My lab ‘keluarga’

I continue to share the meaning of research for non-science students. Zaki was a summer medical student in 2015.

“I am a final year Malaysian medical student studying at RCSI. I had the opportunity to join RCSI Research Summer School (RSS) by assisting in research with Cancer Genetics, Molecular and Cellular Therapeutics Department of RCSI. My mentor was Dr Olga Piskareva. My research project investigated the role of chromogranin A as a biomarker in drug-resistant neuroblastoma by analysing its expression in different neuroblastoma samples of murine models.

Frankly speaking, I had zero experience in clinical research (apart from basic science project I did at high school) before the placement started. The reading materials that Dr Piskareva handed to me felt like an alien language that had to be deciphered, let alone doing experiment with western blotting and ELISA. I remembered my first day at the lab, staring enthusiastically at every apparatus and machines but not knowing how to run them.

Fortunately, Dr Piskareva and other lab buddies were very experienced and helpful enough with my insufficiency. Their  perseverance and  willingness to share knowledge and tip built my confidence and understanding to finish my research project. I never had any difficulty to discuss and ask for help any time I needed it from them in the lab. They were also very warm and friendly not just inside the lab but also outside of the lab.

My poster presentation at ICHAMS 2016

I felt like we were one big multinational family in one small lab. Imagine researchers coming from Russia, Ireland, Italy, Netherlands and myself  from Malaysia working hand-in-hand, together. Over time, we bonded very close especially with our weekly breakfast getaway at Gerry’s and my friend Mei Rin and I even prepared our Malaysian cuisine for everyone in the lab in our last days. Even though most of my friends went home for the summer break, never did I felt lonely during my time in the lab. I am very grateful to have them in the lab and to call them my ‘keluarga’ (means family in Malay language).

The 8 weeks RSS program went very swiftly and fast with weekly mandatory skills workshops and Discovery Lecture Series. We also joined RSS book club discussing a very interesting read “The Emperor of all Maladies: A Biography of cancer” by Pulitzer Prize winner Siddhartha Mukherjee.

After the research, I had the opportunity to do poster presentation at RCSI Research Day 2016 and  International Conference for Healthcare and Medical Students (ICHAMS) 2016 at RCSI. These were great platforms for me to share my findings with other researchers. Above all, these were made possible with the help of Dr Piskareva and my lab buddies in preparing the poster and full report of the research. Additionally, the findings also provided me with extra information about neuroblastoma in line with my medicine study in paediatrics.

I would cherish every moment in the lab and indeed it was a very priceless experience. I would very much do it all over again in the lab if I had the chance because of the craving for knowledge and warmth of the lab buddies.

My presentation at ICHAMS can be found here.”

Ahmad Zaki Asraf

The best Christmas present for researcher

Pic is taken from The Upturned Microscope

One of my classmates shared a funny image of the Upturned Microscope and I could not agree more… That week was exactly 12 months since I have started to apply for funding to carry out neuroblastoma research. Seven applications were submitted to various national and European funding bodies. Some were for a PhD student project, other were for PostDoc or both, Four came back with nothing. Two – decision pending and another one was shortlisted but not funded in the first round. A possibility existed that it could be funded at some day in 2017. So, this pic illustrated my feelings very well..

However, either my efforts were paid off or some Christmas miracle has happened, and I have received a note informing on the green light to funding my application. The funding comes from the National Children’s Research Centre and covers a PostDoc position and research consumables over 3 years. It was the very Christmasy news! I was over the moon.

The conditions of the award states:

Finally, the applicants must indicate how the investment in this research will be measured and communicated, not only to the academic community but also to the hospital, the fundraisers, to parents and patients and to the wider public.

This place will be my research diary to share ups and downs of the ongoing work. Please join me in this exciting journey!

Quality of life for childhood cancer survivors

For children who do survive cancer, the battle is rarely over.  Over 60% of long‐term childhood cancer survivors have a chronic illness as a consequence of the treatment they received; over 25% have a severe or life‐ threatening illness. How much do we know about quality of life of childhood cancer survivors?

Researchers in health- and illness-related social sciences understand that the there is a life after the treatment completed. The life is full if diverse levels and issues from health related to social adaptation in different shapes and forms. Children and teenagers may experience fear when returning to school due to temporary or permanent changes to their physical appearance (1,2). They worry about their ability to socialise with their friends due to lengthy absences (3–5). Treatment can result in the development of learning disabilities in children and thus marking school as a major source of frustration (1,2). These learning difficulties can affect a child’s confidence and self-esteem, if left without attention and care (1,3). All studies come to the same conclusion. Challenges in education of children with cancer are complex, however most can be tackled efficiently through planning and good communication (1–5).

Recently researchers working in FRED HUTCH Cancer Research Center asked adult childhood cancer survivors a number of health related questions about the quality of lives (6,7). The results are far from optimistic: “chance of surviving childhood cancer has improved — but survivors’ overall health has not”. You can find more by following the link.

It is important not only to recognise the problems but to start changing the situation. Apparently much more could be done more efficiently if patients are involved in setting up future research agenda.

Reading

  1. Gurney JG, Krull KR, Kadan-Lottick N, Nicholson HS, Nathan PC, Zebrack B, et al. Social outcomes in the childhood cancer survivor study cohort. J Clin Oncol. 2009;27(14):2390–5.
  2. McDougall J, Tsonis M. Quality of life in survivors of childhood cancer: A systematic review of the literature (2001-2008). Supportive Care in Cancer. 2009. p. 1231–46.
  3. Barrera M, Shaw AK, Speechley KN, Maunsell E, Pogany L. Educational and social late effects of childhood cancer and related clinical, personal and familial characteristics. Cancer. 2005;104(8):1751–60.
  4. Langeveld NE, Stam H, Grootenhuis MA, Last BF. Quality of life in young adult survivors of childhood cancer. Support Care Cancer. 2002;10(8):579–600.
  5. Klassen AF, Anthony SJ, Khan A, Sung L, Klaassen R. Identifying determinants of quality of life of children with cancer and childhood cancer survivors: A systematic review. Support Care Cancer. 2011;19(9):1275–87.
  6. Yeh JM, Hanmer J, Ward ZJ, Leisenring WM, Armstrong GT, Hudson MM, et al. Chronic Conditions and Utility-Based Health-Related Quality of Life in Adult Childhood Cancer Survivors. J Natl Cancer Inst [Internet]. 2016;108(9):4–7.
  7. Armstrong GT, Chen Y, Yasui Y, Leisenring W, Gibson TM, Mertens AC, et al. Reduction in Late Mortality among 5-Year Survivors of Childhood Cancer. N Engl J Med. 2016;374(9):833–42.

E-poster at SIOP2016

Ok. Now, when the stress of the presentation is over, I am happy to share new technologies used during the SIOP2016. As I mentioned yesterday, my work was selected for e-poster presentation. It looked this way:

This is e-poster station, where anyone can look up all posters displayed during the meeting.
This is e-poster station, where anyone can look up all posters displayed during the meeting.

 

It is definitely a step forward. Anyone can look up any poster, listen to a commentary recorded by the author, zoom in and out and send a request/comment to the author. It looks cool and trendy. Though, you can feel invisible as no physical copy displayed in a designated area. No crowds of poster presenters and judges. No waiting faces desperate to share their study…

The actual Poster Discussion session was a traditional presentation when my poster was up on the big screen, I had 8 minutes to convince the audience navigating through figures. This session was late and no many attendees survived to come and challenge your statements. Nevertheless, it was enjoyable experience. 🙂

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Childhood Cancer Awareness Month

September is Childhood Cancer Awareness Month!

Facts about childhood cancer

Childhood cancer is 1% of all newly diagnosed cancers globally (1,2).

It is the second most common cause of death among children under age of 19 after accidents.

Childhood cancer is an umbrella term for a great variety of malignancies which vary by site of disease origin, tissue type, race, sex, and age.

Cancer in children is not the same as cancer in adults (3–5).

The cause of childhood cancers is believed to be due to faulty genes in embryonic cells that happen before birth and develop later. In contrast to many adult’s cancers, there is no evidence that links lifestyle or environmental risk factors to the development of childhood cancer.

The most common types of childhood cancer are (1,2):

  • Leukaemia and lymphoma (blood cancers)
  • Brain and other central nervous system tumours
  • Muscle cancer (rhabdomyosarcoma)
  • Kidney cancer (Wilms tumour)
  • Neuroblastoma (tumour of the non-central nervous system)
  • Bone cancer (osteosarcoma)
  • Testicular and ovarian tumours (gonadal germ cell tumours)

In the last 40 years the survival of children with most types of cancer has radically improved owing to the advances in diagnosis, treatment, and supportive care. Now, more than 80% of children with cancer in the same age gap survive at least 5 years (1,6) when compared to 50% of children with cancer survived in 1970s-80s (7).

A revised treatment protocol was introduced in the 1970s leading to dramatic improvements in outcome for some of the most common blood cancers such as non-Hodgkin lymphoma and acute lymphoblastic leukaemia. The 5-year survival rate for non-Hodgkin lymphoma is 85% in 2003-2009. It was just less than 50% in the late 1970s. The 5-year survival rate for acute lymphoblastic leukaemia is  about 90% in 2003-2009 and just 10% – in the 1960s (1,6).Children with some types of brain cancers survive from 70% (medulloblastoma) to 85% (astrocytoma) within 5 years (2).

Unfortunately, no progress has been made in survival of children with tumours that have the worst prognosis (brain tumours, neuroblastoma and sarcomas, cancers developing in certain age groups and/or located within certain sites in the body), along with acute myeloid leukaemia (blood cancer) (1,2).  Children with a rare brain cancer – diffuse intrinsic pontine glioma survive less than 1 year from diagnosis (8). Children with soft tissue tumours have 5-year survival rates ranging from 64% (rhabdomyosarcoma) to 72% (Ewing sarcoma) (2).

For majority of children who do survive cancer, the battle is never over. Over 60% of long‐term childhood cancer survivors have a chronic illness as a consequence of the treatment; over 25% have a severe or life‐ threatening illness (9).

References:

  1. Gatta G, Botta L, Rossi S, Aareleid T, Bielska-Lasota M, Clavel J, et al. Childhood cancer survival in Europe 1999-2007: Results of EUROCARE-5-a population-based study. Lancet Oncol. 2014;15(1):35–47.
  2. Ward E, Desantis C, Robbins A, Kohler B, Jemal A. Childhood and Adolescent Cancer Statistics , 2014. Ca Cancer J Clin. 2014;64(2):83–103.
  3. Dolgin MJ, Jay SM. Childhood cancer. 1989;327–40.
  4. Miller RW, Young Jr. JL, Novakovic B. Childhood cancer. Cancer [Internet]. 1995;75(1 Suppl):395–405.
  5. Raab CP, Gartner JC. Diagnosis of Childhood Cancer. Primary Care – Clinics in Office Practice. 2009. p. 671–84.
  6. Howlader N, Noone A, Krapcho M, Garshell J, Miller D, Altekruse S, et al. SEER Cancer Statistics Review, 1975-2011 [Internet]. National Cancer Institute. 2014.
  7. Ries L a. G, Smith M a., Gurney JG, Linet M, Tamra T, Young JL, et al. Cancer incidence and survival among children and adolescents: United States SEER Program 1975-1995. NIH Pub No 99-4649. 1999;179 pp
  8. Warren KE. Diffuse intrinsic pontine glioma: poised for progress. Front Oncol [Internet]. 2012;2(December):205.
  9. Lackner H, Benesch M, Schagerl S, Kerbl R, Schwinger W, Urban C. Prospective evaluation of late effects after childhood cancer therapy with a follow-up over 9 years. Eur J Pediatr. 2000;159(10):750–8.