• Profile: Dr. Christian Ogilvie
    Dr. Christian Ogilvie

    University of Minnesota Associate Professor and orthopedic surgeon Christian Ogilvie chose medicine so he could practice science, while working directly with people. He likes teaching people, educating patients. And he likes to fix things. He appreciates the chance to make a big difference in someone’s life, in a moment. To restore them, perhaps, to what they could do before.

    Dr. Ogilvie has been a great asset for RIS. He has embraced our education mission: teaching residents about sarcomas, speaking to medical students through the RIS Maudlin Sarcoma Scholars Program. Dr. Ogilvie has also served in the RIS Board of Directors.

    Family Beginnings

    Christian Ogilvie’s father was a doctor. A spine surgeon, who spent years at the University of Minnesota and operated on many people with scoliosis. Even as a high school student, Dr. Ogilvie was drawn to the chance for sudden change. To take a crooked spine and make it straight, all in one setting.

    In college, Dr. Ogilvie had the opportunity to do service work. He found it “really rewarding to work directly with people,” and he wanted to include this type of feeling with his professional work. He liked science, and decided medicine would be a great career. He returned to Minnesota to attend medical school here, at the University.

    Before and during medical school, Dr. Ogilvie worked in Dr. Clohisy’s lab. Through this work he became interested in tumors. Although he considered pediatric medical oncology for a time, ultimately Dr. Ogilvie wanted to “intervene directly.” He liked performing surgical procedures, and he wanted to take the cancer out. So he took his residency in Orthopaedic Surgery, then a fellowship in Musculoskeletal Tumor Surgery at the University of Toronto.

    Geography

    Upon completion, Dr. Ogilvie moved to the University of Pennsylvania, where he was an Assistant Professor and a surgeon. He developed a busy practice, focused on tumors. In one single year, he saw 400 individual cancer patients.

    When Dr. Clohisy was becoming Chair of the Orthopaedic Surgery Department at the University, he called to recruit Dr. Ogilvie back to Minnesota. In 2009, Dr. Ogilvie returned. He had met his wife here, and the two of them felt this was a good place to raise children.

    At Minnesota, Dr. Ogilvie’s practice still involves tumors. He focuses on sarcoma, but does other things as well, including major trauma. He drew many connections between the two. Like sarcomas, fractures can occur anywhere in the body. Both trauma surgery and sarcoma surgery may involve bones and joints. And, you will not be surprised to hear that trauma surgery calls to Dr. Ogilvie because it offers the chance to take a crooked, broken bone and straighten it out, all in one setting; to place a plate on it; to help it heal.

    You may be surprised to learn that unlike many other tissues in the body, bone really can heal. Cleanly, completely, and without a lot of scar tissue getting in the way of good function. If the conditions are right, if you give it enough time, bone will replace itself and be almost like new. Often, people can go back to doing just about everything they were doing before, because their bone will go back to doing what it was doing before.

    Education

    Medical students and residents may not get much education about sarcomas, even today. Through his practice, Dr. Ogilvie has seen the patients who don’t get diagnosed. Sometimes, an incomplete surgery by a non-cancer specialist will require a second revision surgery, bigger than it would have needed to be.

    Dr. Ogilvie talks to people about sarcomas. He has presented at Grand Rounds for medical students twice, through the Wyckoff Sarcoma Scholar program, and expects to do this again. He speaks to orthopedic residents about sarcomas, since people will show up in their offices with lumps and bumps and pains. Most will be benign and harmless, but some will be cancer. He wants people to consider the cancer, before they cut.

    Patients, too, need education. Teaching people is nice to do.

    Dr. Christian Ogilvie

    What is hard?

    The hardest thing about Dr. Ogilvie’s job “is probably telling someone their kid has cancer. That’s difficult.” The parents are kind of helpless, and they have so many questions. Most times, they worry a lot. The second hardest thing? Telling someone they have metastatic disease. The third? Telling someone they have cancer.

    It is rewarding, though, when you have the ability to tell people you can take out the cancer and they’ll be fine. When you can “educate them a little bit, make some plans” and attack the tumor. Or when a person has pain from cancer in their bone, and has trouble walking, and surgery can help them feel better. When you can “help out with the quality of life.”

    There are lots of opportunities for constructive outcomes. Sometimes, these come in surprising forms. Allowing someone to go home, for even a few days, may be a victory.

    We are thankful that Dr. Ogilvie has decided to embrace these challenges, here.

    By Christin Garcia

  • Researcher Spotlight: Brandon Diessner, University of Minnesota
    Brandon Diessner
    Brandon Diessner

    Medical research is like a 1,000-piece puzzle. Researchers craft studies to discover new pieces, advances in other fields contribute additional information, and organizations like Rein in Sarcoma provide support to fuel the work. The sarcoma puzzle is not yet complete, but there are exceptional people at the table working towards improved treatments and patient outcomes.

    Brandon Diessner, Ph.D. candidate at the University of Minnesota, is one of those people—and he’s no stranger to complex problems. As an epidemiologist and experienced statistician, he digs into giant batches of data to learn why diseases occur in different groups of people. And, fortunately for us, he’s putting his skills to work for sarcoma, alongside his mentor of six years, Dr. Logan Spector.

    Brandon may be early in his career (he will receive his Ph.D. at the end of this month), but he has already amassed an impressive record of sarcoma research. His latest work—featured in the August issue of the Journal of the American Medical Association—investigates why some patients already have metastatic disease by the time they are first diagnosed with sarcoma. The team hypothesized that delays in diagnosis could be at fault, but there might be other factors involved, such as age, race/ethnicity, or genetics.

    Brandon Diessner’s article

    The team analyzed cancer and census data from more than 47,000 soft-tissue and bone sarcoma cases. While overall socioeconomic status did not seem to have an impact, they found that patients with either no insurance or Medicaid insurance were more likely to have metastatic disease by the time they were diagnosed with soft-tissue sarcoma—suggesting that insurance challenges may create delays in healthcare that give some sarcoma sub-types more time to spread.

    The study also revealed that Black adults were more likely to have metastatic disease when first diagnosed with leiomyosarcoma. This is consistent with previous DNA studies that suggest genetic factors likely influence how aggressively some sarcoma subtypes progress. Brandon and colleagues plan to follow this path in their future research, with the goal of better understanding what leads to the development and spread of sarcoma at a genetic level.

    In addition to designing his own studies to further the field’s body of knowledge, Brandon is frequently recruited for his skills as a statistician. He recently analyzed data for a HealthPartners and University of Minnesota study that evaluated a new sarcoma alert system for primary care physicians. The alert is triggered when a physician encounters a soft-tissue mass that is deep, large / enlarging, or painful, and recommends an MRI to check for possible sarcomas. And it works: nearly 20 MRIs were prompted as a result of the alert, and four malignant or potentially malignant tumors were found. Because many physicians are unfamiliar with sarcoma cancer (encountering perhaps one or two cases throughout their career), this alert mechanism could help detect the rare disease sooner and save lives. Researchers envision implementing the alert system in medical record systems across Minnesota, and, eventually, the nation.

    Researchers like Brandon are discovering key pieces to the sarcoma puzzle, and Rein in Sarcoma is grateful that young, talented minds are focusing on this rare disease. Our community continues to come together to support sarcoma research and work towards better detection, improved and expanded treatment options, and a cure.

    Brandon Diessner will receive his Ph.D. in Epidemiology at the end of this month and will continue exploring how genetics predispose people to develop osteosarcoma and Ewing sarcoma at the University of Minnesota. He lives in Shoreview with his wife, MacKenzie, and their first child, a son who they welcomed in July. When he’s not analyzing copious amounts of data, you might find him hiking with his dog and family or exploring new restaurants or breweries in the Twin Cities.

    Nikki L. Miller is a freelance writer based in Minneapolis. 

  • Profile: Dr. Amy Skubitz
    Dr. Amy Skubitz

    It can be really hard to love sarcoma cells when you’re a cancer patient. Yet your future may depend on scientists finding them fascinating. Meet University of Minnesota Professor and tumor biologist Amy Skubitz, who finds cancer cells to be the most interesting in the human body. We can embrace this interest, as she has focused her talents on discovering better ways for doctors to find, predict and stop cancer cells. Often working in collaboration with others at the University, including her husband oncologist Keith Skubitz, Dr. Amy Skubitz has received more than one RIS grant award. What is it about cancer cells? What does a tumor biologist really do? And how can your tumor cells be used to improve cancer treatments?

    Amy Skubitz’ parents were scientists. When it came time for her to choose a college major, she combined their backgrounds in biology and chemistry, taking a major in biochemistry. What she really loved was working in the lab, with hands-on and off-beat procedures, some so delicate that a single human fingerprint could change the results. She loved the quantitative data analysis, too, that followed this work. So she pursued a PhD in Pharmacology and Experimental Therapeutics from the Johns Hopkins University and completed postdoctoral work in Laboratory Medicine and Pathology at the University of Minnesota. Now a Professor in that department, Dr. Skubitz spends her days preparing grant funding applications, conducting scientific research, writing scientific papers, and mentoring graduate and undergraduate students who work in the labs.

    Amy Skubitz seeks excitement in her work. She was drawn to the idea of “discovering something that nobody else knew.” The field continues to change dramatically, as new technology allows new opportunities and much quicker results. Information that used to take weeks to get can now be delivered overnight. The same aspects that make tumor cells dangerous in the body make them fascinating in the lab. Normal cells “don’t do much.” Put them in a lab environment, and they will multiply a couple of times and then just sit there. Cancer cells “grow, multiply, spread out, and move.” They reach out and try to grab things. Through special time-lapse photography, scientists can watch dramatic shifts that happen overnight.

    The trick for helping patients is to identify better ways for doctors to identify cancer, predict how it will behave in the body, and stop it from growing. During her career, Dr. Skubitz has pursued many different paths to these results. In the beginning, she wanted to do cancer research. Of all diseases, this is the one that seemed like such a big problem. “So many people have had cancer, or know someone who has had it,” she said. But her first work in graduate school was with parasites, after she became involved with a Johns Hopkins lab that was trying to find targets for vaccines that could prevent worm infections that plague people in foreign countries. When she came to the University of Minnesota in 1984, Dr. Skubitz was able to find work using similar technologies to evaluate potential new treatments for cancer. She has been working with cancer cells ever since.

    Amy Skubitz came to RIS through her leadership of the Cancer Center Tissue Procurement Facility, which began in about 1995. Before then, after pathologists had finished testing the tumors that were removed from patients through biopsy or surgery, the extra tissue was thrown away. At the same time, researchers were having a hard time finding enough tissue samples to do their work. Dr. Skubitz led the Facility effort, which asked patients to agree that their leftover tumor tissue could be used by scientists, then to have that tissue cataloged and stored for research use. Eventually, University researchers had access to information about all the different genes that were contained in over fifteen hundred tumors. This allowed them to look for profiles or signatures that might be important to cancer growth or movement in the body. If important genes could be identified, this could lead to tests that would help doctors identify tumors or predict their behavior. It also could lead to treatments that block tumor growth or spread in the body. Amy was interested in the opportunities for ovarian cancer, which had been a focus of her work for many years.

    Her husband, oncologist Keith Skubitz, was interested in the possibilities for sarcoma. One person’s sarcoma tumor can have many different-looking areas, so it can be hard for a pathologist to tell if a tumor really is sarcoma, and which kind it is, based only on the small tissue samples taken before surgery. Getting the diagnosis right is really important, however, so patients without sarcoma are not exposed to toxic treatments but patients with sarcoma get the best available treatments for their cancer type. Many sarcoma tumors are really aggressive, but some are not. Again, the best treatment could depend on knowing which is which. And, as you may understand all too well, there is a serious need for better sarcoma treatments to be developed.

    Ultimately, Drs. Amy and Keith Skubitz ended up working together. They stayed up late many nights “in a locked room” at home, after their kids went to bed, reading lists of genes to each other and deciding which may be important. With their first RIS grant, they took this work one step further, testing to see if the genes they had thought were important for an aggressive form of fibromatosis actually appeared to play a role in tumor growth in the body. With fine assistance from pathologist Dr. Carlos Manivel, they were able to confirm that the genes they had identified did seem important. This work continues, and they hope to apply a new technology that will allow much smaller tumor samples to be evaluated, in a much quicker and cost-effective way.

    In 2010, the RIS grant was for work related to the prevailing scientific theory that a small and constant percentage of “cancer stem cells” within a tumor are the ones that actually make cancers dangerous to people, because they drive the spread of tumors throughout the body and are not killed by commonly used chemotherapies. This work also was designed to test chemotherapies against these cancer stem cells, to see if any of the drugs had an effect on the cells. This work also continues.

    It was difficult to end my conversation with Amy Skubitz. She speaks quickly and with great enthusiasm, conveying incredible depth and complexity in an accessible way. I expect she could talk about science for hours, nonstop. In many ways, she has been talking about science for a lifetime. To learn more, you may find her biography and select publications, including many publications related to her work with sarcoma, through the Laboratory Medicine and Pathology website.

    By Christin Garcia

  • Rein in Sarcoma has awarded $40,000 in new sarcoma research grants to Children’s Minnesota and the Mayo Clinic. The grants were announced during the recent virtual Fall Fundraiser. The RIS Research Committee reviews the top proposals brought forward by each institution’s evaluation committee, and in turn recommends final awards to the RIS Board of Directors for approval.

    Children’s Minnesota

    “DICER1-related Genitourinary Sarcomas” | $15,000

    Dr Kris Ann Schultz

    Principal Investigators: Kris Ann P. Schultz, MD, pediatric oncologist

    Lay Summary:
    DICER1-related sarcomas include pleuropulmonary blastoma (PPB), renal sarcoma, ovarian, cervical and uterine sarcoma, and a newly-described tumor type, PPB-like peritoneal sarcoma which may arise from peritoneal structures. We have preliminary data suggesting that in PPB, quantitation of circulating tumor DNA bearing DICER1 “hotspot” mutations may provide a way to measure tumor burden and provide a strategy for early diagnosis, especially for children with recurrent disease. In this proposal, we will leverage our prior Rein in Sarcoma funding and R01-funded existing PPB-related research activities and extend these to include additional DICER1-related sarcomas. Development of this additional collated data source is the next necessary step toward our goal of validating ctDNA for clinical use in children and young adults with DICER1-related sarcomas.

    Mayo Clinic

    “Targeting the Immune Checkpoint B7-H3 for the Treatment of Rhabdomyosarcoma.” | $25,000

    Principal Investigator: Dr. Fabrice Lucien-Matteoni, PhD, Senior Research Fellow in Urology
    Co-Investigators: Dr. Haidong Dong, MD, PhD, Professor of Immunology, a world-renowned immunologist and Dr. Akilesh Pandey, PhD, Professor in Laboratory Medicine and Pathology and Director of the Proteomic

    Lay Summary:
    Rhabdomyosarcoma (RMS) is the most common soft tissue tumor in children, with nearly 20% of children presenting with locally aggressive and/or metastatic disease. A fundamental problem with this disease is the lack of effective and tolerable therapeutic regimens. Current protocols including surgery, radiotherapy and chemotherapy are extremely toxic and may lead to multiple deleterious long-term effects. Moreover, a significant percentage of patients tends to relapse and for those patients, life-expectancy is less than 5 years.

    Our group is dedicated to help develop more effective and more tolerable treatments for rhabdomyosarcoma. In the past year, we have screened for proteins enriched in RMS tumors compared to normal muscle in the intent to identify new therapeutic targets for the treatment of RMS. We have discovered the molecule B7-H3 as an important mediator of tumor progression. B7-H3 protects tumor cells from being attacked by immune cells. We have found that loss of B7-H3 expression leads to tumor regression through an effective antitumor immune attack. In this proposal, we intend to understand how B7-H3 protects RMS tumors from the immune system. Additionally, we will initiate the development of an antibody-based therapy that inhibits B7-H3 function and boosts anticancer immune response. This work will lay the foundation for the immediate clinical utility of developing clinical trials to assess the efficacy of B7-H3 blockade for the treatment of refractory and relapsed RMS.

    These grants are made in addition to research grants to the University of Minnesota made in January of this year.

  • Profile: Dr. Keith Skubitz
    Dr. Keith Skubitz

    University of Minnesota Professor and medical oncologist Keith Skubitz has been treating people with sarcoma cancer for over 20 years. Maybe, he is your doctor. What he really seems passionate about is finding ways for science to help doctors deliver better treatments to their patients. This can mean anything from more effective drugs to portable pumps, which allow patients to take their chemo home.

    Dr. Skubitz received his medical degree from the Johns Hopkins University, then completed his Internal Medicine training at the University of Minnesota. He took a fellowship in Clinical Pharmacology at Johns Hopkins and returned to Minnesota for his fellowship in Medical Oncology. Here he has stayed. Since 1988, Dr. Skubitz has led the University of Minnesota’s medical oncology treatment efforts for adult sarcoma patients.

    Better Patient Care

    One of the first things he did was to study the possibility that chemotherapy could be delivered differently. Drugs like ifosfamide had been given to patients in one or two big infusions, over several hours in the clinic. Dr. Skubitz thought it made more sense to deliver the drug slowly, over many days, by a continuous drip. He said “you knew from high school chemistry” that this might make the drug more effective. For one thing, the long steady drip could increase the chances the drug would be there in the body, active and available to hit new cancer cells as they were turned out by the tumor, day after day. This also could lessen side effects, because people would not need to absorb so much of the drug at once.

    In about 1980, new technology made this option possible. Portable pumps could deliver a slow continuous drip to patients, even while they moved around freely or stayed at home, carrying their pumps in little packs. With a colleague, Dr. Skubitz studied this method and found that it worked. They published their findings, and many other doctors have followed the same approach.

    Finding Better Medicines

    Dr. Skubitz says his work is “certainly very interesting,” and sometimes he and his colleagues have “very satisfying results.” It is hard, however, that the treatments don’t always work. For many patients, “eventually, they stop working.” This is a “high stress” time.

    One way to improve the situation is to find better medicines. Of course, this could mean making something totally new. But it also could mean making a new match, between an existing drug and an aggressive disease. University researchers have been part of just such a solution for giant cell tumors of the bone. These tumors usually do not kill people, but they can grow aggressively and there have not been good treatment options. Doctors use surgery and radiation when possible, but good results can be hard to get and even then, the tumors often grow back. It appeared to Dr. Skubitz and his colleagues that an antibody developed for osteoporosis might target these bone tumors. A small initial study showed that the drug did help. The University now participates in a world-wide follow-up study to consider the best dose and length of time to use the drug, which is seen as a very promising treatment.

    Along the way, doctors also learned more about how tumor cells “talk” to normal cells. In this disease, tumor cells make a protein that recruits normal cells to come nearby and make something – call it factor x – that the tumor itself needs to thrive and grow. The drug works by blocking this protein, interfering with the tumor’s call for normal cells. With fewer normal cells stopping by to donate factor x, the tumor can’t grow so well anymore. Sometimes, it even dies.

    Using New Science

    Cutting-edge science clearly motivates Dr. Skubitz. On the list of scientific articles he’s written, there are many about genes. Dr. Skubitz tries to understand what tumors are telling us through the unique collection of genetic mutations and expressions they contain. When asked if the study of genetics will turn out to be an important thing for patients, Dr. Skubitz did not hesitate. “Absolutely,” it will.

    Of course, genetic work could help doctors develop more effective treatments, targeted directly at the mistakes or pathways that allow the cancer to grow and spread. Even without a cure, genetic work could help doctors predict how dangerous a cancer will be. “Absolutely, definitely” it matters to know which cancers are most likely to be dangerous. This will affect the choices doctors make about treatment. Patients with less dangerous tumors could be spared the more intensive treatments; patients facing tougher battles could receive the most aggressive options.

    Just this month, Dr. Skubitz was at a national cancer conference presenting results from a study that uses genes to help doctors separate the more aggressive cancers from the less dangerous ones. This work grew from one of RIS’ first seed grants. Years ago, University researchers including Keith Skubitz and his wife Dr. Amy Skubitz received a grant to identify the genetic signatures that might help doctors predict what cancers would do. The University’s tissue bank and the RIS grant allowed them to begin. Eventually, they found gene sets that appeared to break sarcoma cancers, ovarian cancers and kidney cancers into two main groups. They did not have enough information about what happened to the patients, though, to allow them to test the idea that the two tumor groups acted differently in people. Recently, the Skubitzes collaborated with researchers in Sweden and Denmark, who did have access to good follow-up information about patients. This work confirmed the sense that different gene sets appear in tumors that are more aggressive than in those less likely to be dangerous.

    Another RIS-funded project that Dr. Skubitz works with is the clinical trial designed to test whether PET scans can show us which tumors are responding to chemotherapy. This is “quite neat,” because it may suggest better measures to test drug response. Using traditional methods, it could look like “you killed it off really well,” but then sometimes the tumor comes back. Doctors believe this may be due to the survival of a select group of deadly cells, sometimes called “cancer stem cells,” which may be great at hiding from toxic drugs or blocking their effects. If doctors could tell early on which tumors are being affected by a drug, they could spare patients who are not responding by stopping the drug and could switch them sooner to a potentially more effective option.

    Always Surprising

    When I asked Dr. Skubitz if there was anything else he thought we should know, he said this sounded an awful lot like the “classic internal medicine question.” Do your visits end with this invitation? Apparently, from the other side of the table, it is “striking” what patients will mention in closing. The doctor may have covered four or five major problems, and “you may think you know why they’re there,” but what’s really of concern to the patient may be something that’s “not even on your radar screen.” It’s surprising what you hear.

    Hopefully, most of us can be thankful that our physicians do ask us for our concerns, and will listen for the surprise.

    By Christin Garcia

  • Profile: Logan Spector, PhD
    Logan Spector, PhD

    Logan Spector is not a medical doctor, but he does have the opportunity to talk with families as part of his research work. In his experience, the first question asked by parents whose children have been diagnosed with cancer is: What’s going to happen to my child? The second question is: Why did this happen to my child? Epidemiologists like Dr. Spector are “here to investigate the why.”

    Back in 2004, a small seed grant from Rein in Sarcoma helped Dr. Spector support a successful application for funding from the National Institutes of Health. NIH funding allows him to study the connection between osteosarcoma and certain genes. The entire field of genetic epidemiology has been revolutionized, with the possibilities changing dramatically in just the last decade. In other work, Dr. Spector uses new technology that could increase the chances of finding key connections between troublesome genes and aggressive cancers. The University of Minnesota, where Dr. Spector is an Associate Professor, is “a great place to study pediatric cancer.” It’s not quite the life led by Colonel Sam Daniels, but it suits him well.

    A Beginning

    At The College of William and Mary, Logan Spector studied biology. For his life, Dr. Spector sought a field where he could use this science without being tied to a lab. Epidemiology offers these possibilities. For a time, Dr. Spector was intrigued by Colonel Sam Daniels, the character played by Dustin Hoffman in the 1995 movie “Outbreak.” But then he discovered that Hoffman played a virologist, not an epidemiologist. What’s the difference? Virologists chase down viruses, sometimes deadly and always contagious. Not the best fit for a man who wanted to have a family one day. And not the study of people, which is what Dr. Spector found really interesting.

    Epidemiology is the study of people. Groups of people, put into categories and then compared. Researchers look for the factors that make a difference. Is one group more likely to suffer disease than another? If scientists can find out why, then we may be able to prevent the harm. Even when this is not possible, it can be helpful to know our chances. And in cancer research, naming the targets can lead to break-throughs in treatment.

    When I think about break-throughs in treatment, I tend to think of fancy new drugs. But here is a more stealth example, at least for those of us who don’t do this for a living: Scientists have discovered that children who have one particular version of a certain gene will face a great risk of getting sick from one of the main treatments used for acute lymphocytic leukemia. Because they know this, doctors now can test their patients to look for this gene. If the children have the version that places them at risk, doctors can lower the dose of the drug, and lower the chance the kids will get sick. Steps like these can lead to real differences in many lives.

    Making this difference seems to call Dr. Spector, who received his PhD in Epidemiology from Emory University in 2002. He began with an intention to work with infectious disease. His dissertation led him to childhood leukemia, however, and he has worked with pediatric cancers ever since.

    Calling for Investigation

    Like many of his colleagues, Dr. Spector is drawn to challenging and important questions. After he arrived at the University of Minnesota, one of his first assignments was to write a book chapter on childhood cancer. So he dove into the literature. There he discovered osteosarcoma and Ewing’s sarcoma, two cancers that were “ripe for study.”
    In osteosarcoma, there was “this very strong clue” that the cancer “mirrors puberty almost exactly.” Girls peak earlier than boys, both in their age for getting the cancer and in their age for puberty. Boys peak later, and their peak is higher than girls. Their pubertal growth spurt is longer and more intense – they get taller and bigger, on average, than girls – and they also have higher chances of getting osteosarcoma.

    Ewing’s sarcoma arises almost exclusively in children of European descent. It also is strongly associated with hernia. This means that children who have certain kinds of hernias are more likely to get the cancer than would be expected just by chance. And don’t think, here, about those hernias your friends may get from lifting too much weight. The hernias that are linked with Ewing’s sarcoma are inherent weaknesses in tissue structure, affecting for example the umbilical cord, the diaphragm or the intestines. People are born with these weaknesses. This suggests a possibility that Ewing’s sarcoma could be caused by things that happen before children are born.

    Basically, there was this “grab bag of things that did not fit well together,” which, to Dr. Spector, was “collectively calling for investigation.” And so he has investigated, with fine mentoring from Dr. Julie Ross, who brought him to the University through a research training grant and who continues to serve as his mentor today.

    Revolutionary Advances

    If you think of the human genome as a book, the Human Genome Project found the first letter of every sentence, and the period at the end of each sentence. Next, scientists began to fill in every seventh letter of each sentence. Now, scientists are in the process of discovering every letter in every sentence. Dramatic changes have occurred in this field, even since Dr. Spector began his work in 2002.

    Several years ago, when scientists wanted to look for certain genetic changes that might be important for cancer, they needed to decide up front. Using the clues they could find, researchers would name the genes they were going to study. The problem with this method is that we people have about 30,000 genes. The ways they combine together, and the things that can go wrong, are almost too many to count. So the chances of hitting on just the right connection, between bad genes and bad cancers, were not great. The studies based on these predictions ended up having a fairly poor track record, as scientists learned that “we don’t know as much as we think about what might be relevant.”

    Enter the Genome Wide Association Study, which now allows scientists to “put a genome on a chip and get back a million base pairs.” I’m not really very sure what this means. But I do understand that what it promises is a much better ability to compare information across people and cancers, and to figure out what really matters. Dr. Spector’s current work includes this kind of research for both osteosarcoma and Ewing’s sarcoma.

    “Those of us who’ve been paying attention,” notes Dr. Spector, have heard a lot of hype for the last 10 years about the benefits of personalized medicine. The benefits “have not materialized as fast as we’d like. But it will happen.” Particularly for childhood cancers, the benefits will come.

    We await this future. And are glad that bright young minds continue to engage the clues.

    By Christin Garcia