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Your body, after cancer

Coming to terms with the 'new normal' after surgery and treatment

March 6, 2015 | By Diane Mapes / Fred Hutch News Service

Diane Mapes

Diane Mapes, who was diagnosed with breast cancer in 2011 and underwent surgery, chemo and radiation, reports on the seldom-covered issue of coming to terms with your post-cancer body.

Photo by Robert Hood / Fred Hutch News Service

I was diagnosed with breast cancer four years ago, in February 2011, and went through the full monty with regard to treatment: a double mastectomy, a few months of chemo and radiation, then daily doses of tamoxifen, a drug that blocks any lingering estrogen from hooking up with any lurking cancer like an overbearing chaperone at an eighth grade dance.

For the last two years, I’ve been living in a reconstruction zone, trying to put Humpty Dumpty back together again with the help of a rock star reconstructive surgeon. Rebuilding breasts is not easy — no matter how you do it, it’s sort of a boob job with a Bride of Frankenstein twist — but I’m finally done and have two breast-like objects on the front of my chest to show for all my trouble.

I call them “the strangers beside me.”

And they are strangers — spongy, cold mounds that feel neither pain nor pleasure, that refuse to budge an inch even when I’m running, that don’t quite look — or act — like normal breasts. Instead, they act a lot like the silicone sandbags I used to tuck inside my bra after the double mastectomy, except I can’t take these off at the end of the day when my chest starts to ache.

Welcome to my post-cancer body. 

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NCI Director Harold Varmus to step down

Fred Hutch researchers reflect on the Nobel laureate’s contributions to global health, cancer research

March 5, 2015 | By Dr. Rachel Tompa / Fred Hutch News Service

Dr. Harold Varmus (far left) with colleagues from USAID and Fred Hutch at the 2011 groundbreaking of the UCI/Hutchinson Center Cancer Alliance facilityh in Kampala.

From left: Dr. Harold Varmus, Nobel laureate and director of the U.S. National Cancer Institute; David Eckerson, mission director of USAID in Uganda; Dr. Lawrence Corey, president and director emeritus of Fred Hutch; and Dr. Corey Casper of the Fred Hutch Vaccine and Infectious Disease Division and co-scientific director, UCI-Fred Hutch Cancer Centre, during the groundbreaking event in Kampala in 2011.

Jacqueline Koch / Fred Hutch file

Dr. Harold Varmus, director of the U.S. National Cancer Institute, announced Wednesday that he will step down effective March 31.

Varmus was appointed by President Barack Obama in May 2010 to lead the institute, which is the cancer-research branch of the National Institutes of Health. In his letter to the NCI community, Varmus said his decision to resign comes with “a mixture of regret and anticipation.”

Varmus’ accomplishments during his nearly five-year tenure are numerous, according to his peers. His influence was felt at Fred Hutchinson Cancer Research Center, in particular for his stewardship of important research programs during a difficult financial period, said Fred Hutch President and Director Dr. D. Gary Gilliland.

“Dr. Varmus' extraordinary leadership at the NCI, even in times of fiscal constraint, has enabled groundbreaking advances in cancer biology and therapy to move forward apace,” Gilliland said. “It is his longstanding vision that has led us, as a national and international community of cancer centers and investigators, to the threshold of developing true cures for cancer.”

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Study reveals how cells’ nuclei keep their shape

Scientists discover a protein that keeps cellular nuclei from shriveling, a hallmark of old age and the premature-aging disease progeria

March 5, 2015 | By Dr. Rachel Tompa / Fred Hutch News Service

A healthy nucleus (left) and a mutant nucleus (right)

Fred Hutch researchers have identified a protein called Wash that helps cell nuclei keep their shape. When Wash is missing, as in the nucleus on the right, nuclei shrink and pucker.

Image courtesy of Dr. Susan Parkhurst / Current Biology 2015

Scientists at Fred Hutchinson Cancer Research Center have found a protein that helps shape the nucleus, a special compartment within cells that houses and controls genetic information. When cells are missing that protein, known as Wash, nuclei lose their classic plump shape and become wrinkled and puckered.

Nuclei pucker in the natural aging process and in certain diseases including progeria, a rare and fatal genetic disorder that dramatically speeds up aging. Whether Wash plays a role in progeria or aging is still unclear, but these findings are an intriguing hint that it might, said Dr. Susan Parkhurst, a biologist at Fred Hutch.

Parkhurst led a study describing Wash’s role in the nucleus, which was published today in the journal Current Biology.

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MacGyvering lab equipment

From old bicycle wheels to an in-house metalworking shop, scientists get creative when the research tools they need don’t exist

March 3, 2015 | By Dr. Rachel Tompa / Fred Hutch News Service

Dr. Anna Greenwood

Dr. Anna Greenwood built a robot using a donated bicycle wheel and a broken rotor to conduct an experiment on why fish school.

Photo by Robert Hood / Fred Hutch News Service

When Dr. Anna Greenwood set out to find the genes that drive fish schooling, she ran into a problem: The equipment she needed to conduct her experiment didn’t exist.

For her work on teasing out an individual fish’s role in this social behavior, she’d have to study one fish at a time in a controlled environment. But, of course, schooling is not a solitary activity.

The solution to her problem included a trip to Jo-Ann Fabric and Craft Stores, a salvaged motor from some broken lab equipment, an old bicycle wheel and a lot of brainstorming. The end result: a homemade fish schooling robot, the next best thing to a group of live animals.

Greenwood, a behavioral biologist at Fred Hutchinson Cancer Research Center, and other basic scientists frequently find that they are pursuing research so cutting edge that the tools they need haven’t even been invented yet. So they do it themselves, often creating their own lab equipment out of a collection of unlikely and disparate parts, just as the TV character Angus MacGyver was famous for doing.

“You think you’re a biologist, but you have to actually be an engineer in some instances,” Greenwood said.

The price of being at the forefront of science can mean being a part-time inventor, something that many researchers have never trained for. The solution may come only through trial and error and a trip to the local hardware store, drugstore cosmetics counter or even their own kitchens. 

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Doctor who cured ‘Berlin patient’ of HIV: ‘We knew we were doing something very special’

Dr. Gero Hütter and Timothy Ray Brown speak about the transplant that forever linked them in medical history

Feb. 27, 2015 | By Mary Engel / Fred Hutch News Service

Dr. Gero Hϋtter and Timothy Ray Brown

Dr. Gero Hϋtter, left, with Timothy Ray Brown. After Brown's cure became public, Hϋtter said he received emails daily from people with HIV saying "Please doctor, do the same for me."

Photo by Robert Hood / Fred Hutch News Service

When Dr. Gero Hütter gave Timothy Ray Brown a bone marrow transplant at a Berlin hospital on Feb. 7, 2007, he knew he could be making history. If, that is, Brown survived long enough to see whether the grueling transplant cured not only his leukemia but also his infection with HIV, the virus that causes AIDS.

Brown did survive, and eight years later, is free of both cancer and HIV. On Thursday, the German doctor reunited with his Seattle-born patient for a rare joint public appearance to talk about how the world’s first -- and so far only -- HIV cure came about and what it means for the future.

“At the time we were doing the transplant, we knew we were doing something very special that could change the whole medical world if it worked,” Hütter told a standing-room-only crowd of more than 200 people - including Brown’s mother – at the downtown Seattle Public Library. “We weren’t clear what would happen. It was a big and good surprise that it worked.”

Added Brown: “I didn’t really believe I was cured until he published the paper [in the New England Journal of Medicine in 2009].”

Identified only as “the Berlin patient” in that first paper and in subsequent media reports, Brown, 48, went public in 2010, around the time he returned from Berlin to live in the United States.

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Fred Hutch to get $7.75M in Obamacare research funds

Project to research better way to treat neutropenia is one of five to get latest funding from Patient-Centered Outcomes Research Institute

Feb. 24, 2015 | By Diane Mapes / Fred Hutch News Service

Drs. Gary Lyman and Scott Ramsey

Drs. Gary Lyman, left, and Scott Ramsey are the directors of the Hutchinson Institute for Cancer Outcomes Research.

Photo by Bo Jungmayer / Fred Hutch News Service

Most people know about common chemotherapy side effects like hair loss and nausea. But another common side effect is neutropenia, an abnormally low white cell count that can lead to fever and infection and land cancer patients in the hospital or even result in their death. 

To fend off neutropenia, oncologists will often prescribe a biologic known as a primary prophylactic colony-stimulating factor, or PP-CSF, that helps boost a patient’s white cell count. But not all doctors use the same criteria to evaluate which patients get this drug and which don’t.

As a result, some cancer patients receive this medication when they don’t really require it and suffer needless side effects like severe bone pain. Other patients don’t receive it at all and endure far more serious consequences: fever, infection, hospitalization and the associated financial burden.

Thanks to a new $7.75 million research award, however, we will have an improved understanding of the neutropenia puzzle and better ways to reduce complications and improve the quality of patient care.

The funding, announced Tuesday, will be used by the Hutchinson Institute for Cancer Outcomes Research (HICOR), a research institute of Fred Hutchinson Cancer Research Center, to conduct a pragmatic clinical trial evaluating the use of colony stimulating factors to reduce the risk of serious neutropenia-driven infections in patients undergoing chemotherapy for breast, colorectal or lung cancer.

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