Insights: Cancer care in Florida
Breakthroughs, trends and players in the medical field of oncology
In microbiology, students learn that RNA is a "messenger molecule" whose job is to carry protein-making instructions from a cell's nucleus to the cytoplasm, the fluid area between the nucleus and the cell membrane. But only about 3% of RNAs actually perform those functions, and until about a decade ago, many scientists viewed the other 97% of "non-coding" RNAs as cellular "junk" -- extraneous material.
Over the past decade, however, a flurry of research has revealed that some non-coding RNAs perform important functions: They switch genes on and off and play a role in the regulation of a wide scope of processes, from the development of an embryo to the development of cancer and other diseases.
At Sanford-Burnham Medical Research Institute at Lake Nona, researchers led by Dr. Ranjan J. Perera are looking at the role that various non-coding RNAs play in the development of skin cancer melanoma and prostate cancers. Perera and collaborators at the University of Queensland in Australia have honed in on one long, non-coding RNA (lncRNA) called SPRY4-IT1 that is elevated in melanoma cells, where it promotes cellular survival and invasion. They also report that melanoma cells have lower levels of another small non-coding RNA, called miR-211.
Perera and his team hope that by identifying early prognostic markers of melanoma and prostate cancer they will one day be able to diagnosis cancers earlier, through simple blood tests as opposed to painful biopsy procedures, and devise better treatments.
While lung cancer is the leading cause of cancer deaths in the United States, more than two-thirds of all lung lesions occur in the distant regions of the lung, making diagnosis and treatment a challenge.
Conventional screening methods, such as traditional bronchoscopy, can only reach lesions in the main bronchial tubes, and patients must often submit to more invasive and risky surgical procedures to get a diagnosis.
Cleveland Clinic Florida is one of several Florida hospitals using a new GPS-like technology to extend the reach of a conventional bronchoscope to lesions deep in the lungs with minimal trauma to the patient.
The procedure, known as electromagnetic navigation bronchoscopy, begins with a CT scan, which is loaded into planning software that creates a 3-D roadmap of the lungs. Once the bronchoscope is placed through the patient's mouth and into the airways of the lungs, a flexible catheter containing electromagnetic sensors is advanced through the bronchoscope.
Those sensors then guide the physician to the target lesion, where the doctor can collect tissue samples for testing and diagnosis. The procedure, which is performed in an outpatient setting, is also offered at North Florida Regional Medical Center, Brandon Regional Hospital, Mercy Miami Hospital and other Florida institutions.