On Sunday June 6th, the Robert H. Lurie Comprehensive Cancer Center of Northwestern University will celebrate National Cancer Survivors Day with the largest event of its kind in the country, featuring a four-mile noncompetitive walk for cancer survivors, their friends, and families.
In honor of this event, we spoke with two key players in the fight against cancer – a researcher using revolutionary technology to detect the disease in its earliest stages, and a cancer survivor with important advice for physicians and fellow patients.
Vadim Backman, professor of biomedical engineering at the McCormick School and member of the Lurie Cancer Center, is using nanotechnology, which allows researchers to work at the level of individual molecules and atoms, to develop early screening methods for colon, pancreatic and lung cancer. We asked Backman how this technology works, and what promise it holds for the future.
Your lab is developing techniques to detect certain cancers much sooner. Can you tell me about this?
Right now, cancer detection is done at the microscopic level—changes in cells that can be viewed with a microscope—and we’re missing important changes at the nanoscale. Before cells become abnormal at the micro-level, they become abnormal at the nano-level. In cancer, changes happen extremely early on, and we don’t want to wait until a tumor forms to detect them.
How can you detect changes at the nano-level?
We use optical imaging techniques that were developed in our laboratory. By observing how light reflects off of different nanoscale structures inside the cell, we can detect nano-level changes that indicate the early stages of cancer.
What’s especially exciting is that these changes can be detected not only in cells from inside a tumor, but from the surrounding areas as well. This means that we could conduct early cancer screenings using cells from more easily accessible areas of the organ.
Take colon cancer, for example. Existing guidelines say that people over 50 should get a colonoscopy once every several years (frequency depends on individual risk factors), but only 25% of people do. And realistically, we couldn’t do this [perform colonoscopies] for everyone because of cost, waiting times, and many people just don’t like getting them.
The solution is to pre-screen. We could brush cells from inside the rectum – not requiring any prep – and analyze them to find alterations at the nanoscale. If the results are positive, the person would then have a colonoscopy. It would be easier to do, cheaper, and less invasive for the patient.
Colon cancer is just one example. This extends to other organs, like the pancreas. Right now, there is no early detection for pancreatic cancer. But, we can brush cells close to the pancreas using upper endoscopy and analyze them for nano-level changes. For lung cancer, we can brush cells from the inside of the cheek. Imagine—going to the dentist and being screened for lung cancer.
At what stage is the technology now?
Along with our clinical collaborators from Northshore University HealthSystem led by Dr. Hemant Roy, we’re in the early stages of clinical trials for all three (colon, lung, and pancreatic cancer), and we’ve studied several hundred patients. But we still need to study several thousand patients. So far, we’ve learned that the technology needs to be refined, and we’re working to find ways to make analyzing the cells faster.
What’s your vision for this technology long-term?
Basically, it could be like the pap smear for cervical cancer, the only really successful screening program for cancer. Cervical cancer used to be the number one cancer in women, and the introduction of the pap smear changed this dramatically. My dream is that a patient could come in for his or her annual physical and, at the same time, have cells brushed from a few areas to be screened for several major cancers. We could find these cancers sooner, and reduce mortality.
Katarina, a cancer survivor and mother of young children, was diagnosed with colon cancer while just in her mid-thirties. Four years later, she has become an advocate for other cancer patients, working closely with the American Society of Clinical Oncology, the Colon Cancer Alliance, Gilda’s Club, the Lance Armstrong Foundation, and the Lurie Cancer Center. We asked Katarina about sharing her experience as an “exception to the rule” to educate physicians-in-training, and advice she has for people facing a cancer diagnosis.
You were diagnosed in your mid-thirties, well below the age range for which doctors recommend regular colon-cancer screenings. How does this aspect of your experience influence your advocacy?
Despite having had all of the symptoms of colon cancer and having pursued medical intervention for quite some time, even I was shocked at my diagnosis, given my age and lifestyle. By virtue of my age, I became an advocate every time I told someone my story.
Currently, I am a member of the Lurie Patient Advisory Board, in part because of my commitment to Northwestern for the quality of care they’ve given me, but also because it is important to have a voice for younger people on the panel. [Younger people] can give a different perspective to the issues that all cancer patients face.
You’ve spoken to Northwestern Medicine physicians-in-training through the Lurie Cancer Center as well. What’s your key message for them?
I want to instill the importance of the exception to the rule. Colon cancer is typically associated with the aging population. When I speak to the residents, they can see my face – I’m a young person. Throughout their careers they’ll get patients who don’t fit the bill, and if they can diagnose the one young person with cancer, they’ve more than done their job. Because it is not just one person they’ve affected – it is that individual, their whole family, and their entire community.
If a physician had been willing to imagine early on that I might have colon cancer despite the fact that I had no risk factors, I never would have been a cancer patient. I would have been treated for pre-cancerous polyps. Unfortunately, that is the shame of it all for most of us under the age of fifty when we’re finally diagnosed.
What advice do you have for patients facing a cancer diagnosis?
First, you need to compartmentalize your journey—your own journey, your family’s, and your various communities’. These all have their own compartments—emotional, physical, psycho-social, medical, insurance, financial, logistics and even the stigma of having cancer. You need to take this all in and then break it down.
Of course there is always the element of sorrow and self-pity. Sure, you can feel sorry for yourself – it is even ok to never stop feeling sorry for yourself. But you need to do so in a compartmentalized space, and then get back to the business of staying on top of your health and living your life. Live each moment with gratitude, grace and passion. Allow yourself to feel the power of life and live in the moment.
You also need to own your own care – be your own account manager. Be proactive – understand your disease. Know what your doctor expects from you, and what you expect from your doctor. It’s critical to choose a doctor who is hearing you. My doctors and nurses made me feel like they really cared about me—and what was important to me—when they were caring for me. It’s important to find a place to give you that.
Finally, I can’t say enough about the community that has embraced me as a cancer survivor. They say it takes a community to raise a child—it also takes a community to get a survivor through the journey. And I haven’t found a more caring community than this one I’ve been forced to belong to because of cancer.
For example, places like Gilda’s Club (a community for cancer survivors, family and friends) can become a home, and it definitely became ours. There is strength in knowing others who are feeling what you’re feeling. You can connect with others and validate frustration, or talk about what’s right about your doctor or your care – it’s empowering. You can turn to these individuals when you feel like the burden you have placed on your family just from your diagnosis alone is enough.
My one regret in all of this is that I haven’t been able, because of the demands and logistics of staying healthy, to extend myself to thank all of them – my doctors, nurses, case managers, and especially my family, friends and neighbors—thank them for taking this walk with me. If I could get this entire group of individuals to walk with me and the Lurie Cancer Center, I have no doubt that we’d more than fill the entire park. So many wonderful people, and I’m so grateful for them.
The 17th Annual Cancer Survivors’ Celebration and Walk will be held in Chicago’s Grant Park on Sunday June 6th, beginning at 8:00 am. For more information and to register, please visit the Lurie Cancer Center’s website at: http://www.cancer.northwestern.edu/home/index.cfm