“General Hospital” character Anna Devane ponders her diagnosis.
Polycythemia vera is an uncommon blood cancer that can be controlled with long-established treatments. So it seemed more than a little suspicious to Vinay Prasad, M.D., M.P.H., when the disease took center stage in an episode of “General Hospital” – the longest running daytime drama on American television.
“I felt there had to be some backstory,” Prasad, an OHSU Knight Cancer Institute hematologist-oncologist told listeners of the public radio program Think Out Loud. “What we found was that a company called Incyte Corporation, which actually manufactures a very costly new drug for polycythemia vera, was in a partnership with ‘General Hospital’ and had helped craft this plot line in an effort to raise awareness for this condition.”
Aggressive prostate tumors can rapidly evolve to resist PARP inhibitors, but it may be possible to detect resistance early enough to counteract.
Two views of the structure of the DNA-repair protein PARP1
It was a surprising discovery that opened up a new avenue for treating prostate cancer. In recent years, studies have revealed that gene mutations long associated with breast and ovarian cancers – BRCA1 and BRCA2 – also play a significant role in driving aggressive prostate cancers
Men with these mutations (about 20 percent of prostate cancer patients with metastatic tumors) have shown very high response rates to a new class of drugs called PARP inhibitors, three of which have already gained FDA approval for use in ovarian cancer.
The bad news: Prostate cancers can rapidly evolve to resist PARP inhibitors.
The good news: It may be possible to detect the emergence of resistant cancer cells with just a blood test, researchers have now found, and that could provide earlier information about PARP inhibitor resistance and important clues about how to overcome resistance.
OHSU Knight Cancer Institute Director Brian Druker talks with Medscape about breaking out of one-size-fits-all thinking in cancer screening and prevention
Knight Cancer Institute Director Brian Druker, M.D., recorded an interview in La Jolla, California, with Medscape Editor-in-chief Eric Topol, M.D.
“We are now in the process of building an entire program on what I call precision early detection of cancer,” said Brian Druker, M.D., “We are trying to be more accurate in taking the same precepts of precision medicine for advanced cancer and using them earlier.”
If it works, Druker told Medscape’s editor-in-chief, Eric Topol, M.D., the early detection initiative at OHSU will find a way out of the big conundrum of cancer screening: technologies that too often fail to find dangerous cancers while at the same time raising too many alarms about essentially harmless tumors and driving overdiagnosis and unnecessary treatment.
Number of prescriptions and assisted deaths under the Oregon Death with Dignity Act. (Blanke et al. from Oregon Health Authority data)
In 1997, Oregon became the first state to make it legal for terminally ill patients to self-administer a prescription to hasten death.
A review of 991 cases of lethal self-medication through 2015 shows that the law’s impact has remained largely predictable. Three-fourths of the people were dying of cancer, nearly all were white and around 70 percent had attended college. More than 90 percent had health insurance, were receiving hospice care and died at home.
Still, some findings surprised first author Charles Blanke, M.D., a professor of medicine in the OHSU Knight Cancer Institute and chair of the SWOG research consortium.
Knight Cancer physician Amanda Bruegl, M.D., is leading an effort to understand health issues among Native American tribes and communities in the Pacific Northwest, with a special focus on gynecologic cancer.
Amanda Bruegl, M.D. (OHSU/Fritz Liedtke)
Throughout medical training, Amanda Bruegl’s commitment to work with Native Americans never faltered. As a member of the Oneida and Stockbridge-Munsee tribes, she is one of two Native American gynecologic oncologists in the United States.
“When I was looking for a job,” she says, “it was really important to me to do something to advocate for Native American women’s health.” She saw a need for that in the Pacific Northwest.
“I was looking for places where there was a significant Native American population and the opportunity to do outreach,” she says.