Closing in on human hibernation
Zeroing in on proteins to unmask pancreatic cancer
Vitamins
The keys to early detection

Closing in on human hibernation

Putting humans in a state of hibernation has been, for the most part, the provenance of science fiction.

But it has been studied seriously as well, and scientists have zeroed in on its potential benefits, such as saving lives. This summer, Dr. Mark Roth and his colleagues at the Hutchinson Center got a little closer to that ideal.

Roth has been studying hydrogen sulfide, which smells like rotten eggs, and its potential to induce reversible metabolic hibernation. In June, his team reported another key finding, showing that inhaled hydrogen sulfide and intravenous hydrogen sulfide appear to work in significantly slowing down metabolism in laboratory specimens.

"Our goal is to develop lifesaving treatment for critically ill people suffering from acute, sustained blood loss, such as in a car accident or on the battlefield," Roth said. "These findings have obvious implications for the military, but they also have tremendous implications for the civilian population."

Roth's study, whose initial research was supported with private funds that opened the door for federal support, said the study's goal is the development of a self-injectable hydrogen-sulfide kit that critically injured soldiers could use in the field to temporarily slow their metabolism and reduce their oxygen demand. This would help buy time until they could get medical attention.

Roth and colleagues already made headlines worldwide in 2005, when they were the first to induce a state of reversible hibernation in mice with hydrogen sulfide. Roth believes it has the potential to help treat ischemic injuries caused by conditions such as severe blood loss, hypothermia, cardiac arrest and stroke.

Zeroing in on proteins to unmask pancreatic cancer

Finding the tools to detect cancer at an early stage of development is a crucial goal at the Hutchinson Center. Most solid tumors can be cured if they're detected and treated early.

That has led to the rising field of proteomics, which seeks to identify clinically relevant trace proteins, or biomarkers, that are leaked by tumors into the blood.

Scientists believe that such proteins could be used in screening blood tests for early and more accurate detection of cancer and other diseases.

In June, scientists reported they had taken a big step in early detection research by identifying a group of proteins linked to early development of pancreatic cancer.

"Our team identified, for the first time, protein changes associated with early stage pancreatic-tumor development in genetically engineered mice that were also found to be associated with the presence of the disease in humans at an early, pre-symptomatic stage," said Dr. Samir "Sam" Hanash, head of the Hutchinson Center's Molecular Diagnostics program.

"Our findings represent a breakthrough in the application of advanced proteomic technologies and mouse models to cancer-biomarker discovery," Hanash said.

With thousands of proteins in the blood, finding ones that signal the earliest stages of pancreatic cancer has been extremely challenging. But scientists such as Hanash hope that someday, biomarkers will be used regularly and effectively in the war on cancer.

Vitamins

The use of vitamins and minerals among cancer survivors is widespread, significantly higher than the general population.

However, their benefits remain unclear, and in some cases, certain supplements may interfere with treatment or even hasten cancer progression.

These are among the findings in a review of scientific literature conducted by Dr. Neli Ulrich and colleagues, who are urging cancer patients and their doctors to communicate openly about the use of vitamins, minerals and herbs.

"Can vitamin and herbal supplements reduce the adverse effects of cancer treatment, decrease the risk of cancer recurrence or improve a patient's chances of survival? We don't really know. Research into these matters has been minimal," said Ulrich, with the Hutchinson Center's Public Health Sciences Division.

"While supplement use may be beneficial for some patients, such as those who cannot eat a balanced diet, research suggests that certain supplements may actually interfere with treatment or even accelerate cancer growth," she said.

One of the key concerns highlighted by the study is the high number of cancer patients who don't tell their doctor that they're using supplements.

"This is disconcerting and suggests that many physicians may not recognize the importance of understanding whether their patients are taking supplements," Ulrich said.

Knowing about supplement use is crucial, she said, because of potential adverse effects. "Evidence clearly suggests the need for caution," she said. "Some vitamins, such as folic acid, may be involved in cancer progression while others, such as St. John's wort, can interfere with chemotherapy. However, we really need more research to understand whether use of these supplements can be beneficial or do more harm than good."

The keys to early detection

A simple blood test known as CA125 detects cancer in about 60 percent of women with early stage ovarian cancer, and 80 percent with late-stage disease. It's a remarkable tool that becomes even more efficient if doctors ask the right questions.

In a recent study, Hutchinson Center researchers determined that when the blood test is coupled with a few questions, early detection rates climbed to more than 80 percent for early stage and more than 95 percent for late-stage disease.

Women should consult their physician if they frequently experience any of the following symptoms:

• Pelvic pain
• Abdominal pain
• Bloating
• Increased abdominal size
• Difficulty eating
• Feeling full quickly

"This research suggests that if a woman has one or more symptoms that are new for her, having begun within the past year, and if the symptoms happen nearly daily or at least 12 times a month, that may well be a signal to go in and discuss those symptoms with her doctor," said Dr. Robyn Andersen, lead author of the study. "It's probably not going to be ovarian cancer, just as most breast lumps are not breast cancer, but it's still a sign that it might be worth checking with her doctor to see if a CA125 blood test and transvaginal ultrasound may be appropriate."

The researchers hope their symptom index will help doctors know which among their patients who complain of symptoms like abdominal swelling and pelvic pain might have cancer.

The symptom-screening index, developed in 2006 by paper co-author Dr. Barbara Goff, of the Seattle Cancer Care Alliance and the University of Washington School of Medicine, is not used proactively in clinical general practice, but Andersen and colleagues are conducting a pilot study to assess the value of using it as a screening tool among normal-risk women as part of their routine medical-history assessment.

"Of course, it is the increase in the detection of early stage disease that is the most exciting," Andersen said. Cure rates for those diagnosed when the disease is confined to the ovary are approximately 70 percent to 90 percent. However, the majority of women with ovarian cancer are diagnosed with advanced-stage disease, when the survival rate is only 20 percent to 30 percent.