Science: Would you help growing "good" gut bacteria when you have colon cancer, hoping for a better clinical outcome?

 I read this paper last week.

"An Integrated tumor, immune and microbiome atlas of colon cancer", 

Roelands et al., Nat Med. 2023 May 19. doi: 10.1038/s41591-023-02324-5. Online ahead of print.PMID: 37202560

https://www.nature.com/articles/s41591-023-02324-5

The journal Nature Medicine is a journal with 53 impact factor (which is ridiculously high from the standpoint of researchers. Usually 5+ IF is considered decent. 10+ is considered a leading journal for the field). That makes Nat Med one of most prestigious or highly regarded journal in medical research.

The authors are from Qatar, Netherland and Italy.

This is an original research providing a synthetic view on colon cancer.

Cancer research progressed with limitations of the time. Different types of molecular analysis became available over time. Earlier research lacked analyses that are now available.

This report integrates several data analysis methods and provides a most contemporary overview of colon cancer that was unavailable or just assumed before.

At first, the authors correctly pointed out that current cancer database most used by cancer researchers (called The Cancer Genome Atlas [TCGA]) is not "complete" and has missing data, such as clinical outcomes, immune activity, or microbiome/bacterial flora at cancer and non-cancer sites. The shortcoming is by historical reasons.

The authors collected treatment-naïve colon cancer and pairing non-cancer colon tissue samples at medical center in Netherlands from 2001-2015. They collected 384 sample sets that passed quality control, which make the cohorts they used. 

They applied various molecular analyses (gene mutation, gene expression, immune cell typing, bacterial rRNA sequencing/microbiome) on the cancer and normal-looking colon tissue, and followed up on the clinical outcomes/survival data. So that we can have overview on colon cancer.

There are questions like, 

"some gut bacteria are associated with colon cancer. Do they correlate with clinical outcomes/survival?"

"what kind of gene mutation or what type of colon cancer is bad with poor prognosis, or is more manageable with favorable outcome?"

"immune system is important for cancer outcomes. What kind of immune cells are critical to anti-tumor activity?" etc etc. 

And these questions can be examined with their datasets.

The report was inevitably somewhat descriptive with statistics, but full of interesting findings.

On the other hand to be honest, with 6 figures, 10 extended data figures and 14 supplementary information figures, it was pain to read through this one, even for a professional researcher.

Their main message was simple. 

Immune cell infiltration (especially, tumor-antigen-bearing T-cell clones) and types of gut bacteria are two important factors to assess clinical outcomes/survival.

I'll just drop one finding from the paper here.

If you have colon cancer, many things are out of your control. What kind of mutations the cancer carries, what kind of treatment options your oncologist choose or are available, how well your immune system is functioning, etc etc.

Immunotherapy is one way to reboot your anti-cancer immunity. Now it is a standard therapy option in oncologists' arsenal. Depending on the cancer and condition of your immune system, they can work remarkably well, or less so.

But gut bacteria is something you can influence through what you feed to them (= what you eat). In a sense, it is a (cancer) environment that you have some control over it.

There are several gut bacteria species associated with colon cancer and/or gut health. Fusobacteria and Ruminococcus gnavus are considered bad guys, while Akkermansia, Bifidobacterium lactis, Lactobacillus acidophilus are considered good guys.

I checked US Amazon. They have supplements for Akkermansia, Bifidobacterium lactis, and Lactobacillus acidophilus. How convenient.

In the paper they found a gut bacteria species Ruminococcus bromii as a bacteria species associated with high survival rate. R. Bromii is bacteria that can use resistant starch as energy source, and can generate butyrate, a chemical that can work against colon cancer cells.

The authors speculated that R. bromii help to optimize local immune infiltration and anti-cancer immunity.

With reservation that they only showed correlation and not causation, you can still take a leap of faith and try to feed R. bromii in your own gut.  

Although US Amazon does not offer Ruminococcus bromii supplement (with a high impact publication to back it up, I'm sure someone is going to start selling it), there may be a few ways to feed R. bromii in your gut, for the people willing to take a leap of faith (come to think of it, how unscientific this sounds).

One way is, as suggested by the authors, to eat castalagin, a type of ellagitannin rich in Oak tree and Camu Camu berry. 

Camu Camu is an exotic berry cultivated in South America, like Brazil and Peru. According to another paper (Messaoudene et al., Cancer Discovery (2022), 12, 1070-), castalagin can directly bind to R. bromii and possibly helping them to increase in the gut.

Another is to eat peanuts. (....seriously, I need to confirm this one).

Out of curiosity, I picked up a bag of peanuts at a local store and ordered Camu Camu berry powder from Amazon, although I don't have colon cancer (hopefully not). Another n=1 human experimentation on myself. Wonder how would Camu Camu berry taste?

Actually, the gut bacteria modulation approach probably is like a balancing act. I'll monitor how it is working for me, and if something is wrong, I'll just toss it.

Their datasets are missing racial information. As mainly European cohort (presumably), their biology may or may not be the same from biology of colon cancer patients in US or in Asia.

But their report is most comprehensive colon cancer dataset available to date. As the datasets are deposited to depositories and are publicly available, I am going to check them out as a summer project.

If you read the whole paper, you'd notice that this research did not come in one-go. They got funding for this analysis, then another funding for another analysis. We can so relate. Rome wasn't built in a day.

Dance: Dallas trip 6/4/2023, WCS day. "Westie Remix HD with Jordan and Tatiana", brunch, critique and guided practice

 Jordan Frisbee and Tatiana Mollmann are West Coast Swing (WCS) champions; 11-time US Open classic division champions and celebrities in the WCS community. 

You can see the reason by just watching their dance. Here I paste a link to one of their performances.

[2015 US Open. Their "routine retirement" piece ]

There are many WCS dancers out there, but few have their level of visible refinements in the movements that can be presented to lay people on Broadway-style shows. 

Being celebrities in a dance community is one thing. Their dance having appeal to broader lay people, thus them being strong entertainers beyond their own community, is another.

They were visiting Dallas for Sat and Sun. The event was called "Westie Remix HD with Jordan & Tatiana". 

There were 2-hour intensive and dance on Saturday (which I missed for Tango party. No regrets). 

On Sunday, the event organizers at Studio 2155 scheduled brunch, 3-hour spotlight critiques and a 45 minutes guided practice. So I signed up.

In the Spotlight critiques, couples who signed up for the critiques dance in front of Jordan, Tatiana, and audience. After their dance, Jordan and Tatiana provide comments on each of the couple for improvements. The personalized feedback can be invaluable for contest-minded WCS dancers.

Each couple danced for about 2 minutes. They could choose blues or non-blues (most chose non-blues), then several minutes critiques followed.

The critique session was quite amusing.

The couples came with different levels of dance skills and appeals. Some are probably novice if not a beginner. A few looked like dancing at a higher level category. 

Note: WCS contest is segmented to categories such as newcomer, novice, intermediate, advanced, all-stars, and champions, by dance points dancers have acquired through participation and winning in contests. The dance points are considered to reflect the dancer's dance level, although not necessarily so. 

At first it was amusing because I thought it was like watching speed dating or something. 

After a few couples dances and comments, I began to catch on the format and started thinking my own critiques, which may or may not align with Jordan and Tatiana's comments.

Besides, their way of commenting was quite entertaining by itself. Somewhat like watching good stand-up. Professional, sincere, sometimes funny, while imparting their expertise. Love it.

Probably people there took the event in their own ways. Dancers taking critiques were naturally focusing on their own dance and comments. For me, the critique session was helpful to transplant their eyes and install their thought processes while watching WCS, or at least an attempt toward it.

As you can see in the format, they did not have much time to make comments. They watch a couple dance. Then one of them started talking.

The format was not rigid, though. In a case, Jordan danced with a girl for 30 seconds, then commented on the connection being (too) steady, instead of "ebb and flow" or stretchy. It was an extended diagnostic time, and connection is not always visible, or can be diagnosed by just watching. They made personalized comments in such a manner.

How did they come up with comments so quickly?

I'd imagine they already had a matrixed system in their minds on the domain of WCS, and used it to get to a personalized advice. 

From the dance visuals they determine;

lead or follow, dancer's level, style, noticeable character,  a subject to be mentioned (like connection, timing, body usage, or anything that would be relevant to judging the individual's WCS dance).

As WCS contests are structured in a leveled manner, the way they address an issue to a novice differ from the way to, say, an all-star. 

Dance teachers have to deal with all the different students, from elementary school kids to graduate school PhD candidates. Isn't it weird or what.

Long and rich experience should have served them to get there.

It was amazing to watch the top-ranked professionals work. I was quite entertained by that.

Of course, how their comments are going to be used is primarily up to the comments' recipients/ dancers. In addition, audience including me got to witness the advice, too, and learned how to see the dance from their viewpoint. Also learned how to diagnose a dance, and how to fix or change the dance for the better, when any of the issue occurs.

I am a dancer and also a dance geek. I found the whole thing amusing, entertaining, and useful. 

Maybe not for everybody. But it was a good time. $35 was cheap for the fun time.

Dance: Dallas trip 6/3/2023, Tango day. Jack and Jill, pro show, milonga

 This past weekend I made a trip to Dallas. Saturday 6/3 was Tango day for Jack and Jill, pro show, and milonga. 

Sunday 6/4 was West Coast Swing (WCS) day for Jordan and Tatiana workshops (next blog entry at a later time).

These two events were overlapping. I went to a half of both.

On Saturday I went to watch Argentine Tango Jack and Jill finals, pro shows, and dance at milonga.

Jack and Jill format was the same with swing dance Jack and Jill. Contestants with bibs, dice roll to determine rotation number, and dance to 3-4 songs in front of judges and audience. Rotating after each song. In nice dresses and suits, which is a difference from swing dance. Swing dancers are more casual.

The host George and Jairelbhi invited professional instructors/performers (Guillermo Merlo, Gimena Herrera, Tomas Galvan, Celina Rotundo, Hugo Patyn). 

Guillermo was performing with Jairelbhi, in place of George who is recovering from his knee surgery.

Guillermo, Gimena, Tomas and Vania Rey were serving as judges for the Jack and Jill.

I enjoyed watching the semi-finals and finals for Vals, Milonga and Salon Tango categories.

The Jack and Jill outcomes?

In addition to dancing itself, I was curious about judging and what they value.

For the leads, in short, the judges awarded "solid and steady".  

This Jack and Jill is for contest novices, and the priority being placed on showing solid lead sufficient to create safe environment for his follow to express her dance is understandable.

For the follows, they seemed to have awarded "relax, expression, and with ease". That is, what was positively evaluated was a little more advanced dancer-looks than the leads.

Perhaps, the judges expected proper role play from the lead and the follow. Solid lead with expressive follow. The frame (him) and painting (her) in the ballroom dance. 

In Jack and Jill, too strong a lead or a follow can easily upset the balance and matchup. That is the tricky part of Jack and Jill contest. I did not watch the preliminaries, but I imagine the balance between leads and follows was not as leveled as in the finals.

Tango follows face dilemmas. One of such dilemmas is "solid follow" vs "expression". The mix is mostly suggested by the lead, but her preferences and tendencies count. For this contest, judges seemed to like dancers who was able to add time for embellishments while keeping more relaxed look. And of course with the music.

This "expression with ease" is a character that comes only after cultivating some Tango in her. It takes experience. So in other words, the judges collectively awarded the looks of "veteran" dancer-follower, it seems.

Pro shows/stage tango were entertaining. And I wanted to be entertained.

I watched Guillermo's performance videos before and loved the style. Suave, I'd say.

Also I appreciate the instruction videos he posted online. Some time ago I was searching for videos to catch up with Tango after covid, and found their tango vocabulary series. It was quite useful for social dances.

Tomas and Gimena presented a fast-paced "perky" Tango. Impressive moves included that move in which he kicks through between her legs successively in molinete. Getting the timing right in the move is not easy, especially with the fast song they danced to. 

Audiences expect professionals to show something amazing. Their techniques did it.

Hugo and Celina were of course both strong dancers. Loved their choreography and expressions.

As this was Jack and Jill week, they added rotation for the three pro couples. 

The milonga ended around 2am. But I didn't feel tired much. After losing 15-20lb (-7.5 to 10%) from dieting this past 5 months, my body noticeably moves easier and smoother to my delight. I should have done this dieting business earlier.

On Sunday they had Tango workshops. I'm sure they were good. But I went to WCS event instead. cont. to Next entry.