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Science

The Fascinating and Evolving Story of Bacteria and Cancer (substack.com) 17

Dr Eric Topol, a cardiologist and director of the Scripps Translational Science Institute, writing over the weekend: It was medical dogma: cancer tissue is sterile. That's what we had learned and taught in medical school for decades even though bacteria were detected in tumors more than 100 years ago. When studies were reported asserting that bacteria were present in tumor tissue, they were consistently debunked as representing contaminants. Then came new tools that include single-cell sequencing and sophisticated spatial profiling providing high-resolution portraits of tumors. The new dogma is that bacteria have a pervasive (yet variable) presence within and across solid tumors -- the "presence of intratumoral bacteria being designated a hallmark of cancer." Furthermore, where bacteria are more apt to be found within tumor regions, T cell recruitment and function is suppressed. These regions of tumor are micro-niches exhibiting immune evasion.

Just as that has been determined, there was a new twist this week: engineering bacteria to induce a potent T cell immune response to kill the tumor. This can be viewed as the polar opposite. Instead of bacteria improving a tumor's ability to duck our immune response and spread, this represents clever ways to genetically manipulate bacteria (aka "designer bugs" with the schematic in the linked post) to make it considerably more antigenic, a new route to immunotherapy.

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The Fascinating and Evolving Story of Bacteria and Cancer

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  • Medical dogma (Score:5, Interesting)

    by GlobalEcho ( 26240 ) on Tuesday April 18, 2023 @02:58PM (#63459804)

    I get the sense there is a tremendous amount of medical dogma that gets passed on even to today's MDs. The most famous example of course was the cause of ulcers (dogmatically due to stress, found in the late 20th century to be bacterial). But a recent famous example was the medical community's deadly dogma concerning aerial viral transmission, brilliantly covered in this Wired article [wired.com] and subsequently broadly discussed elsewhere. This example of tumors containing bacteria has the same flavor of scientific mispractice.

    There are a lot of beliefs in the medical community resting on shaky old studies like that, or on no research at all. The typical medical education consists of tremendous feats of rote memorization rather than scientific thought (just ask any MD how they got through organic chemistry).

    I generalize here; I know this to be a problem for US medical doctors. I am not sure to what extent the rest of the world recapitulates the issue. But since France for example is full of actual doctors recommending homeopathy(!) I am not optimistic.

    • Re: (Score:2, Insightful)

      by tlhIngan ( 30335 )

      Well, there's also the problem of the community.

      Take the HPV vaccine, for example. HPV is often a direct cause of cervical cancer, and many enlightened places offer the HPV vaccine as a matter of course.

      The problem is the community often fears it - it's not the vaccine itself that's the problem, but the implications that if you take HPV out of the equation, everyone will f**k everyone else with impunity. (As if removing one STI from the list of STIs will cause everyone to start poking everyone else).

      So desp

      • And then as we saw during the pandemic, there were plenty of doctors who refused mask mandates, and provided false vaccine information (ivermectin and HCQ were not just spread through social media - many doctors were guilty of it as well).

        Those doctors were definitely a problem, though I would argue generally a different problem than medical dogma. Getting rid of foolish conclusions arising from motivated reasoning is...really hard. I'm more optimistic about mitigating dogma.

        • I believe the problem is that too many doctors think that they are scientists.

          They have some scientific training, but, in many (perhaps most) cases, not enough to make scientific judgements or review scientific papers. I think that especially lacking among doctors is a real understanding of statistics.

          • This is so extremely true. My partner is a research scientist, and she's very up-to-date on her condition, hypothyroidism. She has done countless hours of research, read the papers, and she understands her condition very well, and the potential treatments for it better than most practicing endocrinologists. There's a huge gap between research doctors and the doctors that you see in offices. They keep trying to tell her that this or that treatment is bad for her bones, or increases the risk of breast cancer,

    • I get the sense there is a tremendous amount of medical dogma that gets passed on even to today's MDs.

      Most likely this is in Australia. I do know a kind of dogma used in pathology here (and no doubt elsewhere) - match symptoms/tests with known diseases, then treat that disease rather than treating that patient. Often this abstraction works for something like acute trauma (I wouldn't be writing this if it didn't), but not so well for chronic conditions. And if one's condition doesn't match a known disease (or they fail to ID it), you are told "there is nothing wrong with you" and you're sod out of luck.

      Also

    • by kackle ( 910159 )

      The most famous example of course was the cause of ulcers (dogmatically due to stress, found in the late 20th century to be bacterial).

      In all fairness, perhaps stress allows an overgrowth of the H. pylori bacteria (which people can have without issues), supposedly leading to ulcers. Further, that may be the leading cause, but not the only; regular medications are known for such damage, too.

      • You are missing part of the "stress" argument.

        The argument used at the time was that wealthy people were more likely to get ulcers because they had more stressful lives. It was a bullshit argument intended to show that the wealthy didn't really have better lives than the poor.

        • by kackle ( 910159 )
          I didn't know that's what the argument WAS, but since the data today show that emotional stress affects the gut (such as its microbiome, and hence, the immune system), it wouldn't surprise me that changes there would alter the H. pylori proliferation.
  • by joshuark ( 6549270 ) on Tuesday April 18, 2023 @05:59PM (#63460246)

    The historical cycle repeats...

    https://www.biologicalmedicine... [biological...titute.com]

    Of course "chemotherapy" became the accepted practice.

    JoshK.

    • by swell ( 195815 )

      JoshK,

      I might mod this comment up if it bothered to explain why the link was relevant and where in the long article to find the relevant part.

      Links without explanation don't normally get modded up, so please explain.

      • by joshuark ( 6549270 ) on Tuesday April 18, 2023 @07:49PM (#63460474)

        Ah, swell, you're point is well taken, and in hindsight I can see this...so thank-you for point that out.

        Coley developed the approach of injecting bacterium into cancerous tumors, and that caused the immune system to attack and destroy them. This was before chemotherapy became the default system of cancer treatment.

        Coley developed what was called "Coley's Toxins" which were the bacterium both weakened and dead that he used. The article gives his background, but about a quarter of the way down the Coley's Toxins is explained.

        This is a repeat of history, going into a cycle of repeating, as engineering a bacterium that is used to treat cancer, is what Dr. Coley developed back originally in the 1890s.

        JoshK.

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