Tag: metastasis

Metaphors and concepts (6)

This, my final post in the mini-series about the concepts and metaphors that I’ve drawn from my initial research conversations, deals with metaphors at their most metaphorical. These particular examples are not part of the standard scientific way of talking about something. Signalling or pathways, for example, are no longer really seen as particularly metaphorical but are part of the standard scientific language, even though when you stop to look they are clearly metaphorical in origin. The examples here, however, are drawn from more distant ideas to try to express something which otherwise seems out of reach. This can be especially true when trying to convey some concepts to those (like me) who don’t specialise in this area of science.

“Cell graveyard“

In the hypoxic conditions in the middle of a dense tumour, the majority of cancer cells will die, leaving alive only those with TP53 (or similar) mutations which allow them to continue to survive and multiply. The centre of the tumour is therefore akin to a mass grave for those cells which are not destined to become truly intransigent.

“Launchpad / lift off“

The point at which a cell can emerge from the tumour, going through a process called EMT that allows them to move more freely and spread around the body. This launchpad signals the beginnings of metastasis, beyond which most cancers become a very different proposition for treatment.

“Wings“

The metaphorical effect of passing through the bottleneck of hypoxia and the cell graveyard is to gain wings and achieve lift off.

“Black Swan“

A cancer cell that has achieved wings and lift off….

How does all this relate to the London Cancer Hub?

These ideas are incredibly evocative and loaded with emotional as well as conceptual content. As such. they were ideas that i was immediately drawn to explore. and indeed my first thought in the studio was to start creating a winged object. That may have been in part because I have recently discovered a way to make winged object using a new technique and so it’s rat the top of my mind, but also because there is something very poignant about the idea that something gaining wings and lifting off could have such a devastating impact on the prognosis of someone’s disease.

So how does that relate to the LCH? I am drawn to thinking of both a black swan and a white swan. With cancer, the appearance of a black swan is the point at which the disease very likely becomes unstoppable for a particular individual. I like to think, romantically perhaps, that an equivalent white swan can emerge that will make the combined strength of all the players at the London Cancer Hub unstoppable in the future in their effort to prevent and treat cancer. Despite the prevalence of cancer, one of the many things I have learned over the last few months is the level of the selective and adaptive forces required to create the ‘wings’ in a cancer that make it indestructible. I imagine the effort, resources and energy required to create a white swan will be similarly significant.

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,