Thesun 2009-10-29 Page10 The Race For A Cure

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theSun

| THURSDAY OCTOBER 29 2009

INTERVIEWS VIEWS

Teo with some of her researchers at the Carif laboratory in Subang Jaya

The race for a cure CARIF, THE COUNTRY’S ONLY INDEPENDENT CANCER RESEARCH FACILITY, HAS 24 SCIENTISTS HUNTING FOR A CURE. JOSEPH MASILAMANY NOTES THAT THE WAR AGAINST CANCER HAS HIT THE GENOME TRAIL. THOUGH it may not have the blue chip sparkle of the Pasteur Institute in Paris, the faithful flocking of 24 scientists daily at the Cancer Research Initiatives Foundation (Carif) is testimony that they are part of the global frenzy to find that elusive cure for cancer. The Carif laboratory at the Sime Darby Medical Centre, Subang Jaya, unlike other laboratories is devoid of the harsh odour of ethanol. However, among the whitecoated scientists stooped over their workbenches, the chemistry seems to be right. They function in a collaborative nexus – peeking into a scope, trying to understand the riddles of a gene, staring down the Petri dish containing quibbles of formation or jiggling a test tube of tissue culture – which may probably hold the blueprint for a cure. In tryst with the present, their hopeful eyes are focussed on the future, that might possibly see the day when cancer is beaten right at its source – at the genetic stack.

Breaking new ground Carif CEO Prof (Dr) Teo Soo-Hwang holds court in this laboratory which hails its brittlebrief slogan to the hilt – “you … me … we can beat cancer”. “Since its establishment in 2001, the Carif team has broken new ground in studies involving breast, oral and naso-pharyngeal cancers,” says Teo, a molecular scientist, an academician with University of Malaya and a triple honours top student of her class in Cambridge. “We are looking into the biology of cancer,” Teo tells theSun, outlining on paper the three areas of research undertaken by Carif: identifying key genetic changes in Asians with breast cancer; looking for new ways to diagnose and treat oral and nasopharyngeal cancer – as well as to find a cure for the disease from the country’s vast biodiversity. For Teo and her researchers “looking into the biology” of cancer, simply means finding ways to battle the malignancy in its own turf – the genes and cells – where a single protoplasm breaks away and grows into an unforgiving disease.

Serendipity Listening to Teo, one quickly gets an idea of the sheer size and sweep of cancer’s chilling savagery – its dramatis personae, the twists and turns in its pathological plot and the Asiatic make-up of some cancer tumours. Carif is attempting to understand the stealthy ways of the disease. In other words, stopping cancer in its tracks is basically what Teo and her researchers

are aiming at. The focus is on wayward genes and misbehaving proteins, which may show how cells become malignant. But sometimes serendipity throws a surprise. While looking for the sinister and the malevolent “friendly novel genes” show up under the scope. In a recent joint study with several institutions, Carif isolated certain genes in the body that “stop” normal cells from turning into naso-pharyngeal cancer (NPC) cells among Asians. NPC is a type of head and neck cancer with profound lesions occurring at the back of the nasal region and extending into both sides of the neck in its advanced stage.

High incidence “The Bidayuh community in Sarawak have the highest incidence of NPC in the world while ethnic Chinese in the country have the second highest incidence of this cancer worldwide,” says Teo. This puts Malaysia high up in the global hotspot for NPC, which researchers see as a cancer with a specific “Asiaticness” to it. According to Teo, NPC is more likely to afflict people of southern Chinese ancestry while environmental and dietary factors such as the large-scale consumption of preserved foods like salted fish and vegetables are contributory factors. The NPC study by Carif trawled through 15,000 human genes before identifying the NPC-suppressing genes. The study was peer-evaluated and published in the international Journal of Pathology. This finding brings Carif a step closer towards tweaking these “friendly genes” to beat NPC – long before it takes root and launches a full body assault on unsuspecting Asians.

Asian make-up It is often said that cancer spares no one. It cuts across borders and racial lines. However, it has been noted that the intensity with which some cancers strike

have an uncanny relation to race and ethnicity. Teo says: “Asian women with inherited mutations in their genes (BRCA1 and BRCA2) have a high chance of developing breast cancer.” She says merely diagnosing breast cancers in Asian women, without scrutinising the gene factors and alterations occurring within these genes may present problems in treating and managing the disease effectively.” She says joint studies with University of Malaya on Malay, Chinese and Indian women with breast cancer in the country reveals 48 alterations (18 in BRCA1) and 30 in (BRCA2). “Twenty-four of these alterations are absent in women of European parentage and even more remarkable is that, these 24 alterations appear to be ‘new and specific’ to Malaysian women with breast cancer.” She says the study, for the first time, suggests that the risk profile for breast cancer in Asian women is significantly different from Caucasian women. “We are using this data to develop guidelines for genetic testing for the breast cancer genes (BRCA1 and BRCA2) and to develop an Asian-specific ‘risk prediction model’ for breast cancer as well as appropriate treatment options.”

Oral cancer Like NPC and breast cancer, oral cancers among Malaysians also present a peculiar Asian trait that has gone unnoticed before, Teo says. She says, through joint effort undertaken with Malaysian universities and the Health Ministry, Carif has successfully encrypted via genome scan – the entire cell structures of oral and nose tumours among Malaysians. With the availability of this genomic snapshot, Carif has identified a number of potential “molecular indicators” that can be developed to screen, diagnose and treat oral and nose cancers with a new sensibility. The study also revealed that the genetic profile of oral cancers among Asians and Caucasians are different, and that there is a

Since its establishment in 2001, the Carif team has broken new ground in studies involving breast, oral and nasopharyngeal cancers.”

need to treat oral cancer among Asians with a new outlook, says Teo. Other interesting features detailed by the study, is the wide variance in the morphology (cell structure) among smokers with oral cancer and those who chew betel quid – and the link between oral cancer among non-smokers and the human papilloma virus. Carif, has over the years finger-printed a “genetic roadmap” of oral cell lines from Malaysian patients. According to Teo, it is the largest available index of oral cell lines – malignant and nonmalignant – which will be used to determine how these genes change into cancer cells. Having this index is like having the map of a region before setting out to see what the area looks like. The genome and cells are valuable resource to the scientists at Carif, to look for the right target – and to set right, whatever goes wrong.

Finding a cure The process through which

new drugs are developed is ever-evolving. Trial and error, which once used to be the way alchemists conjured medicine in the past century – is now yielding to the more evidence-based mantra called “drugs-by-design”. Like scientists elsewhere, Carif researchers are not only hunting down “rogue cells” that make us sick, but are also rummaging through a plethora of tropical plants and marine life in search of a cure. “Carif is working with several local and international partners to systematically develop new cancer therapies from the country’s vast natural resources,” says Teo. She said Carif is studying compounds from plants, seaweeds and fungi which may hold the answer to a cure one day – but refused to name the potential botanicals, when asked by theSun. “For now, it is a lab secret,” says Teo. Perhaps Teo’s secret may hit the front page some day, even perhaps win the Nobel Prize – but for now, the deviant morphology is as ballistic … and the world at large is waiting.

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I ADMIRE the stand taken by Prof Emeritus Tan Sri Dr Khoo Kay Kim on the single stream system and his vision of the country’s national education policy. Time and again the historian and academician has put forth practical opinions in the best interest of all Malaysians. What is even more laudable, he presents all the facts without mincing his words. And he does it without fear or favour even though some of the issues concerned are considered contentious. Your report quoted him as saying that the government should restructure the national education system and do away

Single stream schools a wise option with the multiple stream arrangement. He feels this is important if we want to strengthen nation-building efforts. He also suggested the teaching of mother tongues to be incorporated into the curriculum in “Education system must embrace 1Malaysia” (Oct 23). I couldn’t agree more with him on this issue. Even though the medium of instruction in national schools is Bahasa Melayu, children should be

free to pursue and learn their mother tongue comfortably during school hours. Besides that, the authorities should also seek the cooperation and assistance of Chinese schools, recognised for their superiority in teaching mathematics and science, to provide guidance in terms of their methodology and approach. This will encourage parents who have been sceptical about national schools to change their preference.

It is important at this juncture to take note of the professor’s comment on vernacular schools which we inherited from colonial times. He said that during the British era, these schools were set up to allow students to learn about their countries of origin. “However, the system is no longer needed as they are now citizens of Malaysia and should be taught to accept the country and its various races as part of themselves.”