‘The tumor cells of esophageal cancer take shape that we did not think possible’
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Maarten Bijlsma, molecular biologist, wants to understand why pancreatic cancer and esophageal cancer are so poorly treated. He also wants to know how things can be improved. Most people died within five years after the diagnosis, often within a year, and there is little progress in it, while the number of patients is increasing. Last year there were 5,700, slightly more pancreatic cancer than esophageal cancer. Six years ago: 5,200. Thirty -five years ago: 684, only esophageal cancer. « And that increase, » he says, « cannot only be explained by population growth and aging. »
What to do?
« It can be something genetic, something in the area. We don’t know exactly. We see it throughout the northwest of Europe. »
Pancreatic and esophagus tumors are high lifestyle-related?
« I find that a difficult one. Then you blame the patient. Smoking and excessive drinking is never good, you charge your body with carcinogenic substances. Your immune system is inhibited, making the pre -stages of cancer that we get unnoticed in our body are less tidy. Are you talking about almost every type of tumor and now that you get that cancer from this lifestyle, I am very cautious about the age that the strongest contributes to it and you can do little to the esophageal cancer, stomach
For a year and a half, Maarten Bijlsma (Purmerend, 1979) has been a scientific director of the Cancer Center Amsterdam, part of Amsterdam UMC, and he is professor of experimental gastrointestinal oncology. A month ago he gave his inaugural speech. In a brand new research center, he and his group mainly conduct research into tumors in the pancreas and the esophagus. « Those organs, » he says, « come from the same embryonic structure and therefore the tumor cells share properties that make them very malicious. The cells can easily adapt and escape to irradiation or chemotherapy. There are a lot of stroma, connective tissue and the cells that are tumeer and then there are also a barrier and then and then and then and then and then and then and then and then and and then and and then and and then there are also. Cells in the tumors, which makes the disease run unpredictable. «
In your lecture you said: those tumors look like a developing organism.
« Many cells in pancreatic or esophagus tumors are stem cell-like. Like stem cells in an embryo of everything, they can even see tumor cells that look like nerve cells- and shape shapes that we did not like before. Many of those cells do not make it.
In 2008 he obtained his PhD for research into the Hedgehog protein, which in an embryo instructs stem cells what they should become-a cell in an organ, a nerve cell-and what their place in the body is. It was previously discovered that Hedgehog controls the interaction between tumors in the pancreas and the stroma that protects the tumors. « It even seemed like it, » he says, « that Hedgehog was crucial in causing pancreatic cancer, so everyone thought: we’re going to brake hedgehog. Farma dived on top. But it turned out not to work. Patients got worse, very mystery, very frustrating. »
If you feel good, tumors will grow less fast. That has been demonstrated in mice
What also seemed like a golden hold a few years ago: preventing tumors from making blood vessels with which they can feed. Bijlsma: « You would think that tumors die if you brake that. No glucose, no oxygen. » But no, tumors also get more aggressive and patients worse. « Especially tumors in the pancreas, » he says, « turned out to be possible with very little oxygen. For their diet they started to til the stroma. »
After his postdoc, at the University of California, Berkeley, he returned to Amsterdam to do research with physician researchers, aimed at treatments. « Just keeping pipping in the lab to satisfy your curiosity in the long run has something selfish. » New forms of Targeted Therapyprecise interventions per patient, and on immune therapy. « We are going to take great steps in immune, » he says. And yes, then we should also think of vaccines to prevent the return or emergence of cancer, such as already the vaccine against the human papillomavirus, which can cause cervical cancer.
You share a building with the people researching neurodegenerative diseases such as Alzheimer’s. Do you have something together?
« We are the first onco-neurocampus in the world and yes, we can certainly bring each other to ideas, although we do the opposite. They want to keep cells alive and we want to get rid of it. What interests us: how tumors are provided with nerves, so that they can talk to each other and grow tumors harder. »
Brain talk to tumors?
« Of course there are all kinds of steps in between, but we know that the reward system in your brain influences tumor growth through your immune system. If you feel good, tumors grow less hard. That has been demonstrated in mice. Studies are now also starting to say that tumor cells are also the other way around for nerves to be able to talk to the brain.”
The popular version is that as a cancer patient you have to be cheerful and optimistic …
« … otherwise your tumor will grow and that is your own fault. Which of course is not the case. »
Can tumors cause depression?
« We know that tumors can lay the dopamine in the brain and therefore the reward system – to their own advantage. The annoying one for biologists is that we are so complex that you cannot put this in a model to investigate. Your state of mind, your immune system, what you eat, or you exercise, everything has everything. »
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