Category Archives: personalized medicine

Researchers Discover New Target for Personalized Cancer Therapy

Captured by Case Western Reserve University

A common cancer pathway causing tumor growth is now being targeted by a number of new cancer drugs and shows promising results. A team of researchers at Case Western Reserve University School of Medicine have developed a novel method to disrupt this growth signaling pathway, with findings that suggest a new treatment for breast, colon, melanoma and other cancers.

The research team has pinpointed the cancer abnormality to a mutation in a gene called PIK3CA that results in a mutant protein, which may be an early cancer switch. By disrupting the mutated signaling pathway, the Case Western Reserve team, led by John Wang, PhD, inhibited the growth of cancer cells, opening the possibility to new cancer therapies.

Their findings, “Gain of interaction with IRS1 by p110α helical domain mutants is crucial for their oncogenic functions,” was published on May 2 in the journal Cancer Cell.

Cancer arises from a single cell, which has mutated in a small number of genes because of random errors in the DNA replication process. These mutations play key roles in carcinogenesis.

“This discovery has a broad impact on the treatment of human cancer patients because so many cancers are affected by this particular mutation in the p110α protein, which is encoded by the PIK3CA gene,” said Wang, an associate professor in the Department of Genetics and Case Comprehensive Cancer Center. “This is a significant advance because we can now disrupt this misdirected signaling pathway in cancer cells.”

“If you turn on a light, you have to turn on a switch. But in the case of the mutation of this protein, p110α turns on by itself,” Wang said. “The mutation rewires the circuit and is uncontrolled. This implies that if you break these wires, you can control the growth of cancer. Our current discovery may lead to finding less toxic drugs that can be used for personalized treatment for cancer patients in the future.”

“This research will impact the field by focusing us on new targets for treating and preventing metastasis in patients in a many different types of human cancers,” said Stanton Gerson, MD, Asa and Patricia Shiverick-Jane Shiverick (Tripp) Professor of Hematological Oncology, and director of Case Comprehensive Cancer Center and of Seidman Cancer Center at University Hospitals Case Medical Center.  Read more…

Future of Diabetes Diagnosis, with Help from Pharmacogenetics: Dozens of Type 2 Subtypes

Personalized health care in the context of diabetes, and especially Type 2, someday is likely to involve the diagnosis of patients with one of multiple diabetes subtypes based on an individual’s biological symptoms, physical characteristics and genetic profile, according to Ewan Pearson, a clinical senior lecturer at the University of Dundee in Scotland.

Speaking at a plenary session of the 2012 Global Diabetes Summit hosted by Ohio State’s Diabetes Research Center at Wexner Medical Center, Pearson outlined how stratifying diabetes patients by the origins of their disease and genetic predispositions that influence their response to drugs could dramatically change how patients are treated.

This practice could be a long way off, he said, or, “Who knows? This might not be too far away.”

Pearson, also honorary consultant in diabetes & endocrinology at Ninewells Hospital and Medical School, said the current approach to diabetes diagnosis is oversimplified, with the vast majority of cases defined as Type 2 diabetes. Only a tiny percentage are diagnosed as MODY – maturity onset diabetes of the young.

Detailing a number of case studies that make it abundantly clear how different Type 2 diabetes patients can be in terms of biological symptoms and sensitivity to drugs, Pearson suggested that MODY is not considered frequently enough as an alternative diagnosis to Type 2.

Personalized drug treatment could be much more effective in these stratified patients because their genes would offer clues about which medications, and at which doses, will work best for them. For example, studies have already uncovered gene variants that can affect how statins work at different doses – and roughly 90 percent of diabetes patients take these drugs to control cholesterol.

Similar pharmacogenetic research into genetic variants that influence sensitivity to blood sugar-lowering drugs are in their earliest stages. Pearson and colleagues have identified a likely target gene on chromosome 11 that influences the effects of metformin, an enormously popular drug for lowering blood sugar in Type 2 diabetes, but much more work is required to fully understand that gene’s role. Scientists also have some hints about variants that influence response to another class of glucose-control agents as well.

In cases where variants have been identified that affect patient response to drugs, however, the effects are too limited or affect too few people to justify incorporating genomic analysis into clinical care at this point, he noted.

Pearson asserted that pharmacogenetics will continue to advance discoveries that will have clear implications and lead to “good clinical medicine” that will avoid oversimplification.

“I do think this is the future of diabetes and I’m optimistic that we’ll start identifying some subtypes over the course of the next 5 years,” he said.

-Emily Caldwell

Vasectomy Reversal A Good Option for Many Couples

Did you know that a vasectomy reversal can be performed successfully up to 15 years after a vasectomy has been performed? It is important to go to a physician that is experienced in performing vasectomy reversals. It is also important to make sure the female partner is healthy and doesn’t have any fertility problems.

During a vasectomy reversal, the ends of the vas deferens (tubes sperm travel through during ejaculation) are put back together to bypass the blocked portion. This returns sperm to the man’s ejaculate in the vast majority of cases. The unique aspect of this surgery is the size of the repair needed. In general, the vas deferens is repaired with a suture that is smaller than a human hair. It requires skill in using an operating microscope or robotic surgery. The size of the tube sperm travel through is similar to the period at the end of this sentence. It is important to find someone who has been fellowship trained in this procedure for the best chance of success.

To schedule an appointment to see if you or your partner is a good candidate for vasectomy reversal, call 614-293-9253.

View a video of one of our specialists discussing this procedure in more detail

Low Testosterone Not Just a Myth

Most people are aware of the physical and hormonal changes that take place in women during menopause (the end of menstruation and fertility). The less frequently discussed changes during andropause in men are equally common. Many people are unaware of the symptoms associated with this condition, as well as the treatment options available to make these changes easier to live with.

Symptoms of andropause include:
• Irritability or moodiness
• Difficulty concentrating
• Low energy or fatigue
• Low sex drive
• Erection problems
• Increased fat deposition
• Trouble recovering from exercise
• Hair loss

Most men diagnosed with andropause experience a low sex drive accompanied by one or more of the other symptoms listed above. As soon as symptoms become bothersome, it is important to seek medical treatment. If testosterone levels drop too low, you have an increased chance of developing heart disease, diabetes and osteoporosis (bone loss).

The most common treatment for andropause is testosterone replacement therapy. Your physician will consider the symptoms you have been experiencing and identify how your testosterone levels fluctuate throughout a given day. Using this information, your physician will create a personalized treatment plan specific to your situation.

If you think you or your partner may be experiencing andropause,  learn more or schedule an appointment for evaluation with one of our specialists by calling 614-293-9253.

10 Ways to Add Steps in Your Day

1.  Take the stairs rather than the elevator/escalator, especially for one to three floors, both up and down.

2.  During TV commercials, get up and walk around the house.

3.  Return the shopping cart all the way into the store after grocery shopping.

4.  Marching Minutes – every 30 minutes get up from your desk or chair and do 1-5 minutes of walking in place and stretching your arms, shoulders and neck.

5.  Before eating lunch, take a 10 minute walking break.

6.  If you take your kids to sports or activities, dedicate 10-20 minutes of that time to walking around after dropping them off or when you arrive early to pick them up.

7.  Park in the far back of the parking lot and walk further to the door or get off the bus a stop or two before your usual stop and walk the rest of the way.

8.  Never drive through – get out and park and walk into the bank or fast food stop instead.

9.  When people stop to talk with you, make it a moving meeting and walk around together while chatting.

10.  When making a phone call, stand up and pace around as you talk. Or, rather than phone call or email, walk to a coworker’s office or neighbor’s house and talk to them live.

Nothing will work unless you do.

-John Wooden

Living P4 Medicine

Watch these videos to see how our employees having been living P4 Medicine in 2011. Then share with us in the comments below how your New Year’s resolution might incorporate P4 medicine. Do you plan to lose weight? Review your family’s medical history? Get tested? Educate yourself? We want to know your goals so we can share content around those topics in 2012.

Living P4 Medicine: Lindsay Giannobile on Genetic Testing

Lindsay Giannobile from the Facilities and Materiel Management department at OSU Medical Center, shares her experience of the importance of  P4 Medicine and genetic testing in this video. When she was diagnosed with stage three invasive ductal carcinoma, she became concerned with the well being of her mother, sister and family. She examined her family history and had the women in her family tested for breast cancer.

How are you living P4 Medicine through prediction?