Monday, 10 March 2008

Lots and Lots to Read

Clear, partly sunny, minus 12 degrees

I am still learning - Michaelangelo's motto

Michael here - subbing for Louise, while she journeys around the USA. Up till now, we've travelled together to all her events. It's been a ball. I've met so many marvellous people I never expected to meet: writers, editors, fans, booksellers - on and on. We've been around the world too - another highlight I never expected to experience. Now, we have friends all over the world. I'm sure we'll have even more after this week's tour.

But I'm home with Maggie and Trudy (our Goldens) doing taxes and saving us a bit of dough. We renovated our bedroom- bathroom and bought an addition to the property, so it's a good time to cut back. Everyone is, it seems. I'm sorry for all the grief people are experiencing as the economy dips and jobs are lost. Heartbreaking! I wish I knew what I could do.

Anyway, I'm writing a book too - on neuroblastoma - as I probably mentioned the last time I subbed here. One of the benefits for me is that I need to read classic articles on medical topics.

One such, by Alfred G Knudson, Jr., expounds his two-hit theory of cancer causation, something I've known about for years. But to read his articles describing it, the evidence it's based on, and the quality of his writing, his science, is a delight. The two-hit theory says that some cancers, particularly in children, arise after two genetic mutations. In hereditary cancers, in families, one of the mutations is inherited and is in every cell. Nothing happens unless another mutation occurs. In sporadic cases, two mutations need to occur in the same cell. This theory explains why hereditary cancers appear earlier, and can be multiple, while sporadic cancers are far rarer, occur later and are rarely multiple.

An example is retinoblastoma, a cancer of the retina of the eye. A specific retinoblastoma gene is known and there are hereditary and sporadic cases. This is the disease that Knudson studied in elucidating his theory. Well-known Canadian guitarist Jeff Healy, who just died in his forties, suffered from it as a child.

Now, I'm reading another classic by Hiroyuki Shimada in which he descibes the patholic classification of neuroblastoma into favorable and unfavorable histology.

The Shimada classification is used worldwide to characterize this disease. He showed that favorable histology was associated with an 87% survival, while for unfavorable histology it was only 7%. Again, the clarity of his writing, his thought, are breathtaking. What a privilege to actually sit and read them.

I use Entrez PubMed, the website of the US National Library of Medicine, where I can download recent articles, through my McGill retired status. But for older articles, like those written around the study I'm writing about, twenty to thirty years ago, I need help. And the help I get is from Joanne Baird and her co-workers at the Medical Library of the Montreal Children's Hospital, where I worked for two plus decades. I send her lists and after a week or two I receive a fat envelope with all my requests inside. I have about 30 waiting to be read. I'd better get going!

Be well. I hope to hear from Louise any moment telling me she's en route to New Canaan, CT.


donna said...

I have just returned from hearing Louise speak and meeting her on her first stop on the U.S. tour. What a wonderful speaker she is and just as nice in person as I imagined she would be. If she is going to be appearing near you, I highly recommend going to see her. Just delightful. I wish I lived near her as would truly enjoy spending time with her and having her as a friend. Michael - thanks for keeping up the blog!

Michael said...

Thanks, Donna. I couldn't agree more. Part of me wishes I'd been there and could have met you...Another time! But Connecticut isn't all that far. My son went to Suffield Academy.