There may never be one cure for cancer.
However, that may not be as bad as it sounds, notes documentary producer Sue Ridout.
“Because cancer is so many things in so many different people … the idea of coming up with one cure is kind of a dream,” she says.
What is becoming reality, Ridout explains, is a burgeoning database that may allow for the targeted treatment of cancer in all its myriad forms.
That’s the premise of Ridout’s documentary Cracking Cancer. The film, which debuts on CBC’s The Nature of Things Thursday evening, focuses on patients in an experimental trial called Personalized OncoGenomics, or POG.
“I think it’s going to change the way we look at cancer,” Ridout predicts.
Instead of treating cancer based on where it is, POG focuses on what it is.
Researchers base much of their work on two key questions: What does the patient’s DNA look like? And how is that different from the DNA of the tumour?
By focusing on that distinction doctors can discover the crux of the cancer: a genetic mutation that might be something as simple as a protein.
If that protein can be countered, the POG treatment can essentially disrupt the signals that summon new blood vessels to a growing tumour, silencing it as surely as taking away a teenager’s cellphone.
“They give the patient a drug that’s never been used for cancer before and, lo and behold, their tumours stop growing or they even disappear in some cases of what we call super responders,” Ridout says.
Zuri Scrivens is one of those super responders.
A mastectomy, radiation, chemo and hormone therapy initially seemed to help the Langley writer and birth doula. About 18 months later the cancer spread to her liver and lymph nodes.
She was considered incurable.
After enrolling in the POG program Scrivens was given a treatment for diabetes.
Five months later, the cancer couldn’t be detected.
Five years later, Scrivens still appears cancer-free.
Scrivens is one of several volunteers who allowed the film crew access to what director Judith Pyke noted were “their most vulnerable moments.”
“Quietly, often in the corner, we filmed as patients waited anxiously for results, as they went for biopsies and more scans and blood work, as they received great news and bad news. They cried, made jokes, and ‘took it on the chin,’” she stated in a release.
The filmmakers were also allowed to film the POG team as they debated possible treatments.
The approximately three-month POG process is a far cry from the private companies that charge cancer patients thousands of dollars for genetic testing, according to Ridout.
“They’re not just looking at the 26 genes that might be implicated in breast cancer … they’re sequencing the entire genome of a patient. That’s 20,000 genes.”
Once the sequence is complete, genome scientists and specialists known as bioinformaticians quantify the “mountain of data” into algorithms.
Somewhere in the stack of a cancer patient’s 20,000 genes there’s something amiss, something that can offer a clue as to what’s “driving the cancer,” notes trial co-founder Dr. Janessa Laskin. “And then, can we identify a drug that will block the cancer driver in each patient?” she asks.
Part of Ridout’s reason for doing the documentary is that it touches on the legacy of Nobel Prize winner Dr. Michael Smith, who served as the founding director of the Genome Sequencing Centre at the BC Cancer Research Centre.
Smith was instrumental in attracting genome and data scientists to the facility, and Ridout was intrigued at the prospect of that brilliance being harnessed against cancer.
“It’s really quite incredible what they’re doing and they really had their light under a bushel,” Ridout says of the BC Cancer Agency.
Ridout, who once served as volunteer director for the North Shore Community Foundation, became fascinated with POG as an example of what she calls the “personalized medicine revolution.”
“We know that cancer is definitely not one disease. It is as different in one person as it is in the next, and so the diagnosis and treatment needs to be more personalized too.”
Approximately 750 cancer sufferers – many of them diagnosed as incurable – have been enrolled in the trial. To qualify they must be referred by their oncologist and the doctors must be able to attain a viable biopsy.
So far, about 40 per cent of the trial’s patients have seen their tumours stop growing, shrink or disappear, according to Ridout.
However, the documentary is careful not to portray the treatment as a miracle cure, Ridout promises.
Two patients involved in the trial have passed away. Others, such as colon cancer sufferer Karl Pollak, had negligible results and resumed standard treatments.
However, a Bowen Island patient suffering advanced colorectal cancer was essentially in a palliative state when she enrolled in the program, according to Ridout.
After being a prescribed a drug typically used for high blood pressure, she’s still alive nearly seven years later.
There have been other patients in dire circumstances who lived longer than anyone would have expected, according to Ridout.
The trial began with 30 patients in 2012, back when genome sequencing cost $250,000 a patient.
With that price dipping to $20,000, the POG program’s goal is to enrol 5,000 patients (or 100 million genes) and create a database that can inform cancer treatment across the planet.
With enough information, medical science may have a resource that could “revolutionize” how drugs are developed, according to genome scientist and POG trial founder Dr. Marco Marra.
The program could also alter the way chemotherapy is prescribed.
In his story of a woman suffering cancer, I Want to Live!, author Thom Jones penned this line about chemotherapy: “Only an archfiend could devise a dilemma where to maybe get well you first had to poison yourself within a whisker of death …”
“It’s amazing that even in this day and age cancer patients end up given a chemo that’s kind of guesswork,” Ridout says.
The sequencing process should let doctors zero in on what type of chemotherapy would be most effective, sparing many patients from the harsh treatment.
“That is worth its weight in gold to a cancer patient,” Ridout says.
After producing or directing 18 documentaries since 2001, Ridout says Cracking Cancer will be her last major effort.
“It’s a lot of work being an independent producer in this country because you have to be a combination of chief cook and bottle washer,” she notes.
“Like all baby boomers on the North Shore we’ve downsized and we’re going on to the next phase of
our life,” she says, discussing the decision she and her husband made to sell their North Vancouver home.
With this documentary, Ridout says she’s been part of a rare thing: an uplifting cancer movie.
While there may be no cure for cancer, Ridout points out that the documentary shows something else in the arena of cancer care: “a future.”
The movie premieres on CBC Thursday at 8 p.m.
