Metaphors and concepts (5)

I have saved some of the ideas that have proved to be at the heart of my creative research for the latest batch of concepts to emerge from the conversations and research into the cancer ecosystem. And following on from this post I will start to share some of the creative and visual ideas i have been working on – but without posting these concepts first, they would make much less sense. So here goes!

“Hypoxia“

A state of insufficient oxygen. This can happen at the centre of a tumour when the blood vessels do not penetrate to the centre of the tumour, and tends to start happening once the tumour gets to around 1cm. In medical convention, fully oxygenated blood is represented by the colour red, less oxygenated by blue (thinks arteries versus veins). Severely hypoxia tends to be represented by dark blue or black.

In the middle of a tumour the environment for cells is often both hypoxic and toxic – cells that survive these conditions are preselected to be tough, resistent, intransigent.

“Angiogenesis“

The process by which new blood vessels form from existing blood vessels. This is initiated through cells signalling that they are becoming hypoxic. Cells in cancer tumours send lots of these signals and new blood vessels then begin to grow around and into the tumour to try and bring oxygen to the hypoxic cells. The blood vessel growth can be very disordered and excessive as compared with normal vessel growth. The Childhood Leukaemia team shared this image with me of blood vessels from a tumour.

“Mosaic Vessels“

Occasionally blood vessels that grow in cancer tumours as part of angiogenesis include tumour cells as part of the blood vessel structure itself, so that ‘normal’ epithelial cells and abnormal cancer cells form the wall of the blood vessel together. These are mosaic vessels.

“Morisita Index”

The Morisita Index is drawn from statistical study of populations and is a measure within a population of how mixed up or separate the different elements of a population is. In relation to the cancer ecosystem, it measures the degree to which different types of cells – eg epithelial cells, immune cells, tumour cells – are aggregated or segregated. As well as being applied to the nature of different tumours, the index can also be applied to human populations, for example, in a working environment, to express how combined or segregated they are.

“Liquid Tumours“

I have always thought of cancer tumours as something solid. Some hard and unyielding, some softer or floppier, but I had not really considered that tumours could be liquid. Whereas, solid tumours are indeed solid and lumpy, liquid tumours, eg leukaemias and lymphatic tumours, flow.

How all this relates to the London Cancer Hub?

In some ways the easiest concept to apply directly to the LCH is the Morisita Index. In fact, in conversation with one of the researchers who introduced me to the Morisita index, we discussed how he had been drawn to work at the ICR by the multidisciplinary nature of the teams there. I observed that this seemed like a Morisita measure in the workplace…

Other concepts here are less obviously applicable to the LCH directly. Nonetheless I feel that they have relevance to the work i am doing in relation to the LCH as well as the cancer ecosystem. Hypoxia and angiogenesis are to be interpreted literally as part of the cancer ecosystem, but they function rather well as metaphors in the context of the LCH. They are also potentially visually very interesting.

Taking specifically the idea of hypoxia and its relationship to angiogenesis, here is some of my thinking. In the body there are areas that require more oxygen; in organisations there are areas that require more resources or attention. In both cases these call for more connectivity and greater flow though – with the cardiovascular system through the growth of blood vessels, in terms of organisations perhaps one can read stronger relationships, more interaction, greater communication. Where an area of a body is cut or hurt, new blood vessels grow. For new areas of organisation, it is may be necessary to grow new routes of communication, new career paths, new sources of resource. To which you can equate angiogenesis.

These metaphors also work for me in relation to an issue that has troubled me in running the parallel between ideas about the evolution of an ecosystem at the LCH and the study of the cancer ecosystem. Cancer, obviously, is profoundly threatening to the organism. whereas the developing ecosystem at the LCH, one hopes, is going to result in a healthy symbiosis, a mutual thriving. I find the ideas of angiogenesis helpful in relation to this, in that angiogenesis can be a system that functions in a positive, orderly way in a healthy body, bringing oxygen to growing or healing tissue. However, in cancer it can also ‘overgrow’ into a support system for malignancy, playing a role in metastasis as a route through the body. So you can view angiogenesis from both a functional and dysfunctional perspective, as potentially ordered or disordered.

From both the conversations I have been having and my reading, I realise that angiogenesis is no longer the newest focus of research. It was very much at the forefront in the 1990s and 2000s when an active research priority for curing or preventing cancers was developing and deploying angiogenic inhibiting drugs. However, it remains a central part of the cancer ecosystem, and while i was researching at the ICR the Childhood Leukaemias team published several new papers suggesting that new understanding of the role of hypoxia in TP53 mutations could really illuminate what’s going on when cancers metastasise,

Metaphors and concepts (4)

Today I am going to dip in to some concepts that aren’t quite as closely related to ecological mechanisms from the cancer ecosystem. They have come up from a variety of conversations with people from a range of settings – from research science to business development discussions for example. Instead of separating these into the cancer ecology concepts and their relationship with the London Cancer Hub as I have done previous posts in this series, for this post where the concepts are less ecological, i am mixing things up a bit.

“Barcoding“

When talking about some of the data that informs the understanding of cancer evolution, it was explained to be how different cells get ‘barcoded’ so that their behaviour and characteristics can be examined, dependent, for example, on where they are located within a tumour. This enables the team to analyse behaviours or outcomes according to the cell location.

The idea of barcoding made me think a lot about how people are positioned and move around the LCH site and the nature of their experience, depending on where on the site they are based. Most of the people I spoke to spend most of their time in a single location for their work, or certainly mainly within one organisation’s buildings. When I asked about using other parts of the site, most of the people I spoke to kept mainly to their own area. However, a few travelled across the site – between the ICR and RMH for example – on a regular basis, and others talked a lot about travel to and fro from other partner organisations such as Imperial, possibly more than within the LCH. I thave oyed with the idea of making an artwork based on tracking people’s movements around the site. I think it would be illuminating – tho i am not sure how keen people would be to take part!

“Securing“

We had a conversation about patient medical data, its sharing, safekeeping and its absolute crucial role in research. The day of this conversation, an article had been published in the Guardian about how UK medical data was – or was not – being protected, and how much research is impossible without access to large data sets that rely on individuals being secure about how their information is shared. (Articles of this nature are being published every week, reflecting major ongoing developments in this sphere).

Security is an obvious concern in relation to different parts of the LCH and movement around the site is not unrestricted, no doubt for some very good reasons. The ICR, for example, is all access controlled, so that only staff or approved visitors can access the buildings. The Royal Marsden obviously needs to be accessible to patients so there are many spaces that can be accessed without restriction. However, I visited several to office spaces where you needed a pass to get in.

All this set me thinking, are there parallels that I can investigate between the security of medical data and the security of the site? Something to think about, though I have no idea yet where that might lead….

“Bridging“, “Stitching” and “Translating“

These ideas came up in particular when talking about the Innovation Gateway and the development of the new multi-use site that could also house larger biotech or pharma-type companies, and the relationships between the research activities and treatment facilities focused in the ICR and Royal Marsden with the commercial ompanies housed at the Innovation Gateway or on the new site. (Confusingly to me, the new development site seems often to be referred to specifically as the London Cancer Hub on its own, without meaning the whole inclusive site covering the ICR, Royal Marsden etc.)

To me the ideas of bridging and translation apply principally to the LCH rather than the cancer ecosystem, and indicate the perceived or actual gap between the focus and/or the operations of the different types of organisations. ‘Translating’ we spoke about literally in relation to facilitating discussions and agreements across disciplines, in particular, for example, between business areas and clinical or research teams. But the idea works not only in relation to the specifics of language, but potentially also translating between priorities and focus as well. ‘Bridging’ fits nicely with all the spatial ideas that have emerged already in the discussions of the cancer ecosystem but works more or less literally on the site too.

Of these three, I think ‘stitching’, for me, has the most creative possibilities – it is literally an interesting way to make artwork. It also seems to me to be an expressive of what might need to happen to create a single site of excellence where the organisations can build effectively on each other’s work rather than operating as separate but physically adjacent entities.

Plenty of food for thought with all this!

Metaphors and concepts (3)

Today’s concepts and metaphors are mainly related to cancer’s evolutionary abilities. These ideas relate directly or indirectly to the ways in which cancer can mutate, grow and evade treatment and the ways that these are talked of. This particular selection of ideas is currently not at the heart of my artwork development, but I feel it is important to note them nonetheless.

“Wild Type“

The wild type (WT) is the phenotype that is the typical form of a species as it occurs in nature

“Convergence“

Where nature comes up with the same solution time and time again though through different paths, eg human and octopus eyes, bat and bird wings.

“Plasticity“

Cell plasticity is the ability of cells to change their phenotypes – without genetic mutations – in response to environmental cues. This is one of the ways that cancers can become resistant or intransigent. The other main way is through genetic mutation.

“Resistance“

Cancers that evolve to be able to survive specific drugs. This may happen either though the plasticity of that particular cell type or through the processes of selection.

“Intransigence“

Cancers that resist treatment or are unlikely or impossible to be successfully treated.

“Evolvability“

How likely a cancer is to be able to evolve into different manifestations through plasticity or selection. This concept arrived with me through reading this article, co-authored by many ICR researchers (some of whom I have spoken with) rather than via interviews

“Adaptive Therapy“

Using a range of treatment options to manage the cancer as a chronic condition to maximise quality of life and longevity rather than trying to blitz the cancer with the strongest treatments and risking it becoming more and more resistant and intransigent.

How all this relates to the London Cancer Hub

The LCH is undoubtedly at an early stage of its evolution as a single entity, so I would expect some of these notions to apply, albeit maybe not in the specific ways that they apply to disease. And if I think about my experiences of organisation development I can certainly draw parallels.

Intransigence, for example, is something that I definitely came across at the BBC – or at least it felt that way to me. It seemed that any number of people could make any amount of effort to change things – to reduce staff numbers, say – and yet the organisation would seem to go its own sweet way and somehow, despite reductions and redundancies, there always seemed to be the same number of people working there from year to year and onwards.

Plasticity too has a resonance in this respect – for me it equates to how far an organisation can adapt its ways of working without fundamentally changing its structure or identity (something that might feel more like a mutation).

However, these specific concepts have not captured my creative imagination for some reason in themselves as a basis for artwork, though they are definitely informing my thinking. My next post in this series will, on the other hand, focus on some of the concepts that i have started to investigate creatively.

Metaphors and concepts (2)

Today’s ideas are all about routes, travelling, and journeying. Some seem to be so commonplace that they are not really thought about as metaphors at all. And I’m also beginning to pick out metaphors that are more clearly ‘metaphorical’ and used deliberately because of their non-scientific connotations.

Concepts in a cancer context

Many of my descriptions about how these relate to cancer are drawn from a fascinating conversation with the Biology of Childhood Leukaemia team in a discussion about the role of gene TP53 in regulating cancer and the effects of hypoxia (lack of oxygen) on cancer evolution.

“Pathways”

Steps in the process that govern a cellular system. For example, the TP53 pathway is the one that a cell goes through in terms of whether it is ‘allowed’ to replicate, is sent to be fixed or if it is earmarked to die.

An example of how a pathway is illustrated – this one centred on the P53 protein generated by the TP53 gene

“Gateway”

On a pathway there can be a gateway, such as the gateway that cells go through on the TP53 pathway, for example, in order to know if they should go forward to replicate or stop and die. This is a gateway that can become very ineffective in cancer – cancer cells do not die in the same way as normal cells – and may be related to changes or mutations of the TP53 gene.

“Bottleneck”

A point at which many cells fail and a few pass through such as in the toxic environment at the centre of a tumour where the majority of cells die but one or two may replicate with mutations that allow them to survive.

“Signalling”

How cancer cells communicate with surrounding cells. Eg, they can signal to the body to grow more blood vessels to a tumour. Signals can be proximal (ie next door with surface proteins) or longer range chemical (eg with hormones etc).

“Rite of Passage”

This is a more specific metaphor drawn from one of the papers of the Childhood Leukemias Team. This metaphor represents the point of no return in cancer. Specifically, the ‘rite of passage’ in the paper refers to the the point at which the TP53 mutation allows cells to transition through EMT and launch themselves into the rest of the body. THis is the point where cancer metastasises, after which the hopes of ‘cure’ are drastically diminished. A rite of passage indeed.

How all this relates to the London Cancer Hub

While talking to ICR researchers the idea of spatial movement came up frequently, both in terms of their research and about their personal movements around the site and around London. While it seemed to me that in terms of the site, they concentrated on the ICR part of the campus, several mentioned how walking past or through hospital buildings either as part of their journey to work, or to collect samples or meet with clinicians, reminded them of the ultimate purposes of their work. This was especially true when they cam into direct contact with patients, even if this was just seeing or passing them on their own pathways,

Movement around the LCH was not the only example of establishing pathways in a very literal sense. Several researchers also told me about their regularly trodden routes around London as part of their work. For example, one scientist talked about how at one stage in her work she was travelling frequently – occasionally daily – on a circuit between the Sutton ICR, the Chelsea ICR and the Imperial College campus at White City. Interestingly, her work was heavily focused on identifying the spatial arrangements of different cell types in tumours, which are ‘barcoded’ to keep track of their position. We chatted about the possibilities of tracking the movements of researchers in a similar way. I would love to track some staff across the site and see what visual mappings came out of the exercise. I’ll be posting more about the site, its history and pathways through it in a forthcoming post…

And the ‘rite of passage’ for the LCH? I could interpret that in so many ways, so I am going to hold back and see what else emerges,

The role of metaphors

I think I may have already shared that something that particularly interests me for this project – and in my wider work – is the metaphors we use to explain things. Some of these metaphors are so deeply engrained in our language that we no longer even notice they are metaphors. However, when you are an outsider trying to understand something new, the metaphors somehow stand out much more clearly. That’s one of the things I particularly enjoy about working with scientific themes as a non-scientist – the metaphors tend to stand out loud and clear.

One of the principle ways that I am approaching this work is to identify some of the key metaphors that explain cancer as part of a living ecology and the processes that form part of that ecology. That’s why it has been such a joy to be able to talk to the researchers who are doing this work, and not just read scientific paperwork. Although research papers do also contain many useful metaphorical ways of describing their content, I tend to find the richest language when in conversation face to face where we can explore the ideas that emerge in more detail and I can follow particular paths to see where they lead. The wonderful Professor Sir Mel Greaves, who I have been lucky enough to speak to as part of this project, observed that he finds he uses metaphor extensively when talking to a lay audience as he finds this is a most effective way to convey his ideas with real impact.

My hypothesis is that using these metaphors in my artwork will also communicate some complex or unfamiliar ideas more intuitively. That’s where I’m headed with this work and many of the following posts will be based around the metaphors that I’m interested in understanding and pursuing.