Mission: Possible

ancer: it seems like we hear about it all the time, know someone who’s had it, or struggle with it in our own life.

The standard bearers for detection remain the same—for now: mammography for breast cancer, pap test for cervical cancer, and sigmoidoscopy or colonoscopy for colorectal cancer, according to the National Cancer Institute. But exciting new findings are stepping up early detection and more effective treatment for cancers of the lung, brain, breast and more.

Imagine a group of soldiers surrounding an enemy and taking down the base, effectively capturing the bad guys. That’s what a new compound does with cancerous tumors researchers are experimenting with at the UW School of Medicine and Public Health. Highly promising animal studies show the compound can both detect and treat nearly fifty different kinds of tumors, irradiating them from the inside out. The compound localizes in solid, malignant tumor cells until they die.

“Our hypothesis is that this compound becomes trapped in tumor cell membranes because the tumor cells can’t metabolize and eliminate it,” says Jamey Weichert, professor of radiology at the UW Medical School.

In Weichert’s lab the compound effectively locates and destroys tumors in rodents, restoring the cancer-affected animals to good health. Phase one clinical trials have begun to determine patient safety, and completion of the required FDA trials will take several years, says Cellectar COO Neal Sandy, the local pharmaceutical company running the trials.

“We’re excited about the potential of the compound,” says Sandy. “It has the [capability] to treat many different solid tumors and holds promise for patients that have limited options for treatment.”

Lung cancer remains one of the few cancers whose incidence rate has remained nearly steady and the five-year survival rate is below twenty percent—the National Cancer Institute puts it at 15.6 percent (in comparison the five-year survival rate for breast cancer is eighty-nine percent).

That’s why electro-magnetic navigation bronchoscopy is so exciting: it has the potential to catch lung cancer earlier. Doctors insert a scope in the windpipe and down into the lungs, which can detect nodules deemed suspicious and remove tissue for a biopsy. The device uses an electro-magnetic field that provides a 3–D image of the lungs while a patient is undergoing a CAT scan.

“This is a guidance tool that’s used during the bronchoscopy so we know exactly where we are in the chest. And that allows us to do biopsies of smaller nodules to determine malignancy,” says J. Scott Ferguson, director of interventional pulmonary medicine at the UW Medical School. “Three years ago I would not have biopsied anything smaller than two centimeters, and now I’m biopsying nodules as small as five to eight millimeters.”

In the past, Ferguson says it was impossible to perform the procedure even if there was a chance for malignancy—X-rays could catch small nodules but if they weren’t large enough to biopsy, patients would have to wait until the nodule was larger to diagnose.

“We talk about the lung cancer paradox because we haven’t been making early diagnoses—a nodule would be too small to diagnose and the patient would have to wait,” says Ferguson. “I think now we’re able to offer something where there isn’t a wait … We hope to make an earlier diagnosis with a better chance for care.”

A roadmap for recovery? A new type of scan is doing just that. MRI/CT software by Prism Clinical Imaging in collaboration with the Medical College of Wisconsin in Milwaukee can aid in the diagnosis and treatment of brain cancer by creating a specialized map of a patient’s brain during a scan, which collects data that’s analyzed by a neuroradiologist and neurosurgeon and used as a navigation tool during surgery. The map identifies the location of the tumor as well as the “risk zones” around the area that could lead to neurological damage if removed—still a serious challenge in many brain operations.

“The neurosurgeon … obviously wants to remove the tumor but not damage something critical [in the brain that controls] vision, movement or language. The data coming out of Froedtert indicate a pretty significant decrease in surgical neurological side effects,” explains Edgar DeYoe, principal investigator, professor of radiology at the Medical College and co-founder of Prism.

The software is already being implemented at ten sites nationwide and locally is used at Froedtert in Milwaukee and UW Health in Madison.

Scientists estimate that fifty to seventy-five percent of cancer deaths in the United States are caused by lifestyle behaviors like smoking, physical inactivity and poor diet, according to the NCI. The NCI’s website allows consumers a glimpse into their mortal lives that could be the kick in the pants some need. Recent trends indicate that adult/youth smoking rates have decreased (good); red meat and fat consumption have remained steady (so-so); alcohol consumption has risen (not good).

Survival rates after cancer diagnosis are rising—prostate, female breast and colorectal are notables. Oddly, the number of people undergoing screenings for breast, cervical and colorectal fecal occult blood test fell slightly in the past few years. The report cites barriers like lack of insurance and knowledge as reasons why people don’t get screened.

The good news? Cancer rates in general are falling—likely a testament to health education and screenings performed on the right patients at the right time.

Shayna Miller is associate editor of Madison Magazine.