. That enabled healthy and cancerous cells to keep growing indefinitely.
Researchers grew “mini tumors” from the man’s lung mass and from healthy tissue and screened various drugs against them. One proved ineffective. Another worked against the tumor but at too high a dose to be safe. The third did the trick.
A similar approach could let doctors screen drugs for cancer patients.
“What could be more personalized than taking this person’s cell, growing it in culture, finding a drug to treat them and then treat them?” said Doug Melton, co-director of the Harvard Stem Cell Institute. The Georgetown method gives an answer quickly enough that it could save lives, he said.
Tyler Jacks, a cancer researcher at the Massachusetts Institute of Technology and former president of the American Association for Cancer Research, said the next step is to show that this could work for many different cancers and that it leads to better outcomes in patients.
“It seems to have worked in this one instance, but other tumors might prove to be more challenging,” he said.
The National Institutes of Health paid for much of this work and has already sent research teams to Georgetown to learn the method. About a dozen other universities have done the same, Schlegel said.
So far, his lab has grown prostate, breast, lung and colon cancer cells.
Georgetown University is seeking a patent on the method.
AP Science Writer Malcolm Ritter contributed to this report from New York.
Medical journal: http://www.nejm.org
Throat disease: http://www.nidcd.nih.gov/health/voice/pages/laryngeal.aspx
Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP
More Related Stories
- Greek yogurt, toxic waste hazard?
- Glenn Beck: CNN interview with atheist tornado survivor was a setup!
- Incoming BBC news director on journalism gender gap: "We can do better"
- Illegal construction, shoddy materials at fault in Bangladesh factory disaster
- Pope Francis: Atheists are all right!
- Lawsuit alleges anti-gay hiring practices at ExxonMobil
- Boy Scouts poised to vote, still greatly divided on gay youth
- Is recreational pot use safe?
- How I ended up in a pyramid scheme
- My bipolar partner beat me
- Teenagers care more about online privacy than you think
- Radio host tweets rape joke, blames journalists for reporting on it
- El Salvador court delays ruling on abortion case while woman's life hangs in the balance
- Kicked out of the mall -- for an anti-cancer hat
- Why do men pretend to be women online?
- Pa. governor "can't find" any Latinos to work in his administration
- Conservative group blames military sexual assault on "Don't Ask, Don't Tell" repeal
- Is Pittsburgh the next Portland?
- Tornado survivor to Wolf Blitzer: Sorry, I'm an atheist. I don't have to thank the Lord
- Donald Rumsfeld worried that marriage equality will lead to polygamy
- San Francisco Giant Jeremy Affeldt apologizes for homophobic past
Featured Slide Shows
The week in 10 picsclose X
- 1 of 11
Lisa Montgomery embraces her nephew Thursday after a tornado tore apart her home in Cleburne, Texas. The twister killed six people and destroyed entire swaths of the North Texas town.
Credit: AP/LM Otero
Jack McMahon, the defense attorney for abortion doctor Kermit Gosnell, speaks outside the Criminal Justice Center in Philadelphia Tuesday. His client was convicted of killing three babies in his clinic, and will serve multiple life sentences.
Credit: AP/Matt Rourke
A photo taken Monday captures Vice President Joe Biden's response to a Milwaukee second-grader's innovative proposal to end America's epidemic of gun violence. This guy!
Credit: AP/Jenny Aicher
Sen. Rand Paul, R-Ky., flanked by a grouper-eyed Michele Bachmann, addresses the IRS' admission that it targeted Tea Party groups in advance of the 2012 election. In an op-ed for CNN Thursday, the Kentucky senator slammed the president for his faux outrage.
Credit: AP/Molly Riley
Ousted IRS chief Steven Miller is sworn in on Capitol Hill Friday. Miller testified before the House Ways and Means Committee on the extra scrutiny the agency gave conservative groups applying for tax-exempt status.
Credit: AP/J. Scott Applewhite
Attorney General Eric Holder pauses as he testifies on Capitol Hill before the House Judiciary Committee Wednesday. Holder is under fire, among other things, for the Justice Department's gathering of phone records at the Associated Press.
Credit: AP/Carolyn Kaster
O.J. Simpson sits during an evidentiary hearing at Clark County District Court in Las Vegas, Nev., Thursday. Simpson, who is currently serving a nine-to-33-year sentence in state prison for armed robbery and kidnapping, is using a writ of habeas corpus to seek a new trial.
Credit: AP/Las Vegas Review-Journal/Jeff Scheid
Major Tom to ground control: On Sunday astronaut Chris Hadfield recorded the first music video from space, a cover of David Bowie's "Space Oddity."
Credit: AP/NASA/Chris Hadfield
When it rains it pours. President Barack Obama speaks during a news conference Thursday with Turkish Prime Minister Recep Tayyip Erdogan, inexplicably inspiring an #umbrellagate Twitter meme.
Credit: AP/Jacquelyn Martin
A smoke plume rises high above a road block at the intersection of County A and Ross Road east of Solon Springs, Wis., Tuesday. No injuries were reported, but the the wildfire caused evacuations across northwestern Wisconsin.
Credit: AP/The Duluth News-Tribune/Clint Austin
Recent Slide Shows
- 1 of 11