David Gisselsson is a researcher on a roll. In the autumn, he was awarded Lund’s ‘local Fernström Prize’, which goes to a promising young researcher in medicine, and he has recently had an article published in one of the most prestigious journals in the field, Nature Communications.
David Gisselsson’s research is about childhood cancer, in particular DNA changes in tumour cells and what they mean for the prognosis. This can vary greatly: even if treatment of childhood cancer has improved no end, 10–20 per cent of patients still die of the disease.
“Yet there are also children who would probably be fine without chemotherapy, but have to go through the harsh treatment just to be on the safe side”, says David Gisselsson.
The aim is therefore to learn to give just the right amount of treatment in each individual case: not too much and not too little. Looking at tumour cells under the microscope is one way of assessing their aggressiveness. Studying their genetic make-up is another. Cancer cells in adults are known to have major genetic changes – their chromosomes stick together, or divide incorrectly, or end up in the wrong place.
It was thought that cells with certain major genetic changes could therefore serve as signals that the tumours they come from are dangerous, including in children. Cells without changes would then indicate a less malignant tumour. However, David Gisselsson’s research group have shown that it is not that simple. There can be so much variation between the cells within a tumour that some may look dangerous and others harmless.
“If only one sample is taken, it is chance whether the cells show the true nature of the tumour”, explains David Gisselsson.
Fortunately, the solution to the problem is not to take many samples from the same tumour. Instead, the Lund research team (which also includes Linda Holmqvist Mengelbier and Jenny Karlsson) have shown that it is sufficient to study the genetic variation between the cells in one small sample. The greater the genetic variation, the greater the risk of further changes that cause the cancer to spread.
The group’s results have attracted a lot of attention. The news was tweeted by cancer researchers and organisations, David Gisselsson was interviewed on Estonian radio, and many researchers from regions including the Middle East and Eastern Europe have got in touch asking for a copy of the Nature article.
The main type of cancer studied by the group is Wilms’ tumour, a cancer of the kidneys that mostly affects children of pre-school age. This type of cancer is unusually easy to detect.
“The tumour grows quickly and can become over 10 cm in diameter. Someone hugging the child will feel a large growth in their abdomen, and of course they then seek medical help straightaway. It isn’t usually more than 24 hours before the child is admitted to hospital”, says David Gisselsson.
He has two young children, but doesn’t find his field of research depressing.
“One reason is that I am a pathologist – I don’t meet the children; I only see their cell samples. Another reason is that so much progress has been made in the field of childhood cancer ever since the Second World War. The general outlook of those who work with childhood cancer is optimistic rather than pessimistic”, he says.
Text: Ingela Björck
Photo: Gunnar Menander