Word: tumors
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Black focuses his attention exclusively on Schuler's exposed brain and the voracious tumor that threatens it. An hour and a half earlier, he had drilled a series of holes into Schuler's cranium, then connected the dots with a surgical jigsaw. He had lifted out an oval-shaped piece of skull, then cut through and peeled back the dura mater, a thick membrane that protects the brain and spinal cord...
Navigating methodically, Black now divides the tumor from the normal brain, cauterizing severed blood vessels as he goes. He cuts all the way around the edge of the tumor, gradually detaching its mass. Fifteen minutes later, he lifts the bulk of Schuler's cancer out of the hole he has made and places it in a stainless-steel bowl. "Call the tumor guys to come down and get a specimen," he orders. Another piece of the tumor will be sent to Black's own lab while he goes back in to clean up the cavity...
...perhaps for years. By the following day, she will be walking the halls. Not surprisingly, she will feel deep gratitude. This is not uncommon; most of Black's patients exhibit an awe for his skills that borders on worship. "You're God," exclaims another patient on being told his tumor has been removed. "No, I'm not," Black replies, quietly but firmly. He gets such comments frequently, and they make him very uncomfortable. No one is more acutely aware than Black of the perils of the physician-God complex. A lot of his patients would like him to play...
Black is also working on an entirely different experiment for treating tumors. Cooperating with molecular biologist Habib Fakhrai, he is trying to enlist the patient's own immune system to attack brain cancers. Tumor cells produce a substance called TGF-beta (transforming growth factor-beta) that both fuels their own growth and tricks the immune system into ignoring their presence. Using genetic engineering, Fakhrai has come up with a genetic "switch," called TGF-beta antisense. When inserted into a tumor cell's genetic machinery, the antisense turns off the cell's ability to produce TGF-beta. Injected into patients, these...
...reason for such urgency is that no matter how carefully a surgeon cuts out a malignant tumor, the few stray cancer cells that are inevitably left behind will begin to grow again. TGF-beta and dendritic cells, or any one of a dozen other treatments under investigation by Black and others, could lead to the true cure for brain cancer that is Black's long-term goal...