Medicine Science

Ask a ScienceBlogger: What era of science?

You may have noticed that I opted out of the last two or three weeks worth of Ask a ScienceBlogger questions. The last couple of weeks it was because the questions simply didn’t interest me, and the week before that it was because i just plain forgot.

This week, however, our overlords at SEED Magazine demand:

If you could have practiced science in any time and any place throughout history, which would it be, and why?

That’s a pretty easy one. I’m with Stein in that I answer: Now.

Think about it. I’m a physician, and my interest is in studying cancer. I started graduate school in 1990. Since then, in a mere 16 years, the tools that have become available to study human physiology, genetics, and disease are astounding. We have sequenced the human genome and are now busily analyzing the data. For the first time ever, we can now measure the expression of every gene cells or tissues on a single chip, analyze the results, and identify signaling pathways that change based on changes in clusters of genes in response to stimuli or drugs. This new science (known as genomics or genomic medicine) is something that was unimaginable a mere 15 years ago. Now, because RNA expression doesn’t always correlate with expression of the functional protein, we are now moving towards proteomics, where we measure the proteins expressed by cells.

It’s all simply amazing to me. I have tools I never would have dreamed of even in graduate school, and these tools have come into existence in an incredibly short period of time. What new tools will be developed in the next fifteen years?

In terms of treating cancer patients, the advances have come almost as fast. Alties will condemn conventional oncologists for “poisoning,” “burning,” and “cutting” tissue. (As a surgeon, I guess I represent the “cutting” part.) However, less appreciated is that the major focus of cancer research has shifted to looking for less toxic therapies that do the job as well with far fewer side effects as the old chemotherapeutic regimens of the past, with the targeting of tumor angiogenesis (one of my areas of interest) being one such promising strategy. The same is true in surgery. Take breast cancer, for instance. In just the time since I graduated from medical school, we have gone from a high percentage of women getting mastectomies to being able to save the breast in 2/3 to 3/4 of women. We have gone from removing nearly all the lymph nodes under the arm on the side of the breast cancer, with all the attendant complications of lymphedema, arm pain and numbness, and decreased range of motion, to sampling only one to three lymph nodes and getting the staging information we need, reserving complete lymph node dissections only for women who have positive lymph nodes. We are tailoring our therapy to molecular targets, for example the Her-2/neu oncogene, with the promise of more targeted therapies to come.

What other time period could offer so much promise?

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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