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Bicyclists race to find cancer's 'canary'

Palo Alto-based Canary Foundation seeks ways to detect cancer earlier

More than 800 bicyclists taking part in a massive bike ride this Saturday, Sept. 28, are pedaling to fund research that could make detecting cancer as easy as taking a blood test at the doctor's office and finding the tumor with advanced ultrasound tests.

The Canary Challenge, which will host 5k, 50k, 75k, 100k and 100-mile bike rides, raises funds for Stanford Cancer Institute and the Canary Center at Stanford for Cancer Early Detection. The challenge goal is $1 million.

In the nine years since the Palo Alto-based Canary Foundation was founded, it has already made inroads to improving detection and diagnosis of tumor cancers before they turn deadly. Seeking to discover the "canary in the coal mine" of cancers, the foundation has seven clinical trials underway.

Former Silicon Valley executive Don Listwin started the Canary Foundation in 2004 after his mother died from ovarian cancer.

"Her doctor sadly gave her antibiotics for an infection, which they thought she had, and it turns out it was a very large piece of stage 4 ovarian cancer pressing on her, and she dies a year later," he said.

Listwin wanted to understand the cause of such a mistake. Most of the nearly $10 billion spent annually in the U.S. is used to develop new cancer treatments, drugs and care for patients, but not much is spent on early detection, he learned.

"When you find cancer early, you will live nine times out of 10. When you find cancers late, the person will die nine times out of 10," Listwin said on Wednesday.

A cancer tumor before it spreads is about the size of a blueberry; the tumor by the time it is typically found is the size of an onion.

"We feel that's crazy that so much has gone into pharmacology, and it can't be applied until it's too late," said Therese Quinlan, the foundation's senior development director.

The foundation is collaborating with the Stanford School of Medicine Department of Radiology and with researchers worldwide on diagnostics for early tumor discovery.

Researchers focus on ovarian, prostate, pancreatic, lung and breast cancers, which are all tumor-based as opposed to blood-related cancers. The foundation has clinical trials for ovarian, prostate and lung cancer.

The foundation's goal is to use two techniques that could find early cancers in all tumor-related cancers, including the brain and colon, Listwin said. They are looking at biomarkers — proteins and other substances in the blood that indicate the presence of cancer — and enhanced ultrasound and diagnostic imaging that can pinpoint small tumors.

An advanced magnetic-resonance imaging machine (MRI) helps researchers profile proteins that can indicate different cancers, according to Dr. Mark Stolowitz, director of the Canary Center's Proteomics Core Facility. The body has 120,000 forms of proteins, and in cancer, the body makes more of specific types in response to the unregulated growth of cancer cells. Scientists are looking at the degree to which the proteins are present, which can indicate cancer, he said.

Previous clinical trials for ovarian-cancer screening have mostly involved only one biomarker, CA-125, in a blood test, but it isn't always accurate, according to researchers. Canary's research looks at another protein, HE-4. The researchers are using a new mathematical calculation to determine whether the biomarker indicates the presence of cancer.

An annual screening for the biomarker together with the math calculation could determine a baseline for what a healthy biomarker level is in a particular woman. A deviation might indicate the presence of cancer. The patient would then receive a second screening using ultrasound imaging, Quinlan said.

One promising diagnostic-imaging technique that the foundation is currently testing uses microbubbles, or small, gas-filled spheres. When microbubbles are injected into the bloodstream, they are coated with antibodies that cling to biomarkers found only in a tumor's blood-vessel system, Quinlan said. When scanned with ultrasound, the microbubbles surrounding the tumor reflect a specific sound that is different from surrounding healthy tissue.

Microbubble technology is currently in the U.S. Food and Drug-approval process. Foundation researchers predict the combination of a better blood test and microbubble imaging will reduce ovarian-cancer deaths by 25 percent.

The foundation is using the biomarker and microbubble technologies to see if other tumor cancers can be detected in their early stages.

With pancreatic cancer, for which survival rates are poor, patients are often symptomless until the cancer has spread to other organs. Researchers think no single biomarker will be sufficient with pancreatic cancer. They are developing tests to use combinations of biomarkers, blood and imaging to find early tumors.

The foundation has created blood tests in collaboration with The Lustgarten Foundation, a pancreatic cancer research organization in Bethesda, Md., for its project to detect 60 pancreatic-cancer biomarkers. Canary Foundation is working with many institutions to create a bank of blood samples to help identify potential pancreatic cancer biomarkers.

Finding new biomarkers through proteins, genetic material and hormones could also help reduce the necessity for many prostate surgeries. Most prostate cancers are not lethal even if left untreated, but doctors currently don't have a fool-proof way to determine which can be safely left untreated. Better testing could distinguish potentially lethal prostate cancers, Quinlan said.

The foundation and Stanford University Medical School's Nuclear Medicine Clinic are also developing diagnostic-imaging molecules that detect lung tumors earlier without need for surgery. The Stanford team is currently testing the imaging molecules in patients.

During Saturday's bike challenge, people can tour the Canary Center at 3155 Porter Drive, said Erica Glessing, the foundation's marketing director. Information about the Canary Foundation and the Challenge is available at www.canaryfoundation.org and canarychallenge.com.

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