Angela Yurtin
Pd. 2
The articles The Cancer Killer, Insurance, and The Enemy Within all highlighted many concerns and problems that arise with cancer. They not only introduce medical aspects, but also the societal aspects as well. The articles also told of many procedures and ideas that are currently being studied and tested, and they highlighted many important breakthroughs.

The Cancer Killer was based on new research and development of the p53 gene, and how it affects cancer. It is a very important gene that when healthy, keeps cells on track. However, when a mutation occurs, many serious problems can develop.
The p53 gene was discovered in 1979 by David Lane of the University of Delaware and Arnold Levine of Princeton University. It wasnt until 1982 that biologists isolated the gene and found that it seemed to cause cancer. In 1989 Levine and Volgelstein found that the gene was responsible for killing tumors. This is when cancer research took a turn and began to focus on the molecule of the year, as proclaimed by Science magazine. Recently, Nikola Pavelitch of New Yorks Memorial Sloan-Kettering Cancer Center was able to get a photo of the gene, and she notices that when the disease (cancer) is forming, rogue molecules are present that keep it from performing its good deeds. There have since been 5,200 studies on p53 and researchers are sure it will be a major discovery.

The p53s function is as the director to control damage within the cell. When it is healthy, normal cells keep them around and they continue to degrade and replenish themselves. If a high alert is set in the cell due to invaders such as radiation, chemotherapy carcinogens, or chemotherapy drugs, the DNA is damaged, creating a potential risk for cancer. The p53 stops degrading and becomes active as it builds its supply and turns off the defective cells ability to replicate until it can repair the damaged DNA. It can do this by getting into the DNA and inhibiting the growth of the cell or even terminating it.

If the p53 gene is unable to perform its job, serious problems can arise, such as the onset of cancer. Most often, a mutation of the gene causes one of the 2,362 chemical letters that compose p53 to change. The p53 then generates garbled proteins and it fails to stop the defective cells from copying themselves. This is the cause for 60% of all human cancers.

One reason a person would have a mutant gene is the Li-Fraumeni families disorder where the sperm or egg cell has a mutant that is passed to the child. In theory, the child receives one good gene which could right the bad cell, but it does not work this way. Every cell that has no good p53 cells completely lack the functions of the gene. When one of these cells makes a spelling mistake, and the cell has become one step closer cancer as it has lost its primary defense. Many mutated p53 genes are inherited from parents, but most of the mutations are not. These are mutated because of a copying error that occurred and thus makes the p53 ineffective.

Recently, many have noted that the cancers associated with p53 mutations are quite aggressive in nature. These cancers are more often fatal than those of people with a healthy gene. A mutation can do more harm to the cell than cripple it, and it can actually worsen the conditions. A mutant can actually turn on a set of genes that make a cell immune to cancer drugs and therapies.

One major characteristic of cancer is that it leaves no trace of where it stemmed and why. The p53 may change all this for oncologists, who will be able to trace the cancer back to its original cause, the step where the mutation began and made the situation detrimental.

Lung Cancer is caused by substances in cigarettes and smoke that changes the G to a T (benzopyrene) or a C to an A (cigarettes). The benzophyrene clings to an active spot in the mutation, which robs the lungs of the mechanisms it requires to suppress tumors. This is the first step in cancer.

Liver Cancer is usually affected by the Hepatitis B virus and aflatoxins. The aflatoxins change the G to a T, and may become out of control and a hepotocarcinoma will develop. With Hepatitis B, proteins that are made where p53 are made keep it in a double-helix and keep it from escaping and taking care of the mutation that has occurred.

Skin Cancer causes the p53 gene to be suicidal because of the sunlight. The UV light can also cause the change of CC to TT which can cause damage and it can then continue to spread without any regulation.
Cervical Cancer is caused by human papilloma virus (HPV) that gets in undetected. It then continues to reproduce itself to create many viruses that will eventually digest the p53.

Breast Cancer is an exception to the 60% of human cancers caused by p53 in that many variations of it still contain a healthy p53 gene. When p53 is the cause, a protein traps the p53 and keeps it under wraps as the cancer runs its course.
Researchers are currently making great leaps of progress in the early identification of cancer due to the discovery of p53. The can now see if the p53 has any pollutants attached or if it is defective in any way. Research can now test for the presence of the gene and tell whether it is healthy or not, which can let us know how heavily to monitor and begin to treat the cancer that may surface.

This new discovery has unveiled a wealth of treatment opportunities, as well as being able to give insight as to which method of treatment would be best for each individual case of cancer. The presence of a healthy p53 gene that is just trapped by a tumors defenses can be very responsive to radiation therapy because this could release the gene to produce its initial reaction it would produce if it were not trapped. This also shows that people without a healthy p53 should not undergo this treatment because it would not be very effective, which eliminates the pain and cost of such a therapy that would inevitably prove unsuccessful.
The p53 has also shown great opportunities for progress in treating many types of cancer. Jack Roth of the University of Texas M.D. Anderson Cancer Center has made viruses that actually contain sets of healthy p53. These viruses would then be injected into the tumor and could act as the bodys own genes, killing and destroying the tumor. In a study, 3 out of 9 patients experienced their tumors halt in growing, and another 3 patients experienced shrinkage of their tumors.

Another possibility arises from Frank McCormick of Onyx Pharmaceuticals, who turned broken p53 against the cell. In a tumor cell with broken p53, the gene infiltrates tumorous cells then replicates and bursts the cell. The virus he injects actually spreads, so the need for treatment would only be one or two doses to destroy the entire cancer.
Others have visions for the future of p53 research. Curt Harris of the National Cancer Institute sees many drugs that keep the p53 from being tied up. It prevents it being surrounded and therefore encapsulated in a potentially harmful way.
This research in p53 seems very impressive to me because I didnt realize that the science was getting so specific and so close to any possible cures. This seems a promising road for many patients that have healthy p53 genes because of the many ways to destroy the things that interact with it. For those with mutants, I can see how the technology can be helpful in keeping them away from radiation and chemotherapy which may make them weaker without producing results. There also seems to be headway in giving these patients a second chance with injections of other p53s.

Insurance is a very informative article that sums up the fears and concerns many people have about knowing what their genes have in store for them with respect to medical coverage and financial security. It also has a very informative section that highlights many common terms that are associated with cancer and therapy, and it explains them in a user-friendly way.

This vocab section tells us that a gene is a unit of heredity that has a specific sequence of chemicals that is on one of the 23 pairs of chromosomes in our bodies. This code of chemicals determines which proteins are made. The gene is found in every cell, but each cell has a different set that are turned on, giving it its unique function. A mutation is a gene that has experienced a change in this normal sequence and is now defective because of this change. These mutations are caused by such things as inheritance, chemicals that will cause such changes called mutagens, and viruses, among other things. This then leads the gene to produce the incorrect protein and it is no longer able to fulfill its own job in the cell.

The rest of the article sums up the concerns. Since genetic testing has come into play, many insurance companies have access to this information. These large companies are not concerned with the current status of your health, but rather with the risks you have to become unhealthy. The DNA testing information will show your risks and may potentially cause a genetic underclass that label people a bad risk for medical problems to come. The raising usage of the testing will make this type of discrimination a large-scale problem.
The thought of being uninsured makes the testing seem very unappealing, and this can cause harm to the advancement of the science behind the testing. The testing has helped give people control by being a great factor in early detection and monitoring, as well as alerting them to potential problems they may experience. These tests can keep people healthy by having them change their lifestyles so they remain healthy, but with the risk of discrimination looming, many people will choose against knowing, putting them at a larger risk with respect to their health in the future.

One thing the government and science is trying to install is a system of privacy, but it is not that way as of yet. It is already beginning as insurance companies pick apart peoples records, employers get their hands on benefit info, and other services can get in on the records such as schools, adoption agencies, and even the military services. All of these areas can see these records and could possibly deny you for services, benefits, and even jobs not because of a disease you have, but because of a gene or family condition that exists that is not the norm.

It may seem like a problem that looms in the future once the testing gets more popular, but the reality is that it is already here. At the Georgetown University, a sociologist by the name Virginia Lapham completed a survey on 332 families that sought help in the genetic help group. In these cases, 22% had been refused insurance and 13% had lost their jobs to problems they didnt have yet. At the Harvard Medical School, Lisa Geller noted 200 cases of discrimination against completely healthy people. Their cases ranged from lost jobs due to treatable problems, and the inability to give a child up for adoption because of a family history of disease. The discrimination has begun.

Is it any wonder, then, that many people faced with the decision choose not to be tested? Out of many studies completed, way less than half the people in each study would choose to know if they had a mutation or not because of fear of losing their coverage. Not only do the people fear knowing they will get a debilitating disease, they fear being discriminated against.
This lack of interest will definitely cause a lack of scientific progress because they cannot find people to help them with their studies. For example, in the University of Pennsylvania Cancer Center, only one-fourth of the women who have been found to have a genetic mutation for cancer will help in research that follows their diagnosis.
The next step is for a lack of discrimination to occur, and federal agencies are supposedly stepping in to help. The lawmakers have begun to talk in Congress to strengthen existing bills so that many important agencies that could potentially get a hold on the info can no longer get it. But this makes insurance companies angry as they say they charge people based on their risk factor, and these tests will help give a person the fair rate they deserve. But is it fair to charge someone or stop their coverage for something they cannot control based on heredity and no lifestyle?
But the article finally points out that discrimination, while being a major problem, is not the only one. The knowledge of a mutation can only be a prediction, and it doesnt dictate when or if the person will experience the problems associated with it. It can also split up families, not to mention kill the hopes of a person who knows they will become terminally ill.
I think its a shame that somebody would be denied coverage or loose their job because of a problem they do not have. I also think that this risk of being discriminated against will seriously hinder a persons decision on taking a very valid and potentially critical test that can help them prepare for the future and change their lifestyle so they stay healthy. I think the government should step in and make the info classified only to those who can help a patient with it, not hinder their lives.

The final article, The Enemy Within is a great source of explaining what happens during cancer and how we can take steps to prevent it with many possible solutions. It begins by explaining a drastic procedure used to cure a little boy named Dustin Fargan from his usually fatal medulloblastoma brain tumor that did not respond to usual methods of treatment. On a risky long shot, a new treatment was tried that involved completely destroying his ability to make bone marrow and red and white blood cells. He was revived after surgery with a fresh batch and he has remained cancer free for four years, which means his case has made a major leap for oncologists.

The oncologists seem very optimistic as they have learned how to treat many cases, but just dont have the means to do it yet. They have revealed malignant cells and have formulated plans of attack so that just maybe they can lower the rate of deaths in the US from the whopping 554,740 per year. They have also come to realize that there is no miracle cure, but that each case must be treated with its own uniqueness. But with each success, they are one step closer to a cure.
Cancer is known to be a genetic disorder, that is caused by cell mutations that occur during the process of division. The oncogens stimulate a cell to divide, and a tumor suppressor damps it down in a normal system. When the mutations take effect, they multiply and begin playing games to keep itself alive. Some of these tricks include: silencing the genes which indicate a dysfunction in the DNA when it is being copied, becoming immune to poisons and anti-cancer drugs, and acquiring the ability to supply itself with blood vessels it uses for its own nutrition. This all creates the cancerous tumor that will spread.

One way of attacking is to stop the cell cycle by harming it in one of the critical steps during the division. These steps give the opportunity to intervene, and many modern techniques take advantage of these separate steps. Anticancer drugs utilize this with many forms that intervene at various intervals. Clophosphamide damages the DNA and makes it perform suicide, taxoids deactivate the molecule that separates into two strands, and topoisomerase-1 inhibitors block an earlier step. All these are effective, but they hold the drawback of being harmful to other cells in the body. The next set of these drugs that are currently being manufactured will be much more selective and will only harm these problem cells.

Monoclonal antibodies are made of proteins that readily bind to protein antigens and can target and attack them. Deadly varieties can be made with radioactive iodine. This treatment kills the antigens of cancer cells which are seen as dangerous. In a study of 21 patients with B-cell lymphoma, 19 experienced partial to complete recovery and remissions.This is proving effective, even though it had previously been discarded as invalid.

Cancer attacks the immune system, and a new thought is to strengthen the immune system against any potential invaders. But it is not that easy because the cells that cause tumors have come from our own bodies, making them much harder to control. An experiment by Hsu extracted special white blood cells known as dendritic cells from a few patients who have B-lymphoma and bathed the cells in and antigen that is on the surface of the tumor, then replacing them in the body. These cells eat antigens and break them down so they can be attacked by the bodys defenses. Two of four patients had complete successful remissions, and two more had reduced tumors. M.D. Anderson Kleinerman noted the favored sites to be the lung and liver, where mass amount of macrophages inhibit. But these macrophages will only attack if there is a strong jolt to stimulate them, and Kleinerman provided this by injecting bacterial proteins, and one-third of the patients tested remain disease free.
Antigenesis is a process cancer uses to supply itself with blood and nutrients, and many procedures are being looked into that stop the cancer here such as interluken, that causes capillaries to be obliterated, and angiostatin, which keeps them shrunk. These may slow the invasion process, and halt the clusters of present cancerous cells.
Even typical patients who will receive the normal treatments of radiology and removal will reap the benefits of better science. A higher-dose chemotherapy is becoming the normal treatment, and it is very beneficial in that it supplies more effective treatment with less side effects. They have also noticed that the p53 gene can tell whether or not these treatments will be beneficial. Those patients who have mutant p53s may find solace in the 112 chemicals that have been discovered to possibly suppress them. The future is getting brighter.

Cancer is now being seen as a terminal illness that cannot be treated by some miracle cure, but rather with a series of complex steps that results in remissions. Many of the upcoming waves of treatment will be discarded, but many will be rejoiced and adapted for practical use. Cancer many never have a cure, but it is treatable as a chronic disease, and scientists are finally understanding what needs to be done to make complete remission a probability and not a possibility.

This article alerted me to the many new ideas and techniques that are coming into play. I never realized the industry had so many possible outlets and so many paths that may prove successful. I also think the concept of having cancer being treated as a chronic illness makes the most sense, and it is the most likely to succeed. I think that the new and promising procedures are providing hope to many victims, and with a little more research and understanding, the science will the find the treatment that is right for your particular affliction.
All these articles opened a window to me as I now have a better understanding of what cancer is, and how it is caused. I think the most crucial step in finding an answer is gaining knowledge of each individual case and meeting the needs of the patient. With research that is going on now, a solution for almost any cancer is coming into play. Many people in need of more involved treatments will get them with the new discoveries being made as cancer therapies move into the next phase. Now that there is a better understandment of the disease, it can be treated more effectively.