Thank The Lord (Of Your Choice) That The Border Patrol Missed This Guy

One of the most talented medical researchers in the field of brain cancer, Alfredo Quiñones-Hinojosa, M.D., came to this country from Mexico without proper papers. From an illegal migrant worker to a nationally prominent scientist at Johns Hopkins Medical Center in Baltimore, MD. Such a journey is possible only in the Land O'The Free and the Home O'The Brave. If this is a (fair & balanced) testament to the human spirit, so be it.

[x Geezer Bulletin]
Brain Cancer: Could Adult Stem Cells Be The Cause—And The Cure?
By Barbara Basler

Alfredo Quiñones-Hinojosa, M.D. in his field of dreams.

It was national news when Sen. Edward Kennedy of Massachusetts was diagnosed with brain cancer last May. Then, just weeks later, veteran political columnist Robert Novak also was found to have a malignant brain tumor. Suddenly, the public was awash in a flood of stories about this deadly form of cancer. The fresh focus on this disease comes at a critical time, as scientists explore a new theory that could unlock the mystery of brain cancer—and other cancers as well.

Paradoxically, adult stem cells may be both the cause of cancer and a cure for it.

That theory, barely discussed even five years ago, has captivated the country’s leading researchers, including Alfredo Quiñones-Hinojosa, M.D., a 40-year-old one-time farm worker from Mexico who now heads the Brain Tumor Center at the Johns Hopkins Bayview Medical Center in Baltimore.

Quiñones is a researcher with a difference. Dressed in his green scrubs and fresh from the second of what will be three brain surgeries that day, Quiñones puts in punishing 16-hour shifts, working not just in the operating room but in a brain cancer research lab as well. “The surgery can be perfect, a beautiful work of art,” he says. “But I still know that no matter what I do, these patients will eventually succumb to this disease. So how can I not look for a cure when I see my patients and their families and the suffering this cancer causes?”

It’s that work and passion that last year led Popular Science to name Quiñones to its annual Brilliant Ten list of “the most creative, the most groundbreaking, the most brilliant young scientists in the country.”

Quiñones is convinced that adult stem cells act as triggers for brain cancer. (Unlike the use of embryonic stem cells, which requires the creation and destruction of an embryo, the use of adult stem cells found in children and adults is not politically controversial.)

Stem cells become new cells to maintain and repair tissue. Neural stem cells, for example, create new brain cells, while hematopoietic stem cells create new blood cells.

New studies suggest that cancer of the brain—along with cancer of the breast, prostate, colon, pancreas, lung and a host of other organs—grows from adult stem cells present in many tissues.

It’s not clear how stem cells may cause cancer, but investigators theorize that rogue cancer stem cells have an uncanny ability to repair damage to their DNA and are therefore able to withstand standard radiation and chemotherapy treatments. Quiñones and his colleagues hope that by targeting these cells, they can destroy the cancer and prevent its return.

“We were once taught that brain cells die and can’t be replaced,” Quiñones says. “We now know that the mammalian brain has the ability to regenerate through adult neural stem cells. What we are exploring—and this is the great leap—is whether normal neural stem cells can lose their ability to self-regulate and become dangerous stem cells that create tumors.

“We are just beginning to understand this link between stem cells and cancer,” he stresses. “We have to prove that brain cancer stem cells exist. But I think the potential here is real.”

Close to 44,000 people will be diagnosed this year with tumors that originate in the brain; half of the tumors will be malignant. Another 170,000 patients will learn that cancers from other parts of their body have spread to their brain.

Brain cancer is one of the most intractable. In the last 30 years the median length of survival for patients with cancer that originates in the brain has increased by only four months—to 14.6 months.

“I think of this as the worst cancer, and if we can make progress with brain cancer I assure you that many other cancers will benefit, too,” says Quiñones.

Along with his stem cell research, Quiñones runs a lab that is analyzing the medical records of thousands of brain cancer patients, looking for clues to more effective treatments. So far he’s found that patients with high glucose levels and patients who are clinically depressed have much worse outcomes than other patients.

“Now, when I meet a patient, I want to know his glucose level and whether he is clinically depressed, because we can treat those conditions and improve his chances for survival,” he says.

Quiñones’ pursuit of a cure for brain cancer is marked by the same grit and determination that have shaped every facet of his life. This is a doctor, after all, whose life here began one cold, dark January night when, as a frightened 19-year-old, he climbed a chainlink fence along the border between Mexico and the United States. The first time he clambered over the fence he was caught and sent back across the border. Just hours later he was back. This time he made it over and escaped into the night.

An undocumented immigrant, Quiñ­ones spoke no English and had no job skills. He labored as a farm worker in California. “One day a friend said to me, ‘You will always be a migrant worker,’ and something inside me just snapped. I just couldn’t accept that,” he says.

Quiñones, who lived in a dilapidated trailer, took English lessons and enrolled at a community college while juggling jobs as a painter and welder. He won a scholarship to the University of California, Berkeley. From there, he went on to medical school at Harvard University. He became a citizen.

Now, his office walls at Hopkins are covered in awards.

“This is a man who won’t take no for an answer,” says Henry Brem, M.D., chair of neurosurgery at Hopkins. “He’s an inspired scientist, and an extraordinarily hard-working one.”

Today, standard procedures for brain tumors, like Kennedy’s, call for removing as much of the tumor as possible, followed by radiation and chemo. But excising all the cancer lacing surrounding tissue is difficult, and 90 percent of the tumors grow back. It may be, Quiñones says, that just a few cancer stem cells left behind after surgery renew the tumor.

“We have isolated cells from human brain tumor samples that in a petri dish act like brain cancer stem cells,” Quiñones says. “We’re still not sure that they actually behave that way in the brain, but there is some very good data to suggest they do.”

The first evidence for brain cancer stem cells was reported in a study published in 2004. Scientists in Canada isolated tumor cells with a genetic mutation they believed identified the cells as brain cancer stem cells. When they injected 100 of these cells into the brains of mice, the mice developed brain tumors. They also injected tens of thousands of other brain tumor cells without the mutation into mice—and all failed to produce tumors.

It appears that cancer stem cells may make up only a tiny portion of the brain tumor, which means that if they do trigger tumor growth, scientists may have been studying the wrong cells 95 percent of the time.

“Stem cells are a new paradigm,” says Quiñones. “Imagine a world where we know which cells are responsible for the cancer and we understand how they work—and how to turn them off. That’s the world I want. If it’s there, we have to find it.”

Paul Watson of Baltimore, who lost his 19-year-old son, Aaron, to brain cancer last year, says this gifted surgeon with the warm, engaging manner “is a man of passion and great understanding. From the moment we met him, he was there for us, through three operations.”

Despite the operations and the best treatment available, Aaron died 18 months later, and Quiñones went to his young patient’s funeral.

“Dr. Quiñones held my hand and said that Aaron should not be dead,” Watson says. “He said we have to find a cure for this disease.”

[Barbara Basler is the Senior Editor for the AARP Bulletin. Photo of Alfredo Quiñones-Hinojosa by Chris Hartlove]

Copyright © 2008 AARP

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