The “War” on Cancer with Denis Guttridge, PhD

The Medical University is home to the prestigious Hollings Cancer Center, the only National Cancer Institute designated center in South Carolina. Hollings Cancer Center is a tremendous resource, not only for state-of-the-art research and discovery, but the translation of that discovery into lifesaving therapies and prevention tools.

Dr. Denis Guttridge is a professor in the Department of Pediatrics, director of the Darby Children’s Research Institute and associate director of Translational Sciences at the Hollings Cancer Center.

Read The Transcript

[00:00:05] Loretta Lynch-Reichert: Hello everyone and welcome once again to the Medical University of South Carolina Science Never Sleeps podcast. I’m your host, Loretta Lynch-Reichert. This month we take a breather from the all-consuming topic of COVID-19 and discuss another very challenging but well researched disease – cancer. The Medical University is home to the prestigious Hollings Cancer Center, the only National Cancer Institute designated center in South Carolina. Hollings Cancer Center is a tremendous resource, not only for state-of-the-art research and discovery, but the translation of that discovery into lifesaving therapies and prevention tools.

Today, our guest is Dr. Denis Guttridge, professor in the Department of Pediatrics, Director of the Darby Children’s Research Institute and Associate Director of Translational Sciences at the Hollings Cancer Center. Welcome, Dr. Guttridge.

[00:01:03] Denis Guttridge: Good morning, Loretta. It’s a pleasure to be here.

[00:01:06] Lynch-Reichert: Let’s begin with what is the significance of a National Cancer Institute designation. Why is that so important and prestigious?

[00:01:16] Guttridge: Well, the importance of being an NCI designated cancer center is that you literally are chartered. You’re asked to carry on a mission by the National Institutes of Health, by the National Cancer Institutes and, the way I look at it, really by our U.S. taxpayers, to say “we are asking you to give us the best treatment in cancer care.” And so when you have that mission, when you have that designation, and you know what you’re chartered to do, and you take that very seriously. For us here, being the only NCI designated cancer center in the state of South Carolina, we view it as that we have... our mission is to give the best cancer care to the people of South Carolina and so when you are charted that way by an NCI designation, you very much know what your goals are and all of the cancer centers, I believe, have their own way of looking at that with respect to their own state and how we care for our people in the state of South Carolina.

[00:02:23] Lynch-Reichert: And do I understand correctly that when you have an NCI designation, the focus, in order to provide that state-of-the-art clinical care, is research? And if so, also another question related to that is because it’s so prestigious, how many other academic health centers in the country have that NCI designation?

[00:02:47] Guttridge: Right. So to get to your second question first, I think the number now is 71 or 72 NCI designated cancer centers. There’s a further designation that’s called comprehensive, but all that speaks to what you were just saying in terms of that designation does tie into research and you’re absolutely correct and when we say research, we can actually stratify that into two areas. We can talk about basic research, basic science research, which is really the research that’s done in the laboratory, and we can talk about what we call translational research, the research that leaves the laboratory and gets passed on to the physician so that we can start clinical trials. And I think the word clinical trials now, in the last year, is a word that most of the public understands, because of everything we’ve gone through with COVID and we understand the importance of clinical trials and whether you’re looking for a new vaccine in COVID-19 or you’re looking for a new clinical trial that will provide us a new way of treating cancer, it’s exactly the same thing.

It’s the way to say ‘can you take a drug, can you take a device, can you take a new imaging diagnostic, can you take a new biomarker, can you take a new medical device, whatever that treatment is, can we translate that into a population of patients and test whether it’s really going to make a difference?’ Whether it’s safe, first of all, and whether it’s going to make a difference. And that is a type of research that is done in an NCI designated cancer center. Again, it is expected to. It doesn’t mean that if you’re not NCI designated you wouldn’t be able to do that, it just means that if you are funded by the U.S. taxpayer to be an NCI designated cancer center, this is your mission and you have to do that and you’re expected to do that and every five years we’re reviewed by the NCI very rigorously and we have to show them, have we been good researchers in the lab? Have we also been good translational researchers and shown that we can translate that research into the clinical to accrue patients so that we can do clinical trials and show that our compounds are safe and that they’re effective and that we can move them forward to be able to again, bring better treatment.

[00:05:17] Lynch-Reichert: And speaking of research, I’m going to delve into a question that many people ask, and I think the answer will clear up some misconceptions. The question I often hear is why do we put so much money, time, and energy into researching cancer, but so far, no cure is at hand? Can you explain to our audience the difference between the big C, Cancer, and all the myriad cancers.

[00:05:46] Guttridge: Yeah. Now I’m an individual by nature that... I’m a glass half full kind of guy, so I will tell you that I’m an optimist. And that’s difficult to be an optimist sometimes when you are personally affected by cancer. And I don’t pretend to understand what that’s like because I haven’t... fortunately I haven’t had that personal experience, although many people in my family – I've lost my mother to breast cancer, I’ve lost my uncle to cancer, my godmother to cancer – I have a family history of cancer and I take it seriously in terms of screening myself routinely because I’m aware that I’m at risk.

So I’m personally affected that way, but I say that because being an optimist, I often tell people when I talk about cancer that when we say, well we started the war on cancer - ‘we’ meaning the Nixon administration started the war on cancer, exactly fifty years ago. We’re celebrating the fiftieth anniversary in 2021 of when we officially started the war on cancer. And when we talked about ‘well we started that war, how are we doing in that war?’ and people say, like what you said, ‘we’ve put so many billions of dollars into this, have we even made an impact?’ and I said, actually we have. And I tell people this because I think the general public doesn’t know this and it’s probably our fault because we haven’t been good enough messaging it. But when I say the cancer community, the cancer research community really started to make great strides in the 1990’s. So between 1970’s, when we started this effort, and the 1990’s, about two decades, we didn’t have much to show for. But now you talk about the mid-90's to where we are today. When I share this number with people, I say do you know that we’ve actually decreased cancer deaths across all cancers by over 30%?

[00:07:45] Lynch-Reichert: Wow.

[00:07:45] Guttridge: Think about that. That’s what you said right? Wow. And that’s the response I get from people because people say, “I never knew that” and “is that a real number?” Look it up, it sure is. And when I say well let’s talk about a cancer that’s the most common in women, breast cancer where there’s over 250,000 cases in the U.S. that are diagnosed per year. It’s our most common cancer in women. What if I were to tell you that since the 1990’s we’ve decreased breast cancer deaths by over 40%?

[00:08:16] Lynch-Reichert: Wow! I am so... wow.

[00:08:17] Guttridge: That blows your mind. Now if you have a close friend or a relative that is an advanced breast cancer patient, what does that mean to that breast cancer patient? That doesn’t quite have the effect, because they’re already in stage 4 metastatic, they’re taking probably advanced therapies that may or may not be working, because we still lose close to 40,000 breast cancer patients a year, right? So we still haven't won that, right? But when we think about winning, I can point to many battles that we’ve won, right? And when you say, “well where have we won?” You can point to basically the ones that we’ve had the strongest effects on are the ones that we’ve been able to screen.

So screening has been magic because when you can tell somebody is either going to be predisposed to cancer or we can find it when it’s really small, in what we’d call like a stage 1, your chances of living are astronomically going to be better than if unfortunately we only diagnose you when you’re in your advanced stage. Even though I’ve had it in my family, I know that if I'm unfortunate to have it but if I can find something where I'm at a stage 1, I’m going to be much more likely... and this is what’s been happening in breast cancer and colon cancer with colonoscopies and other ways which right now we’re screening for people, and in lung cancer and this is great imaging and other great technology... so that all goes back to what we’re talking about research.

It’s not only about researching for a new drug, it’s about researching in physics and engineering for new imaging technologies so we can find tumors much deeper into tissues when they’re much smaller and we can biopsy and then we can have the pathologist tell us “yes that looks cancerous.” Well let’s go in there and scope it out and then let’s make sure your lymph nodes are clean and make sure there’s very little chance you’re going to have any advancement from that initial staging, right? And that’s how we’ve gotten to 30% and that’s how we’ve even been better in breast cancer.

And the numbers in lung cancer are looking really good because lung cancer is our number one killer, but again by things like smoking cessation and the billions of dollars that our taxpayers have put into that, we’ve been very aggressive across the country in showing people that if they can manage their smoking and they can cut it out of their lives and we know the carcinogens that were a causative factor in changing the DNA in our lung cancer, in our lung cells were a contributing factor in lung cancer. We’ve been able to dramatically reduce that and now when you think about what’s revolutionized cancer care in probably the last five now years, with - I think the general public is starting to be aware of the word immunotherapy - this is again from what my oncology colleagues tell me has been a game changer in lung cancer.

So between asking people to smoke less, being able to screen early, having good surgeons to take out a tumor and then being able to also incorporate good new treatments that includes immune =therapy, the numbers and what we can predict in the next 20 years and how we're going to be able to cut down lung cancer by another 40%? You don’t ignore those numbers. You have to be able to tell somebody we’re not losing this war. We haven’t won it because I can tell you many cancers that are still grim, but it’s hope and I can tell you, and it sounds very philosophical, but there is not a single grant that goes out of my lab from any one of my grad students or postdoc fellows that we submit without knowing that we have the taxpayer’s best interest in mind. Where we know that research is going to be funded by a taxpayer dollar and we’re only going to do that research based on the hope that we’re going to make our own difference by what we can contribute to this solving and curing the war and finding an answer to this.

[00:12:40] Lynch-Reichert: You work in the trenches, so you know what you’re talking about when you’re talking about hope but let me dig just a tad bit deeper. So to be clear, there is the big C, the overarching disease condition, and then there are all the ways that condition manifests throughout the body, and if I understand correctly from biology, the big C is basically an overgrowth of cells. Can you define it a little bit better, the big C, and then let’s talk a little bit more about those diseases that are the most frustrating right now to manage.

[00:13:14] Guttridge: Yeah, so the big C can really occur in two ways. You could either be born with a mutation that we call a familial cancer, where you’ve inherited a mutation based on your family history and we often talk about that with breast cancer. There’s about a 10% chance that a woman may have a mutation that’s been passed down where then she is very likely to have breast cancer. But when you know that with good genetic counseling, you can treat that accordingly. And then there’s the other type of big C that arises what we call spontaneously, meaning because of many risk factors, either you’re smoking, weight management, socioeconomic, there’s a lot of factors, genetics, a lot goes into play of why people would get cancer. But it is spontaneously arising somewhere in your body over the course of time, mutations have happened into your DNA and this has caused a normal cell, let’s say in your kidney or in your liver, that was performing a normal bodily function is no longer normal. Over the course of time, it has incurred enough mutations, our immune system unfortunately, which is very good at recognizing these mutations and clearing out these mutant tumor cells at the very very beginning, for whatever reason - there’s lots of mechanisms and we’ve become very good at understanding that - no longer is able to clear out that mutation, that mutant cell, and so now that foreign cell starts to divide and it escapes the immune system and it becomes a tumor. And if it advances and we don’t see it, then it can metastasize and that’s when it becomes very dangerous, when it moves from the local area it was in and uses the circulation systems that we have to go to another site and to spread. So those are the big C’s and they are both started by mutations in our genes, that’s where it all starts.

Now, we have taken - if I can use the word advantage - we’ve taken advantage of knowing about mutations because when we talk about a big C, we have to break that down in what we’ve learned now in the last 20 years by all the great research that’s gone into it, again we give credit where credit is due. This has all been supported by our U.S. taxpayer who has been able to give us the opportunity to be able to understand how to sequence our DNA very rapidly now and what that means is now, we’ve been able to understand that when we talk about a big C in one type of cancer, let’s go back to breast, we know now that there’s just not one type of breast cancer. I know that you’ve heard about that, and I know many people probably listening to this that have heard about that, but we talk about subtypes.

And that’s important to know because the more we know about that cancer, breast cancer as a subtype, than that means that the better we’ll be able to understand how drug A can fight subtype A and how drug B can fight subtype B. And with that information we can then start doing, the word is ‘personalized medicine’, but we very much believe we can do that. And immune therapy is a perfect example of that. We know that people who have lots of mutations in their cancer tend to respond much better to immune therapy than people who have cancer but that don’t have a lot of mutations in their tumors. But we again know that by being able to get that genetic information and subtype these tumors and be able to recognize what type of tumor may be more responsive to a particular therapy. So big C’s break up into smaller C’s into subtypes that we can profile because we have access to genetic material and importantly, then we try to understand how we can take that research and how we can translate it by knowing that subtype and then figure out why is that subtype the way it is and can we then design treatments against that specific subtype? In certain cases, we have been able to. We have been able to win certain smaller battles in certain subtypes of cancers.

[00:18:09] Lynch-Reichert: I think it’s important to note that Hollings Cancer Center is not only is a high impact, high performing research center in the terms of clinical trials, it’s also a place where you can learn how to prevent cancer because there’s research being done about that and maybe that’s one of the more important messages people can get early in their lives, is how to narrow the opportunity for cancer to happen in the body based on environmental factors, on how you live your life. I know we’ve talked to Dr. Marvella Ford many a time about disparities in cancer. Can you tell us about the current research being done regarding cancer, where it’s going compared to where it has been, especially now that we know, to some degree, we can control those risk factors, if you will. If that’s a fair statement.

[00:19:02] Guttridge: I think, you know, if you took – I'll be able to answer it in one way based on what I know but I’m sure there are other cancer experts in specific fields that would also be able to tell you “wait a minute, we’d also do it in this way too” so I’m only going to answer it in one way, just to be fair to my colleagues. Because you’re absolutely right, Dr. Ford, who works in her area, would be able to tell you other ways in which they feel their breakthroughs are going to be occurring.

But I’ll go back to just something that my oncology colleagues, we talk all the time on, and that’s this immune therapy, right? Because we’ve seen the difference, okay. I have a colleague of mine who’s a colon medical oncologist, so in the GI. Now there are subtypes of colon cancers that absolutely have responded so well to immune therapy and when I heard my colleague say this to me about four years ago when this was just starting to happen. He, in his patients, whatever he could give them back at the time, four or five years ago, he was maybe getting a 10 to 20% response. Meaning 20% of his patients were responding to the kind of chemotherapy or treatment he was able to give to them at that time, right? And then when immune therapy started coming around and they were testing it on all variety of cancers and he gave it to this subtype of colon cancer patients that he had, now he was getting a response over 60 to 80%. He used the word to me “Denis, this is a gamechanger.” This is an oncologist whose been in the profession for like 40 years. He’s been living with seeing his patients not make it in many cases who had more advanced stages in colon cancer. And he was telling me, a PhD scientist that studies cancer, that “Denis this is a gamechanger.”

He would not use those words if he didn’t believe it himself, if he wasn’t seeing it himself in his patients. Now does this mean it’s applicable to all colon cancer patients? No, it does not. It is a subtype of colon cancer patients who have high mutation rates because high mutation rates makes these cancers more sensitive to this immune therapy that works so well. Okay. But I use that example because what I think throughout oncology we’re trying to understand is how do we replicate that? How do we make immune therapy work on cancers right now where nothing is working or very little is working, okay? We have to understand why that cancer is not responsive to immune therapy and we have to figure out a way to make it responsive, so figure out from the research why isn’t it responsive and then from the research how do we make it responsive? It goes back to the original question about being an NCI designated cancer center. We’re chartered to figure that out, right?

And so in my own research I work in both pediatric cancers and also adult cancers and on the adult cancer side, I work in pancreatic cancer. That is an example of where we’ve seen very very little difference. Ruth Ginsberg, Alex Trebec, Aretha Franklin, Patrick Swayze, we can go on and on with all the celebrities and all the famous people we’ve lost to pancreatic cancer. And it is predicted to be in about a decade from now our second deadliest cancer, so it’s on the rise and we know that now immune therapy has not really worked in that cancer. Now a lot of labs are putting a lot of effort into figuring can we make it work and there's some promising research that’s being done on that but to get to your question where are the breakthroughs going to come? The breakthroughs are going to come when I think we can exploit what we’ve done so well, we’ve seen game changing things happening in subtypes of colon cancer, certainly in lung cancer, certainly in melanoma, and in some other cancer types as well and I can tell you that many of my colleagues here are spending a lot of time figuring out how can we make immune therapy more affective and how can we apply that to other cancers because we’re all hopeful that we will be able to because we’ve seen the science and we’ve seen the changes and we’ve seen patients live longer ant that’s ultimately what we’re striving for.

[00:23:51] Lynch-Reichert: Yeah, in fact when we first began the podcast, my first guests for the podcast were members of the team in immunotherapy and it’s really wonderful to see the passion of these people - talk about science never sleeps, you know, they’re at it day and night and they’ve already made a difference. What are the most prevalent cancers in South Carolina and what is Hollings Cancer Center doing to make a difference for our citizens?

[00:24:21] Guttridge: We reflect what the country sees, right? Lung, prostate, breast. These are still the number one cancers in our country and as well, in our state. We have a higher minority population, we are more diverse, so numbers for African American males for example, in prostate cancer are significantly higher than in a Caucasian population. So we know in our state we have to be more mindful to trying to improve treatment in prostate cancer because our own South Carolinians, our African American men are more susceptible to prostate cancer.

[00:25:10] Lynch-Reichert: Can I ask a question with regard to that?

[00:25:11] Guttridge: Yeah.

[00:25:12] Lynch-Reichert: Is it because, and I don’t know if you guys have been able to delve into all this research, but is it because African American men are more susceptible or is it because they don’t have access to preventative medicines and care that Caucasians have? Is that a fair question?

[00:25:31] Guttridge: It is a fair question, but I almost say that would devote a separate podcast.

[00:25:37] Lynch-Reichert: I’m sure. But I mean it’s something to think about in terms of, and we won’t get into it, but it’s something to think about in terms of health policy for our state and talk about prevention and economic impact and so just listening to you, I see how this is not just a question of cancer care or research, it’s a question of the health and well-being of our citizens and the health and well-being of our state. Just that one type of cancer presents a lot of issues that folks should know about.

[00:26:15] Guttridge: Absolutely. Because I don’t study that particular cancer, I don’t want to say anything that would misinform your audience, but I can tell you that you are spot on in how you view this as a very important cancer and how in our state we have to think about it from many different ways. It is not only being able to do the research so that you can provide better, cutting edge therapies and then be able to provide clinical trials and enroll patients to try to be able to see if those therapies are effective, it’s being able to do what Dr. Ford does and others that are part of what we call our Cancer Control Program in our Cancer Center.

If you allow me, this goes back again to this NCI designated cancer center. As a cancer center, you are asked by the NCI to have a program that is what we call Cancer Control, where you are going out into the community and you are then connecting with those in the community to try to engage, to inform, to educate about these kind of care practices that you’re doing. For prostate cancer, it’s absolutely the case where our Cancer Control team, which is really a beacon of our cancer center, and what they do and how effective they’ve been go out and try to then tell people ‘we need your help’ because the research that we’re doing at Hollings Cancer Center is really only going to be as good as your ability to help us understand by enrolling in clinical trials if they’re going to be effective because we don't’ know at the end of the day if whatever we do in our labs and whatever we do in translation and apply it to the clinical, are those new treatments going to be more effective for a Caucasian population or an African American population right? And if it’s only going to be the former, then how have we served our state?

We’re only going to serve our state if we can serve everyone in our state. Doesn’t matter what your race or culture, or sex is, it has to be applicable to everyone. In order to know that, we’re going to have to do this as a team, we’re going to have to be able to tell you that we’re going to need people to enroll in our clinical trials. In our day and age where we’ve heard a lot about miscommunication and mistrust, and even now with COVID how many people are mindful of the vaccination, you know, it’s what Cancer Control does for us. It’s one of the things they do, and they do it very well. But that kind of gets to your question about it really is an all-encompassing thing. It’s what we can do but it’s also what our own people can do in our state with us to try to tackle this big problem at least for something like prostate cancer. Does that help?

[00:29:27] Lynch-Reichert: That is... yes, I think that absolutely summarizes what opportunity being an NCI designated cancer center can do and what MUSC does statewide. I think that is very important and we will share with folks the Hollings link so that they can become community engaged with the cancer center, which I know you all really desire. We talked about translational science. You are the associate director of translational sciences at Hollings and so, but you’re a basic scientist. Could you just kind of explain the importance of each in making the whole?

[00:30:06] Guttridge: Yeah, the importance of each in making the whole absolutely requires very close communication and coordination with all of those three parts and into the summation of those three parts. So when we talk about research on the basic science side, which is what I do, I’m a basic scientist, it really is being able to do the experiments in your laboratory that can be done either in a test tube or tested in an animal model and that’s about as far as we get because I’m not a clinician. So I have to, at that point, if I feel like my research or any of my colleagues’ research is working on that basic science side, sees really promising results from what we’re able to do in the test tube and what we’re able to test a little further on, in terms of maybe - let’s say we go back to that example of in certain cancers like pancreatic, we haven’t figured out why those tumors are not responsive to immune therapy, we have to figure out why and we have to figure out how to treat them.

So figuring out why, that’s what a basic scientist would do. They would get into the nuts and bolts about what is so special and different about a pancreas cancer that is different from let’s say lung cancer, melanoma, or certain subtypes of colon that have been very responsive, right? So those are the kind of breakthrough basic science discoveries that you try to make and then if you have an understanding, you say how can we now translate that? That’s that second part, right? And so this is where now you’re going to have the basic scientists and the physicians start to get together and figure out translation. And the translation part still typically uses animal models because unfortunately, this is still the best way to be able to understand if a particular, whether it’s imaging, whether it’s surgical, whether it’s a device whether it’s a drug, you have to kind of figure it out in this kind of system before you can advance it to people. That’s typically what the pipeline is when we talk about translation.

But it’s the physician and the basic scientist who now kind of start working together to figure out what would be that kind of treatment that we would use, that we would test? Can we get results that are going to be meaningful? And if the results are meaningful, then it goes to that third part where we can actually now start having discussions with the FDA, put together a protocol - what we call phase 1, again I think the public is more familiar now with these phase 1, phase 2, phase 3’s because they’re really all about first – safety, and second – about how effective they are and then how really effective they are by being able to prove it in a much bigger population. You get all the people that are really good at statistics to tell you whether it’s meaningful or not. And it’s whether it wasn’t really a one off or lucky thing because your numbers were so low that just by flipping a coin, you got lucky and it worked. But you’ve got to prove it, right? So those are the kind of the three steps and so it’s my role in the cancer center as associate director of translational science, you know, I work closely with the associate director of clinical science because together we are supposed to move that - again as a cancer center - we are supposed to move basic discoveries from the lab all the way to clinical trials, that’s what we’re expected to do and so we have to be very good at making sure we as a cancer center always have mechanisms in place so our basic scientists can find our physicians and talk, right?

And that’s very difficult because you can ask that question to every scientist and physicians across the country. It’s not just science, I mean look at the past year what we’ve all figured out over COVID is everybody's so busy right? It’s so hard and... I’m proud to say that in our cancer center that we have since 2018, I think, figured out another way in which we can bring our physicians closer to our scientists and that’s basically by organizing these subgroups of tumor specific working groups, so we have currently eight of these tumor specific working groups where really on a monthly basis, people who are experts on breast cancer or pancreatic cancer or lung cancer or heme malignancies or colon cancer, they come together and the basic scientist talks to the physician and they talk about what breakthrough discoveries are happening and importantly how do we move them along?

And I’ll just finish by saying the last piece of that puzzle though, and I very much strongly believe in this and I think this has been very well proven by COVID-19, is that you can do all the great groundbreaking discoveries in the lab, you can move that and translate that and move that to the clinic, but mostly at the end of the day what you’re going to kind of still need is a partner in the pharmaceutical industry and so we’ve heard a lot about Pfizer, we’ve heard a lot about Moderna, we’ve heard a lot about Johnson & Johnson, we’ve heard a lot about AstraZeneca, and what that means is that you know, there is a component to being able to translate and effectively treat where you’re going to need that third entity of that team and so what I also try to do is, where it’s appropriate, if we can find a drug that’s already out there that may be specific for that discovery we made in the lab and it could move things quicker to a clinical trial, we will contact that pharma to see if they want to partner with us so that we can move that. And that’s again, what a cancer center is supposed to be doing. It’s supposed to be in a way leveraging all resources that we can to bring best care practice to our patients of South Carolina.

[00:36:26] Lynch-Reichert: I couldn’t have said it better and in fact, again, one of the reasons we do these podcasts is to help and inform our audience that Medical University of South Carolina is an academic health center, the only academic health center in the state of South Carolina. And what makes that so important is just what you’re talking about - when you have basic scientists who are just down the hall from clinical scientists and you get to talk to each other and you inform each other’s research and care, that makes such a huge difference. It’s like you said, it’s not like a hospital can’t really care well for a cancer patient, but the Hollings Cancer Center is at the ready, all of these different resources to come together, all of this brain trust, all of this care and direction and focus that makes such a difference and I just really hope our citizens will take full advantage of this opportunity because it’s a great resources, it’s a great treasure. Tell me, what kind of optimism can you share with regard to pediatric cancers?

[00:37:37] Guttridge: Yeah, you really touched on something very important, I’m very glad you brought it up Loretta, because just yesterday I was on a call with many other people, but we were listening to a couple who was sharing their story of their child who had a neuroblastoma and was treated here with our pediatric oncologists at Shawn Jenkins Children’s Hospital, which we’re very proud of to have this new hospital and the kind of care we can bring and what we’re expected to give for a pediatric population.

The reason your question is so meaningful is because, yeah I can tell you again, I can throw a lot of numbers at you and I could say, “well if you want to talk about winning that war... back in the 1970’s if you were a parent and you were told that your child had cancer, the chance of your child living five years? Five percent. Five percent! That’s a death sentence, right? Now where are we in 2020, 2021? We tell you your child has cancer and what’s the chances of them being able to live – and we talk about this five-year survival rate because that’s the way we look at it, it may not be the right metric but that’s how we talk about it. We’ve gone from 5% now to, we can say, 90%. What? You’re telling me I have a 90% chance that my child can live through this cancer? It’s going to be a hell of a journey, most likely your child is going to get aggressive surgery, aggressive radiation, aggressive chemotherapy, but yeah.

We don’t know about the long-term effects, there’s going to be probably some of that, but they’ll live, you know? And so you’re like, wow that’s awesome. But what about those parents we talked to yesterday, right? Does that give them anymore comfort? Probably not. Because they don’t know, they would just have to start the journey and they would have to hope that they’re not going to be the unfortunate 10%. And just like we talked about with any cancer patient or family member who has to deal with that on a personal level, yeah we’ve had some wins. The reason I’m getting into it with this one is because yeah, they’re the little people, right? They’re not supposed to get cancer. Older people get cancer because our immune system wears down, we’re predisposed, maybe we don’t take care of our body the way we should. But these are little people, they’re innocent. It was unfortunate. Just to let you know though that the little people can take the aggressive treatments better because they’re younger, so their tissues regenerate better. They have more stem cells so when we do things like stem cell transplant therapy, bone marrow transplant, it’s very aggressive and very hard on them, but it’s been successful because they have a chance to rejuvenate and regenerate better than probably you and I can, right? Because some of our stem cells have been a little depleted as we grow older. But yeah, we’ve done very well. Now you know there are going to be some cancers that we can say ‘curative’ when an oncologist will be able to tell a parent, we’ve diagnosed your child’s cancer, we can give you pretty good confidence that this will be curative. So those are magic words but sometimes you can say this should work, but if it comes back and it doesn’t, it recurs, and its metastatic, you know the chances are going to be a lot harder. And then we’re going to have to fight this longer.

And unfortunately, that happens because we’re obviously still losing children to cancers and just like adult cancers, there are some right now that we haven’t been able to effectively treat when they're in their more aggressive form. But you know going from 5% survival in 1970 to 90% survival now is a good number and we just have to work really extra hard and that’s part of what I contribute with my oncology colleagues, again, trying to figure out how do we find the next discovery, how do we translate that? Importantly I'd love to do more clinical trials right here in Shawn Jenkins because we’re perfectly suited for it in our pediatric oncology division, with Michelle Hudspeth and her colleagues.

[00:42:16] Lynch-Reichert: Right right, she’s excellent. Absolutely. Wonderful. And hopeful and I guess we just keep powering on with the help of our community and... I think if anything when people get the call to please participate in some form or fashion, that they should consider this as a real honor and opportunity to be a part of something bigger. Both for themselves and for their family and for humanity, and so I just want to thank you so much Dr. Guttridge for a very hopeful and informative conversation. I truly look forward to speaking with you in the future to get updates on how we are moving the needle forward in cancer research and prevention. Thank you so much.

[00:43:03] Guttridge: And thank you for having me on. Just to let everybody know out there that when we talk about the Hollings Cancer Center and MUSC Health, we’re really talking about a community, a family, and it’s a team effort. It’s what we can do, but it’s what all of us can do, and we need you and that’s how we’re going to solve many of the problems we’re working on in cancer. Like you said, Loretta, I can tell you because I observe it, my colleagues work very very hard and we’re proud of that, but we also know that there’s obviously more to do. So, thank you for having me on, it’s been a pleasure.

[00:43:40] Lynch-Reichert: Thank you, it’s been a pleasure. And to our audience, if you’d like to learn more about the incredible work being done in cancer research and clinical care, check out the Hollings Cancer Center website at hollingscancercenter.musc.edu. Thank you Dr. Guttridge, I wish you every success as you work toward making a difference in cancer care and to our audience, we’ll see you next time.