Breakthrough (10 page)

After landing back in Maryland, I knew there was something else I needed to confront—the loss of Uncle Ted. I hadn't fully realized it, but that initial numbness I had felt since his passing had been replaced by a heavy pain that sat inside my stomach. Now it felt like a big, immovable boulder.

More than anything, I
wanted
to understand why he had died. I
needed
to understand why he had been taken away from me.

And that's when I had an idea. Maybe, just maybe, I could find a cure for pancreatic cancer.

If I had been just a little older and had had time to become a bit more realistic, I probably would have laughed off the idea. After all, I'd hardly be the first person to try, and most of those people were fancy scientists with impressive PhDs from expensive colleges who, unlike me, were old enough to go to an R-rated movie.

There was an older, more mature part of me that knew at the time how ridiculous this all sounded, but the younger, brash part of me was quick to shut him down. Whether it was youthful exuberance or even unbridled stupidity, I didn't know for sure, but whatever the reason, I was all in. Turns out I was the only one.

The first words out of my dad's mouth after hearing my dream were: “Jack, isn't that a little far-fetched?” My parents knew that when I invested myself in an idea, I wasn't a toe-dipper, I was a cannonballer. This probably explains why both of my parents were so dead set against the idea of me dedicating so much of my time to such an impossible task. Especially one that offered such a small chance of reward. After everything I had been through, they weren't exactly sold on the idea of their son leaping into something as heavy as cancer research.

I couldn't really blame them for that one.

However, not having my parents on board was not an option. Their approval was crucial. It wasn't as much about my own morale as it was practical things, like having them drive me places to get supplies or using their credit card to buy stuff online.

Personally, I thought this project was the perfect fit for me—I was in search of an outlet for all my grief, and cancer was in need of a cure. Using everything I learned from giving persuasive speeches to science fair audiences, and also my extreme stubbornness, I began wearing my parents down. Maybe it was the passion I had, or maybe they knew I was going to go ahead and try whether I had their blessing or not, but whatever the case, my parents reluctantly gave me their approval.

Now it was time to begin. I knew from all my time spent working on science fair projects that any discovery begins with identifying goals and then figuring out which questions needed to be answered to get from point A to point B. That part was easy. I already knew what my goal was—to cure pancreatic cancer.

As someone trying to fight cancer of the pancreas, the first question for me was pretty obvious: What the heck is a pancreas? In the beginning, I didn't even know what a pancreas was. I mean, I'd heard of a pancreas and I knew that it was an organ in my body and that it was important, but what exactly does a pancreas do? I had absolutely no idea. I didn't feel intimidated by my lack of knowledge, since I knew I had all the tools I needed to start: Google and Wikipedia.

I started by typing keywords into my laptop—“what is pancreas”—and clicked on the first result that popped up. It was an article on a popular website devoted to health issues, appropriately titled “What Is a Pancreas?”

Turns out the pancreas is actually pretty cool and has
a lot
of responsibilities. The pancreas is a six-to ten-inch-long, spongy, fish-shaped organ located behind the stomach in the back of the abdomen and it produces important enzymes and hormones that help break down foods. Without it, we can't convert the food we eat into the nutrients that we need to survive.

The pancreas also has another huge job. It produces the hormone insulin and secretes it into the bloodstream in order to regulate the body's glucose, or sugar, level. I also learned it has two different kinds of glands. The exocrine glands help speed up chemical reactions and break down fats and proteins. There are also the endocrine glands, which make hormones like insulin that help balance the amount of sugar in the blood. If they aren't working, we get diabetes.

All this information was a lot to digest (get it?). But now that I knew what a pancreas was, I was ready to move on to my next question: What is pancreatic cancer?

After a quick search online, the first thing I realized was that Uncle Ted wasn't the only great person who had fallen victim to pancreatic cancer. This is a particularly lethal form of cancer that has killed a lot of great people, including Steve Jobs, the founder of
Apple. It also took the lives of actor Patrick Swayze, actress Joan Crawford, anthropologist Margaret Mead, and famous opera singer Luciano Pavarotti.

A little farther down, I discovered a story that revealed a disturbing trend: while many different kinds of cancer were becoming less frequent over the past decade, rates of pancreatic cancer have been
increasing
since around the year 2000. The American Cancer Society estimated that 46,420 new cases of pancreatic cancer will be diagnosed in the United States in 2014 and 39,590 people will die that year from the disease.

The lifetime risk of having pancreatic cancer is about one in seventy-eight. It is about the same for both men and women. People get pancreatic cancer when cells in the pancreas begin going wild, growing out of control. Rather than developing into healthy, normal tissue, they continue dividing and form masses of tissue called tumors.

Now that I knew what pancreatic cancer was, I needed to know what caused it. I found a link to a website for Johns Hopkins Hospital. I figured the site had to be credible since it was put together by one of the best hospitals in the world (remember, the information we get from the internet is only as good as its source). I clicked on it.

According to the Johns Hopkins site, doctors and scientists believed there were two main causes of pancreatic cancer. One of those theories was that the damage, or mutations, to our DNA that
causes wild clumping in pancreatic cancer might be something we inherit from our parents that is triggered when we get older. But no one seems to know yet whether pancreatic cancer is an inherited disease.

As I researched further, I learned that we have two copies of each gene in our body—one from each of our parents. Scientists believe that people who inherit cancer usually have one mutant copy from one parent and one normal copy from the other parent. As they age, some of these people will damage the good copy of the gene in a cell in their pancreas. That cell will have two bad copies of the gene, and, as a result, that cell in the pancreas will grow into a cancer. These cells just sit like a ticking time bomb until they reach a certain age, when a trigger goes off and the cells begin to mutate.

Pancreatic cancer is considered one of the deadliest cancers in the world. According to the American Cancer Society, for all stages of pancreatic cancer combined, the one-year survival rate is just one in five, and the five-year rate is only 6 percent! That means that only six out of every one hundred people who are diagnosed with pancreatic cancer survive the next five years. You don't have to be good at math to realize that no one in their right mind would want odds like that.

However, reading about those horrible odds led me to another question. How could it be that despite all the new advances in science and exciting breakthroughs in technology, survival rates for
pancreatic cancer have remained so astoundingly low?

This is largely a matter of timing. Over 85 percent of all pancreatic cancers are diagnosed late, when someone has less than a 2 percent chance of survival. At this point, the tumors have usually spread and it is no longer possible to operate and cut them out. Why is pancreatic cancer being detected so late? Partially, this is because pancreatic tumors are hard to detect. The pancreas is nestled deep in the abdomen, beneath other, fragile organs. It also doesn't help that the pancreas is surrounded by dense, drug-blocking tissue. Another issue is the test itself. It hadn't been updated in six decades! The current test is also way too complicated. To screen the blood of a patient at risk for pancreatic cancer, a doctor must send vials to a lab, where it can then be tested for elevated levels of a biomarker, which is a term for an early indicator of disease.

There were more problems. These tests are extremely expensive, costing eight hundred dollars each. They're also really inaccurate—missing 30 percent of all pancreatic cancers. While missing only 30 percent is great if you are a major league baseball hitter (that would mean you are batting .700), it's not so great if you are hoping to defeat a deadly cancer and a matter of days can mean the difference between life and death.

This meant that one of the biggest problems with pancreatic cancer wasn't the treatment, but the detection. That's when it hit me. I didn't need to find a cure for pancreatic cancer. I needed to find a
better way to find pancreatic cancer before it spread to other parts of the body and while it could still be treated. I thought of something the doctors had said after Uncle Ted passed:
Maybe if we had caught it earlier
.

I decided that I had a new mission. I would find an early-detection method for pancreatic cancer.

Unfortunately, there was something else I had to do first—begin high school. On my first day as a freshman at North County High School, I was excited at the prospect of forging a new reputation with a new group of kids, but I was also nervous about having a repeat performance of my middle school years.

The first day began with me slinking from class to class with my head down. Almost everyone had gone to school with one another for the past eight years and already had friends, so no one had any reason to talk to me. All morning I had an ominous feeling that my make-or-break moment would come at lunch. I knew that where I sat would have far-reaching implications for the rest of my future at this school. If I chose wisely, sitting at the right table could help me make important friendships for the rest of the year, or even longer. I was also aware of the dangers. The mistake of unknowingly setting my tray down with the wrong group of students could create the kind of negative first impression that would be hard to overcome.

When the fourth-period bell rang, I walked into the cavernous lunch hall. I was struck by the sheer size of the room. It was so much
bigger than the lunch room in my old school. I had become that cliché kid in the movie—the one nervously clenching his lunch tray in his hands as he looks around the room of students, trying to find a safe place to sit down and eat.

I scanned all the different cliques in a desperate search for a safe haven. To the left were the jocks. I remembered them from middle school. No way. To the right were a group of teens wearing designer clothing. They looked okay, but way too hip for me. And besides, there were no open seats next to them. I knew this wasn't good. In standing still, staring, looking like a total weirdo for way too long, I was also putting myself at risk. It was important that I move and move quickly.

I spotted a group of girls sitting near the back of the cafeteria. They were flipping through their books and seemed cool. By their relaxed sense of style and easy smiles, I could tell I would like them. And there was an open seat at their table. I walked over, careful not to dump my tray, and came out with my intro.

“Hi, can I sit here?” I asked.

“Sure,” a girl with a nice, welcoming face answered. “I'm Chloe.”

Chloe. My savior.

For the rest of the lunch period, I sat in silence, eating quietly. If I didn't say anything at all, I figured, I couldn't say anything wrong. Besides, I was savoring the moment. After all, the ambiance of a high school cafeteria was a step up from my former lunch table, the
handicapped stall in the boys' bathroom.

The most important part of the day behind me, I spent the next two hours going through the motions until the final bell rang.

When I wasn't in school, I was hard at work on my project. Now that I had discovered a new goal—finding an early-detection method for pancreatic cancer—I began setting up scientific criteria, a set of rules to work with. In my case, I needed to come up with some ideas as to what the ideal test would have to look like in order to effectively diagnose pancreatic cancer.

I decided that in order to have the kind of impact that could really make a difference, the test would have to be cheap, fast, and simple. My test needed to be sensitive enough to catch the cancer early, but also minimally invasive so it wouldn't bother patients too much. To accomplish this, I knew I'd need a solid plan of action. In science, the defining characteristic of all knowledge, including theories, is the ability to make falsifiable or testable predictions—in other words, predictions that you can prove are either true or false. The specificity of your predictions determines how useful your theory is.

I needed to find some clues that pancreatic cancer leaves in the body to make its presence known. After a lot of searching, I was able to find this great article in a publicly accessible scientific journal called the
Public Library of Science
that listed a database of different proteins that are found in patients suffering from pancreatic cancer.

Why are proteins so important? That wasn't an answer I needed to research online to find. I had learned all about proteins during biology class, in between my torture sessions in middle school. Proteins do most of the work in cells and are required for the structure, function, and regulation of the body's tissues and organs. They are everywhere. 20 percent of the human body is made up of proteins, and they play a crucial role in almost all biological processes.

I also learned that proteins are large, complex molecules made up of hundreds or thousands of smaller units called amino acids, which are attached to one another in long chains. There are twenty different types of amino acids that can be combined to make a protein, and the order of the amino acids determines each protein's unique three-dimensional structure as well as its specific function.