Genome scientist Yaron Butterfield jokes that he takes his research seriously—maybe a little too seriously. The scientist, who is working on cell mutations in brain tumours, got a devastating diagnosis himself back in 2004.
“I used to joke around with my mom, saying that if I were ever to get sick, cancer would be the best disease for me to get since I work in the field,” Butterfield tells the Georgia Straight in a phone interview. “In a way, I feel very blessed to understand the disease from the patient’s perspective.”
He was just 28 when he had a grand mal seizure at his parents’ place. Except for a few headaches, he’d had hardly any symptoms leading up to the collapse. After blacking out, Butterfield woke up in hospital a day and a half later. A biopsy revealed he had glioblastoma—a fast-growing and aggressive form of brain cancer.
The tumour was too deep in his brain for surgery, so Butterfield had chemotherapy. But he was too “genetically sensitive” to the drug and had to stop. After radiation, doctors tried chemotherapy again, even though they felt that the chances of it being effective were slim. It worked.
The bioinformatics coordinator at the B.C. Cancer Agency’s Genome Sciences Centre is now doing the kind of research that could drastically change the way cancer is diagnosed and treated.
Neurosurgeon Brian Toyota, the head of BrainCare B.C., a branch of the B.C. Cancer Agency that is supported by the B.C. Cancer Foundation, says that the treatment of brain tumours could be vastly improved with continuing advances in genome sciences.
“The standard way of treating tumours has been very brutal: you take a tumour out, look at it down a microscope, and, based on its shape and colour, give it a name,” Toyota, the BCCA’s provincial chair of neuro-oncology, explains in a phone interview. “It didn’t matter what your gender, race, or age was: if your tumour has that name, you get that treatment. But you could have a tumour of the same name respond completely differently to treatment [than another]. You’d need a completely different strategy.
“What we prefer to do is take that cell and find out what makes it tick,” he says. “Now we have the technology to look inside a cell and see genetically what makes it function. Instead of getting a textbook prescription for treatment, we look at each individual tumour: these are its strengths, these are its weaknesses, and this is how we’re going to pick on it.”
Toyota compares the genetic approach to cancer treatment to fixing a car that’s stopped running.
“You assume it’s out of gas, so the first step is to give it gas. Then you change the oil. But you actually have to lift up the hood; the mechanic goes in there and tells you what isn’t working, so you have a specific fix,” he says.
“The ways of treating tumours that are beckoning now are extremely exciting and promising.”
Besides being involved in rigorous research, BrainCare B.C. is dedicated to the day-to-day care of brain-tumour patients.
In fact, Toyota started the organization in 2007 after treating many brain-tumour patients and seeing gaps in care. Facing brain cancer is especially difficult because the disease can take such a toll: it can alter people’s personality and, more than any other type of cancer, can compromise people’s basic humanity.
“Probably most of the emotional turmoil is upon diagnosis and the brain-surgery operation,” Toyota says. “That is when you create bonds of trust. With BrainCare B.C., the patients have the reassurance up-front that they know everything at the very beginning.
“We’ve hired dedicated patient and family counsellors, social workers, and brain-tumour-specific nurses who help guide our patients through the system,” he notes. “If you’re on that side, as a patient, it is pretty overwhelming. You might be working with three or four different physicians and there may be gaps in communication. These people are one-on-one patient advocates.”
BrainCare B.C. is working to ensure that people with brain tumours throughout the province have access to patient advocates and a streamlined medical experience. To make people’s treatment more efficient, the health-care providers on any given patient’s team—surgeons, oncologists, radiation specialists, and neurologists, among others—meet weekly to discuss cases.
Since Butterfield returned to work, he’s been involved in the discovery of a set of mutations in a gene called CIC that is specific to a type of brain cancer called oligodendroglioma.
This kind of genetic research into brain tumours could have far-reaching implications.
“The future of cancer treatment in general has to do with personalized medicine and genetic analysis,” Toyota says. “The next wave of cancer treatment involves not just better weapons, it equally involves using a better gun sight to clarify a better target, to not be satisfied by cell shape but discovering the systems it uses to survive. We are now entering a brilliant phase of cancer-cure discovery.”