As the doctor stepped toward the podium, he adjusted the microphone ever so slightly. He clicked past his black introductory slide, which bore his multiple credentials to an image of a sick, young child.
Robert Arceci, University of Arizona College of Medicine-Phoenix faculty member and co-director of the Matricaria Institute of Molecular Medicine at Phoenix Children’s Hospital, presented at the Mini-Medical School 2.0 on Wednesday evening in the Virginia G. Piper Auditorium on Van Buren and Sixth streets.
Mini-Medical School 2.0, a monthly lecture series by the University of Arizona College of Medicine-Phoenix, focuses on the past, present and future of medicine, including the use of genomics in precision health.
Arceci is the founding editor-in-chief of the print and online monthly medical journal Pediatric Blood & Cancer and specializes in those areas. He showed the progress of genomics in relation to the treatment of cancer in children in his presentation.
“In many ways, this is going to represent the democratization of medicine,” Arceci said. “The fact of the matter is we don’t (currently) dose based on genomic information.”
Genomics is based around the ability to map genetic material. Every strand of human DNA comprises approximately 6 feet of material, Arceci said. Genomics can lead to several “disturbed,” often unwarranted, genetic changes resulting in multiple conditions, including Down’s syndrome.
“You get the genotype and then you look at that and see if you have something potentially identifiable,” Arceci said. “And then maybe, if you’re lucky enough, you can find something and treat that patient.”
Children and adults with Down’s syndrome have an extra copy of chromosome 21, which can result in intellectual disability and physical growth delays. Arceci said 30 percent of individuals with Down’s syndrome at birth also have a disease that mimics leukemia.
“It is characterized, we now know, by a mutation of a gene called GATA1,” Arceci said. “And yet, it goes away in 80 percent of them. It just disappears and never comes back. But, in about 20 percent of them, it does come back and when it comes back usually there’s another genetic mutation.”
Arceci said despite the recent findings and innovations in genomics, doctors continue to treat patients with similar treatment plans and medications.
“We are quite different, but we still give the same drugs to everybody,” Arceci said. “Here we have some people that do very well. Their cancers go away. Other people don’t respond at all.”
Cancer, in particular, is quite different between adults and children, Arceci said. This was supported by a 10-minute clip of “A Lion in the House,” a documentary conceptualized by Arceci during his time at Cincinnati Children’s Hospital Medical Center.
Film directors Steven Bognar and Julia Reichert started filming “A Lion in the House” in July 1997. It began after Arceci approached the couple, asking them to make a long-form documentary on the families with children battling cancer.
“What I asked them to do was to show health care disparities, research, what families go through,” Arceci said. “Tell the public what we don’t understand.”
Over the span of six years, Bognar and Reichert followed five families in and out of the hospital. About 960 hours of raw footage was edited down to 15 hours, then nine, Arceci said. At nearly four hours long, the final film premiered at the Sundance Film Festival in Park City, Utah, in 2006 as the longest documentary ever shown in the competition.
Sariah Montes, a freshman nursing student at Chandler-Gilbert Community College, said the lecture and documentary clip in particular provided some much needed insight and clarity into genomics and childhood cancer.
“We can become really advanced in medicine,” Montes said. “I think that if we become more focused in it, it will benefit the whole healthcare system.”
Montes is currently working on an honors project that requires her to attend medical lectures and events. She plans to transfer to Northern Arizona University after completing her associate’s degree.
“(I was surprised) when he was comparing the 1 in 10 survival death rate of (childhood) leukemia patients versus bungee jumping or sharks,” she said.
Montes’ mother, Amy Montes, attended the lecture with her daughter. As an early childhood educator, she said she could personally relate to the documentary.
“There’s so many different factors that go into the drugs that they choose and how everybody’s so different,” Amy Montes said. “It’s really just trial and error.”
Arceci said, in terms of the future of genomics, that timing is everything and research is often the literal means between life and death.
“I know that this Friday two more kids are going to come into the emergency room with leukemia, and we’re going to give them the same damn three drugs we give them every month,” Arceci said. “Half of them will live and half of them will die.”
Contact the reporter at carolyn.corcoran@asu.edu
