What started as a personal journey of a doctor turned patient morphed into a way to share what’s universal in dealing with cancer, in my case a nasty leukemia (CLL), a failed transplant and a successful clinical trial. The telling of my journey has become a journey to teach about CLL, related blood issues and all cancers. Please visit our new website http://cllsociety.org for the latest news and information. Smart patients get smart care™. If you want to reach me, email bkoffmanMD@gmail.com
Sunday, March 15, 2015
ESH 2014: Dr. Cathy Wu Explains TUMOR HETEROGENEITY and CLONAL EVOLUTION in CLL (Chronic Lymphocytic Leukemia)
This is taken from the first of a two part interview with Dr. Cathy Wu in Greece where I spoke on the patients' perspective at a meeting of the Greek Hematology Professional Congress.
It is also a teaser of what is to come in the new website of the nonprofit The CLL Society. That CLL specific education and support site should launch in the next few weeks. It will offer much deeper and broader information and be more searchable than is possible with a blog.
Be assured that my blog is not going away but may revert back to more of a personal blog and the place where I continue to host my candid and occasionally combative opinions and commentaries.
Truth is that the plethora of news and emerging therapies in CLL have outgrown the capacity of my time linear blog to keep up. This new format also will offer the chances to hear other patient voices in what will be the only patient driven physician curated place on the web for CLL support and education.
I and the team of fellow volunteers are pretty excited. It's been a ton of work, but our mission is to address the unmet needs of the CLL community and we believe this new website will be a helpful piece of that effort. There is great information out there and we want to help everyone find it and explain it in our soon to be born strong and friendly CLL focused website. Honestly, my efforts to help launch our nonprofit 510c3 and its website has consumed me, leaving less time to post here.
While we are still building phase 1 of the new website, I plan to continue to post news and interviews like this one here modified for this blog. The website will offer more links, a glossary, some surprise, and a whole lot more.
Stay tune, but I digress.
This clonal heterogeneity discussion is very important stuff on how our cancer evolves and what it means when we consider therapies.
TAKE AWAY POINTS:
·Cancer by its nature is genomically unstable. ·Over time it acquires more mutations. ·New clones and sub-clones can arise over time. ·Therapy can influence the balance and evolution
of the clonal and sub-clonal populations. ·Those changes may have significant implications
for how to best manage our cancer.
Hematology in general and CLL
specifically are full of jargon and acronyms that can be both overwhelming and
daunting.With time and experience,
you'll become familiar with the terminology and acronyms.We will try to explain each medical term the
first time it appears in an article, but we will use the true terminology so
that you gain comfort and familiarity with the medical terms that you will see
in your lab reports and in medical articles. We will also provide a glossary
for your reference.
In the first of our two part interview from the International
Conference on New Concepts in B Cell Malignancies: From molecular pathogenesis
to personalized treatment in Greece in November 2014 she reminds us that
while the concept that any cancer is made of multiple populations of different
cells dates back to the 70s, it is our recent ability to look deeply and
quickly at the genome with next generation genetic sequencing that has really
cracked open our understanding of how huge a factor this is in one’s particular
CLL aggressiveness and its ability to become resistance to therapy.
We now know that questions about the presence or absence of
a good or bad prognostic indicator often should not be answered with a simple yes or no.
More importantly we know that our population of our cancer
cells evolves over time. Hence the need to repeat FISH and other tests when the
An analogy: In most good movies the lead protagonist has an
arc to his or her character. We see how he or she changes and evolves in
response to the support received or the challenges faced.
So too it is with our cancer. Unfortunately CLL is much more
like a movie than a snapshot. Dr. Wu explains our cancer may evolve over time
in response to therapy and other selection pressures.
Please enjoy our video interview with Dr. Cathy Wu.
A family doc and husband of 1 and father of 4 and grandfather of 3 who loves his family and his work. I live with no TV and no microwave, but wouldn't last a minute without friends, art, music, books and the beach. Hockey, good jokes and exotic travel are pretty important too. Writing, Talmud and Zen give meaning to my life. My diet is organic vegan, often raw. I hope the blog makes the load lighter and the path both safer and more fun for those who read it or are going to similar places. I want to help. I crave your comments. If you are new to the blog, check out the portrait my son Will painted (it is the first post), and my very first text post.