Confronting cancer
Some seek
fickle fame, others riches. Chandra
Kirana would be happy if she could just find a marker for colorectal (bowel)
cancer that will make the diagnosis simple and lead to a cure.
Success
would be major news and celebrations universal, not exclusive to the elite of
international biomedicists. These are
the top white coats hunting the elusive markers that will show whether a
patient is seriously sick or just off color.
It’s
painstaking work demanding patience, critical thinking, perseverance and,
literally, microscopic attention to detail.
It could also earn the scientist who cracks the code a Nobel Prize and
applause for the nation that nurtured such talent.
But Dr
Kirana can’t work in Indonesia despite her research showing the Archipelago is
rich with plants that may prevent or cure a wide range of diseases, including
the Big C.
“There
isn’t the equipment, or if there is there’s no budget for maintenance,” she
said in New Zealand. “In some
universities there’s not enough money for laboratory rats.
“It would
be good if that wasn’t the situation but I’ve had to spend 18 of my 48 years
out of my homeland to study and work.”
Bowel
cancer is the third most commonly diagnosed cancer in the world behind lung and
breast. Screening for over 50s is often recommended, particularly if family
members have the disease.
The
incidence was once low in Asia. No
longer, as people abandon traditional plain, fresh and wholesome fare for the
preserved and processed foods of the West.
The trend
has links with toilet terror – irregular visits, pain and a red stain noticed
in the bowl before flushing. Wise ones
are in a doctor’s waiting room before the cistern refills.
“This
doesn’t mean you have cancer, it could be something else,” said Dr Kirana. “However at the moment the next stage in
treatment is a colonoscopy, which is very harsh and intrusive.”
Skip this
paragraph if you’re squeamish for even the brazen find the procedure
embarrassing and discomforting. It involves inserting a camera on a 1.3 meter
long flexible tube through the sedated patient’s anus. Samples from the bowel walls may be taken
for analysis.
Now imagine
not having to bare your bottom but an arm to provide a simple blood sample. This can be tested to determine if the
problem is piles, benign polyps or cancer.
When the
prognosis is bad, but the disease spotted before spreading, it’s scalpel
time. If in a Wellington operating
theater before the anaesthetic wafts you into wonderland you might notice Dr
Kirana waiting for the surgeon to excise the diseased gut.
She then
slices out the cancer, snap freezes it in liquid nitrogen and heads back to her
university laboratory. Here she
examines the cells using laser capture microdissection and mass spectrometry
equipment, analysing, thinking in every dimension, trying to spot the
aberrations or patterns that might provide the clue.
Her
speciality is proteomics, the study of proteins and the way they behave. This
research is so leading edge that the word – a mash of ‘protein’ and ‘genome’ -
didn’t exist before 1997. The science is moving so fast the technology is
trailing researchers’ demands.
Dr Kirana
grew up in a village near Probolinggo in the sweetlands of East Java. Many evenings she walked through cathedrals
of green cane taking dinner to her father, a chemist in a sugar mill.
“My Dad
worked hard and I felt sorry for him,” she said. “We weren’t rich. I went to government schools. I knew I had to
do my best to please my family, though I was never pressured to study. But I did well and was always getting top
grades.”
She wasn’t
alone. Along with determination her
family has splendid intellectual genes.
Her mother studied to be a doctor before costs crippled hopes. Her siblings have turned to science and
teaching.
“At first I
just expected to be a wife and never thought of going abroad, even though I’d
learned English,” Dr Kirana said. “Then
I wanted to be a doctor and was admitted to the medical faculty at a university
in Solo (Central Java).
“However I
worried that if my patients died their families would be distressed and maybe I
couldn’t cope. Better to work behind the scenes.”
So she
joined the Biology Faculty at Yogya’s University of Gadjah Mada (UGM). After graduating she taught at Malang’s
Brawijaya University, got married and discovered the other element necessary
for a successful career – a supportive spouse.
When the
couples’ two daughters were born Eko gave up his bank job to become a
house-husband.
Unfulfilled
with one qualification Dr Kirana went back to UGM for a master’s degree in
science. She won an Australian
scholarship, picked up another master’s degree at Adelaide University, then a
doctorate.
A fan of jamu,
the traditional herbal remedies of Indonesia, she examined turmeric, the yellow
spice widely used in cooking, medicine and cosmetics, particularly skin
care. It may have anti-cancer
properties.
Other
plants under her microscope have been the tastily named zingiber, a genus of
gingers with a place in kitchen and sickroom.
After
working as a postdoctoral fellow for CSIRO, the prestigious Australian
government science agency, in 2007 Dr Kirana returned to Indonesia expecting
employment.
Instead she
encountered obstructive nose-picking paper shufflers who wouldn’t make eye
contact. “It was a culture shock,” she
said. “I was so angry.” Within a month she was back on a Boeing
heading for a job at NZ’s Wakefield Gastroenterology Research Trust.
In
Wellington chairing the Indonesian community group till this year and singing
in the Embassy choir are proof her position and stellar qualifications haven’t
made her arrogant or aloof.
And her
diet? As a Muslim she doesn’t drink or
smoke. She feeds her family wholemeal
bread, home-grown green vegetables and, of course, turmeric extract.
“I love
going to work each day,” she said. “I’m very lucky. I’m my own boss. My message to young Indonesians is to work
hard. The rewards aren’t always
immediate but they do come.”
(First published in The Jakarta Post 10 September 2012)
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