Cancer.
Barabasi states in Linked, “Cancer is the most researched human illness ever” (191). Ever. Although I do read up on cancer frequently, I guess this fact never hit me. I believe it speaks volumes about an illness…
Since I am a nursing student and cancer interests me, I had to seize this opportunity to share some of my knowledge about a current cancer treatment.
Back in the 50’s and 60’s there was this drug called Thalidomide. Thalidomide was used mainly as a sleeping pill and an antiemetic to combat morning sickness in pregnant women. The drug was distributed in many countries, mainly Germany (where it was originally produced) and Great Britain. To my knowledge it was not dispersed in the United States at that time. In the early 60’s it was discovered that thalidomide had some teratogenic effects in the infants whose mothers had used it. (Teratogenic is the medical term used to say that something will cause congenital malformations and result in serious abnormalities at birth, another example of something that can be described as teratogenic is alcohol.) The resulting birth defects included short or absent long bones and missing limbs. Obviously these are devastating side effects.
Only two-thirds of the children that were born with deformities due to the use of thalidomide survived their first year of life. Once it was discovered what was causing all of these deformities, Thalidomide was quickly taken off the market. (It was later found that this drug had never been tested on pregnant animals, so its tragic adverse reaction was not discovered until after it had been on the market for quite some time. When it was finally tested on pregnant animals, it was found to cause deformities on the offspring.)
How this relates to cancer…
The reason thalidomide caused such devastating results was that it inhibited angiogenesis. Angiogenesis is the process by which new blood vessels are formed. Consequently, if a woman took thalidomide while pregnant, the drug disrupted fetal development (and thus babies were born without limbs). Moreover, it was discovered that this mechanism of the drug has positive effects on those patients with cancer. Prevention of angiogenesis does not allow a tumor to grow (no blood vessels=no nutrients) and thus is pertinent in the prevention of tumors transforming from a dormant state to a malignant one.
Consequently, the drug is now used for multiple myeloma. It has even become a first line drug. Researchers in Australia conducted a trial of the drug on a group of cancer patients. What they discovered was that the thalidomide doubled the number of T-cells in the patients. (T-cells are a type of white blood cell that are involved in every immune system reaction in the body) Consequently, the patients were able to fight off the illness better than without the use of the drug.
What I learned from working at the hospital:
This past Wednesday I was at work (I work on the hematology/oncology floor @ UH). It just so happened that a patient on the floor was receiving Thalidomide. The nurse that was gathering the drugs for the patient had a nursing student working with him and they were going over all of the drugs their patient was receiving. I joined in on their conversation as they were discussing Thalidomide and found out some interesting facts about the drug (including some of what is listed above). I also found out that this drug is very regulated. Most hospitals have drugs drawers designated to each patient. Pharmacy comes and fills these drawers with the drugs prescribed to each patient for a particular day. If more drugs are ever needed, a nurse can always call and ask pharmacy to bring them to the floor. Every hospital floor also has a narcotics drawer. To access this drawer keys are needed and every drug removed must be signed out and the remaining drugs must be counted so that there are no discrepancies in the remaining total. If part of a narcotic drug is ever going to be wasted (for example if only half of a tablet is needed), another nurse must sign-off that he or she witnessed the wasting. At the end of every shift, the narcotics are counted and if there is an error, it must be corrected before any of the nurses can leave.
Thalidomide however cannot be obtained through the narcotic drawer nor can pharmacy stock it in the patient’s designated drawer. The hospital pharmacy never carries Thalidomide. Calling pharmacy and asking them to bring the drug to you will more than likely cause them to laugh at your request. The only way Thalidomide can be acquired is by having a company that produces it ship it to you. Thus, if a patient is at the hospital, it must be sent there and it remains locked until it is ready for use. Measures are taken to insure that the women using these drugs are not pregnant. These steps have been taken because of the devastating effects it can have on.
This situation is not unique. There are many other drugs that are not solely used for the purpose they were made. I find these “investigational uses” or “off-label uses” very interesting.
Comments
Posted by: John
Posted on: November 30, 2005 11:39 PM
It is always interesting to find out some of our greatest drugs we have today were discovered by accident like penicillin. Yet pharmuceticals spend miillions of dollars to find the next miracle drug to cure cancer or aids.
Posted by: zach newman
Posted on: December 1, 2005 07:00 PM
that's pretty cool. i never knew that thalidomide was originally used as a sleeping pill. i really like the idea that cancer networks are scale free and that by limiting supply of nutrients to the cell hubs (by using thalidomide) we can break down the netwrok and help treat cancer
Posted by: John
Posted on: December 3, 2005 10:28 PM
This is really stupid. But with the knowledge I have gained from you blog now I understand some more of the lyrics in Billy Joel's We Didnt Start the Fire. Check it for yourself! http://www.lyricsfreak.com/j/joel-billy/72985.html