Oct 27, 2014 — Imagine knowing whether your child is at risk for developing cancer. There would be the chance to stop the disease before it even starts. Joshua Schiffman, M.D., associate professor of pediatrics at the University of Utah, and pediatric oncologist at Primary Children’s Hospital, is part of the first initiative of its kind – the Primary Children’s Hospital Pediatric Cancer Program - that promises to do just that. He explains the program and how it will further a mission of eradicating childhood cancer.

Interview

Interviewer: Imagine knowing whether or not your child is at risk for cancer. There would be the possibility to prevent the disease before it even starts. Pediatric oncologist Dr. Joshua Schiffman is part of the first initiative of its kind that promises to do just that.

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Interviewer: Dr. Schiffman, tell me about your study.

Dr. Schiffman: Right now, we've instituted a very large study through Primary Children's Hospital and the department of pediatrics to investigate every new child diagnosed with pediatric cancer in the state of Utah and the surrounding states.

Interviewer: Oh, really?

Dr. Schiffman: This program, called the Primary Children's Hospital pediatric cancer program, is one of its kind across the globe. We are doing whole-exome sequencing on every child and their parents and, when applicable and available, their siblings. This enormous unprecedented genomic sequencing effort is all to determine which children are at risk for cancer and why so that we can start to develop unique and effective prevention strategies and hopefully go on to expand this to a global population to one day hopefully prevent childhood cancer.

Interviewer: Have you started doing that?

Dr. Schiffman: We have started doing that, and we're starting to find some very interesting patterns of inheritance. Also tied into that project is not just genetic risk but trying to understand what are the long term consequences for childhood cancer in terms of late effects, what is the cost of treatment to these children, what are the immediate toxicity of these cancer therapies that we're giving, and what are the pharmacodynamics and pharmacogenetics of these therapies.
What we hope to do, going forward in the future, is take our genetic information and tie it all together to try to determine is there a genetic risk that we can identify for long term side effects, a genetic risk for toxicity, a genetic risk for drug levels in the bloodstream. There's no better place to do that type of work through the department of pediatrics with all of its collaborations and team building.

Interviewer: Yeah. I think an important point of that is this information may not just be beneficial for the patient but for the knowledge of how cancer works and the genetics of cancer.

Dr. Schiffman: Absolutely. We are in our initial phases of this pediatric cancer program, and our goal is to build this into something larger in order to take this to the globe around the world. It's not just our children in Utah that we care about. It's every child. I often say that one child diagnosed with cancer is one child too many. Through all of these different genetic efforts, epidemiology efforts, using tools like the Utah population database, we hope to reduce that number to no child diagnosed...

Interviewer: Can you give a specific example of how that information could help somebody.

Dr. Schiffman: One day if we are successful in identifying who's at genetic risk for cancer, you can imagine that it may be even possible to check a child at birth to see if they've inherited the genetic risk for cancer. If that's the case then there may be, one day, a drug we could give or a vaccine to intervene before that child develops his or her cancer, or in the very least screen closely so that cancer is identified the moment it begins. There is lots of new technology out there circulating, tumor DNA, imaging, and so on, where we can try to identify cancers at their earliest stage.

Interviewer: That's really exciting.

Dr. Schiffman: It's a very exciting time to be a pediatric oncologist. I should say that in pediatrics, which is how I'm trained, we always talk about prevention. We would rather prevent disease than have to deal with disease after it already develops. All of these genetic and genomic efforts here at the University of Utah in my mind are all to advance that mission of prevention which is so important and is our guiding light in the field of pediatrics.

Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.