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The lung cancer blame game

The shame, blame and stigma surrounding this deadly disease affects everything from patient follow-through to research funding

Nov. 21, 2017 | By Diane Mapes / Fred Hutch News Service

Janet Freeman-Daily

Janet Freeman-Daily, a metastatic lung cancer patient from Seattle, witnessed so much stigma after her diagnosis, she became a patient advocate.

Photo by Robert Hood / Fred Hutch News Service

Editor's note:  November is Lung Cancer Awareness Month, but sadly, many people are still not aware that anyone with lungs can be diagnosed with lung cancer, whether they smoked or not. We're bringing back this piece from May 2015 about the stigma associated with the disease. Please share with your community.

When Sherry Stoll* was diagnosed with breast cancer in late 2011, her community rallied around her.  Friends, family and even strangers sent fruit baskets, handmade blankets, get-well cards and restaurant gift cards so she wouldn’t have to worry about cooking meals while going through chemo and radiation.

It was an interesting experience for the 53-year-old from Pittsburgh, especially since it wasn’t her first bout with cancer. A year and a half earlier, she was diagnosed with lung cancer.

The response from her community then?  Crickets.

“There was definitely a lack of support and sympathy,” said Stoll, a stay-at-home mom who now runs the nonprofit lung cancer advocacy group, We Wish. “My family was there for me, but most people when they heard about it, were like, ‘Wow, that’s really a shame. Did you smoke?’”

Most people know that lung cancer is an aggressive killer, caused by a number of factors including smoking, genetic mutations and environmental exposures to carcinogens like radon and asbestos. But more and more patients, doctors and researchers are pointing to another harmful influence contributing to the suffering, delayed diagnosis and possibly even early deaths of those hit with the disease: stigma.

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Understanding HIV’s evolutionary past — and future

Studies of how the virus evolved and how it might change down the road could help researchers develop vaccines or cures for the infection

Nov. 20, 2017 | By Rachel Tompa / Fred Hutch News Service

Artist's rendition of HIV virus

Evolutionary biologists at Fred Hutch are studying how HIV evolved before it was able to infect humans — and how it may change again in the future — in the hopes of getting one step ahead of the virus.

Stock photo by iStock

Editor’s note: Although best known as a cancer research center, Fred Hutch also is a hub of HIV research. This is one of a series leading up to World AIDS Day on the breadth of our work, from investigating HIV at a molecular level to searching for a cure to running the world’s largest HIV vaccine clinical trial network. Learn more Dec. 1 when our scientists, led by President and Director Dr. Gary Gilliland, gather with HIV advocates and members of the public at noon in Pelton Auditorium to talk about the role Fred Hutch plays in ending this global pandemic.

We are all shaped by our past. It turns out that our viruses are too.

At approximately 100 years old, HIV is a relatively recent arrival on the human virus scene. But its roots stretch back much farther. Understanding where the virus has come from can help us understand where it’s going — and how to stop it — say evolutionary biologists.

HIV’s “ancestors go back many, many millions of years,” said Fred Hutchinson Cancer Research Center virologist Dr. Michael Emerman.

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Adam Geballe elected AAAS Fellow

Hutch virologist honored for revealing key players in molecular ‘arms race’ between viruses and hosts

Nov. 20, 2017 | By Sabrina Richards / Fred Hutch News Service

Dr. Adam Geballe

Virologist Dr. Adam Geballe was named a AAAS Fellow for his work on the molecular 'arms race' between viruses and humans.

Photo by Bo Jungmayer / Fred Hutch News Service

Fred Hutchinson Cancer Research Center’s Dr. Adam Geballe has been named a fellow of the American Association for the Advancement of Science (AAAS). Fellows are elected by their peers for their scientifically or socially distinguished efforts to advance science or its applications. Geballe, who is associate director of the Hutch’s Human Biology Division, was recognized for identifying two key proteins in a virus called cytomegalovirus (CMV) that counteract the defenses of the humans it infects.

CMV causes a common and usually symptom-free infection. But it can be dangerous in individuals whose immune function is weak, such as newborns or those undergoing transplant. As the human body has evolved strategies to block CMV, the virus has evolved its own methods to circumvent these barriers.

It was Geballe’s contributions to our understanding of this struggle, by revealing the molecular determinants of the ‘arms race’ between CMV and humans, which led to his election as AAAS Fellow. He joins 13 other Fred Hutch researchers who have also been honored by AAAS, the world’s largest general scientific society, dedicated to advancing science for the benefit of all.

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Smoking after a cancer diagnosis

Lighting up can be a source of shame and treatment complications for cancer patients, but Fred Hutch researchers are here to help them quit

Nov. 16, 2017 | By Diane Mapes / Fred Hutch News Service

Cigarette butts

Photo by Robert Hood / Fred Hutch News Service

They know it’s wrong, they know it’s foolish, but they’re stuck. Their bodies are under the influence not just of cancer but nicotine, a substance more addictive than heroin.

Yes, some cancer patients still smoke.

Tobacco smoking is so addictive that 64 percent of smokers diagnosed with cancer continue to light up even after they learn they have the disease. Many try to quit after diagnosis but can’t because of the drug’s stronghold on their bodies. Others are so stressed about the cancer and its treatment that they continue to use cigarettes as a crutch. Still more are nihilistic, figuring, “Hey, I’ve already got cancer, what does it matter?”

Researchers at Fred Hutchinson Cancer Research Center and its clinical care partner Seattle Cancer Care Alliance know it does matter, though, and point to a host of reasons why smoking cessation is even more important after a cancer diagnosis.

“Stopping tobacco use after diagnosis offers many physical and mental benefits,” said Donna Manders, a tobacco treatment specialist at SCCA. “First, there’s the possibility of living longer, but there’s also a better chance of successful treatment, fewer and less serious side effects from every kind of treatment — surgery, chemo, radiation, transplant — and faster recovery from treatment, too.”

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Targeted therapies push metastatic prostate cancer in new directions

Combination therapy could help stave off new “escape variant” of disease that arises in response to powerful treatments

Nov. 14, 2017 | By Sabrina Richards / Fred Hutch News Service

Dr. Pete Nelson

Dr. Pete Nelson and colleagues showed that prostate cancer finds new ways to escape today's crop of life-extending, hormone-targeting therapies.

By Robert Hood / Fred Hutch News Service

The character of recurrent prostate cancer is changing in response to more targeted treatments, according to work published last month in the journal Cancer Cell by scientists at Fred Hutchinson Cancer Research Center and the University of Washington. The team found that as treatments more effectively target the androgen receptor — the molecular engine that drives prostate cancer growth — prostate tumors developed a new way to resist treatment: by ditching the androgen receptor and turning on an entirely different pathway to fuel growth.

The findings support a growing movement toward combination therapy in prostate cancer treatment as a way to head off new drug-resistant forms of the disease.

The recurrent prostate cancer cells have found “a bypass mechanism that allows these cells to survive” and begin to resist treatment, said Dr. Pete Nelson, the paper’s senior author. Nelson, a prostate cancer researcher at Fred Hutch who also treats prostate cancer patients at Seattle Cancer Care Alliance, holds the Endowed Chair for Prostate Cancer Research at Fred Hutch.

Science for Life

Dr. Nelson spoke about his prostate cancer research at the November 2017 Science for Life. Watch his presentation and join the conversation on our Facebook page.

The vast majority of men diagnosed with prostate cancer can expect to live long, full lives. Right now, the 10-year survival rate is 91 percent. But in some men, the disease rears its head again or presents in an advanced stage. Once it recurs, oncologists keep prostate cancer in check with treatments that prevent sex hormones like testosterone from feeding tumor growth.

New, more potent versions of these treatments aren't raising the rate of prostate cancer recurrence — in fact, men being treated with today's androgen receptor–targeting therapies are living longer than ever. But when tumors do resist treatment with these drugs, the rate at which they're developing the new bypass is rising, said Nelson.

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Scientists-turned-entrepreneurs share lessons learned launching startups

From venture capital to office space to acquisitions, academics starting companies face a steep learning curve — but there’s help to be found

Nov. 13, 2017 | By Rachel Tompa / Fred Hutch News Service

Map of Seattle's South Lake Union Neighborhood showing Fred Hutch and Hutch-launched startup companies

Startup companies launched by Fred Hutch scientists are adding to the "biotech cluster" in Seattle's South Lake Union neighborhood.

Map by Jim Woolace / Fred Hutch News Service

When Dr. Mark Roth launched his first startup company in 2005, the biologist had a relatively straightforward goal: Translate the preliminary but promising results he’d seen in his Fred Hutchinson Cancer Research Center lab to a medical treatment that could actually help people.

Measured simply in dollars and cents, the company, Ikaria, was a success. Buoyed by Roth’s own scientific achievements — he was awarded a MacArthur Foundation Fellowship in 2007 and had notched several high-profile scientific publications — Ikaria acquired another biotech company before being bought itself by the U.K. pharmaceutical company Mallinckrodt Pharmaceuticals for more than $2 billion.

But by Roth’s measure, he had failed.

Ikaria didn’t move his ideas — to use certain simple salts to stem injuries caused by loss of blood flow — to a clinical trial, let alone to market. Ikaria — and later Mallinckrodt — ended up focusing on different types of therapies.

Roth knew he needed outside investors to get his company off the ground. But once he’d found financial partners, his work shifted from the traditional academic path.

“You have a fiduciary responsibility for shareholder value that precludes you from operating as a person who cares only about the science and experiment,” he said. “I was in a position where my obligation to shareholders meant that I had to make decisions that I don’t think were in the best interest of the science. There’s a trade-off.”

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