As you know from my previous post, our research team at the BC Cancer Agency’s Centre for Lymphoid Cancer has undertaken the ANGELYC project (Analysis of Genomes to Eliminate Lymphoid Cancer). I thought you might be interested in an example of why this is important. It involves an odd coincidence in my practice.
A few years ago, I saw both a husband and wife as patients within about six months of each other. What was odd was that both of them had developed the same type of follicular lymphoma. Even more odd, in each case the lymphoma first showed up as a lump under their arm.
We know that lymphoma cannot be spread from one person to another, and this husband and wife were not related before their marriage. So, inheritance could not explain this occurrence. In addition, they did not share any common history of exposure to chemicals or any other environmental substance. In the end, this can only have been a coincidence.
When they finished all tests, we were able to show that each of them had an identical follicular lymphoma that had spread to lymph nodes in several parts of their body so they had the same stage of disease. However, although they were diagnosed with the same type of follicular lymphoma (despite us trying to find microscopic differences), their subsequent courses of treatment were very different.
The wife remained my patient for many years, occasionally requiring some mild treatment, and had little trouble from her lymphoma until late in her 80s when it caused her death. However, her husband became quite ill from his lymphoma, which progressed despite our best treatment, and he died within a few months of diagnosis.
Obviously there is something we do not understand about lymphoid cancers. Although their lymphomas appeared identical under the microscope and were exactly the same using our best tests, they were clearly very different. Those differences must be present within the genetic information in the lymphoma cells. We will not understand those differences, and not be able to develop personalized approaches to treatment, until we can analyze the basic genetic signals in the cancerous cells.
That is exactly what the ANGELYC project will do.