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Sunday April 4, 2010
By Dr ALBERT LIM KOK HOOI
The symbiosis that supports well-rounded human development.
THEY say “travel broadens the mind”. I agree. Travel also expands the heart. We become more accepting, more accommodating, and more forgiving.
I was in Bali earlier this month to chair an Asian meeting of oncologists. As the chair, I was to introduce the speakers. A professor handed me his curriculum vitae (CV). I read through his CV and made a mental summary of its contents. I had to decide what to mention and what to leave out so that I could make a succinct and elegant two-minute introduction.
The professor mentioned his qualifications, positions held, and achievements, as I would have expected him to. He also mentioned his wife’s name and her date of birth! That was a first for me and it took me aback. For fear of making a faux pas, I decided not to tell the audience the professor’s wife’s age. She might have been mortified.
Should I have? Would you have? Asians are an open, friendly, and family-oriented lot. Perhaps Prof wanted to share with us details of his family to better bond with us. He had nothing to hide. I don’t know.
I have chaired meetings in Europe, North America, and Australia. The speaker’s financial position, marital status/sexual orientation, religion, and medical history are usually under tight wraps and I have always respected that. Even if I am privy to such personal details, I would never divulge them.
Who’s right and who’s wrong? You know the answer. Both are right. The question of wrong does not arise. Cultural traits and preferences are exactly what they are, and I hope we accept them all with a big heart. Of course, a meeting of oncologists is more than understanding each other’s culture and sampling local cuisine. It is about science, medicine, and oncology.
Whatever our cultural backgrounds, science was our common cause. We discussed some aspects of cancer nanotechnology. Nano is the Greek word for midget and so we are talking about the small. In this case, the very, very small.
A nanometer is one billionth of a meter. The width of a human hair is, on average, 100,000 nanometers! Human cells measure between 10 and 100 nanometers. It makes a lot of sense that we wish to exploit scales of this order of magnitude in medicine and cancer because cells and biological processes are in this range.
When we give an anti-cancer drug to a patient (usually injected into a vein), we have no control over how the drug is distributed and how long it stays in the body. Ideally, we want as little as possible of it in the patient’s normal tissues and organs and as much of it as possible in cancer cells.
In the last couple of decades, research in nanotechnology has allowed us to do just that. Doxorubicin and paclitaxel are two drugs commonly used in the treatment of cancer.
Nanotechnology formulations of these two drugs are available. Vectors carry the drugs – size of vector plus drug is 10 to 50 nanometers – to the cancer cells with little of the drug diffusing into normal tissues. Consequently, there will be more tumour cell kill and less damage to normal tissues.
I was particularly happy when we discussed one drug of this class, paclitaxel polymeric micelle. It was designed in Korea and is marketed by an Indonesian company. The Asian century beckons even in science and technology.
We also touched on pharmacogenomics. Each of us has a different way of metabolising drugs, i.e. how it circulates in our body, how we break it down, and how we get rid of the breakdown products. This is because we have subtle differences in our genome.
Simply put, our genes affect how we handle drugs. The anti-cancer drug, irinotecan, comes to mind. We can now vary the dose of irinotecan we give our patients according to their genomic profile. Patients who lack a certain enzyme which is needed to detoxify the drug will be given a lower dose to avoid unnecessary toxicities.
The “cultural evening” that followed the scientific seminar naturally centred on Balinese culture. We were entertained with the Legong, where the performers’ eye and facial expressions told a story of love and betrayal. In the Barong dance, the lion or dragon represented good.
This eternal struggle of good versus evil is common to both Eastern and Western cultures. Partially clad male bodies swayed rhythmically to the chick-chack, click-clack sound they made during the Kecak dance.
If I had been in Berlin, it would have been a string quartet of two violins, one viola and one cello, performing Bach’s Air on G.
It is a rich and fascinating world, both scientifically and culturally. The more steeped we are in science, the better our pursuit of the objective truth. The more we are exposed to the cultural practices of others, the less likely we will become cultural and moral absolutists.
Science knowledge and a non-judgemental approach to culture will make us less likely to preach and to proselytise, to desecrate and to destroy.
Dr Albert Lim Kok Hooi is a consultant oncologist. For further information, e-mail firstname.lastname@example.org. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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