Chapter 96: Cellicure (7)

On the sixth day, Young-Joon visited Sunyoo Hospital again. He was alone without Song Ji-Hyun. He met Professor Kim Chun-Jung and pitched the idea.

“Let’s scan glucose and see where the cancer has spread since cancer cells eat a lot of glucose.”

“Are you going to use FDG?”

FDG, or fluorodeoxyglucose, was glucose that was labeled as a radioisotope. It was a drug that was often used to study diabetes and such, and it was easily absorbed in places where glucose was absorbed as it had a very similar structure. FDG emitted positrons from where it was absorbed, so it allowed one to see how the glucose moved with a positron emission tomography scan.

The problem was that FDG was a radioactive material. It constantly emitted radiation, internal contamination occurred continuously within the body, and it wasn’t metabolized and destroyed easily like glucose. It was discharged from the body as urine after a long time, but until then, the patient’s body was like a walking, radioactive lump.

“I’m against using it.” Kim Chun-Jung shook her head. “She is still young. I would use it if the patient was old and there was a high risk of metastasis. But not Lee Yoon-Ah.”

“You’re saying that since cell division must keep occurring in the body as she is young, internal contamination, which can cause damage to DNA, will do more harm than good, right?”

“That’s right,” she replied firmly.

“I thought so as well,” Young-Joon said. “I don’t want to use FDG. Let’s just scan glucose.”

“Pardon?”

“Since we don’t have time, I wasn’t going to develop a new technology that had to go through clinical trials. I am going to change how we use existing technology, and we are going to track glucose with the safest material possible. Give a few candies to Lee Yoon-Ah. Then let’s take a picture of the change in glucose concentration with an MRI.”

Kim Chun-Jung froze for a moment. For a second, she thought that Young-Joon had gone insane.

“Um... Mr. Ryu, we can’t take a picture of glucose concentration with an MRI.”

“We can. It was just that there was no one who tried to take a picture of glucose concentration with an MRI.”

“...”

Kim Chun-Jung was extremely confused.

‘What the hell is he talking about?’

MRI was a diagnostic imaging technique that was able to provide abundant information about things such as bone marrow or soft tissue in bones by imaging water molecules in the body. However, glucose wasn’t water, and an MRI wasn’t an optical device, such as a microscope. It was impossible to measure the flow and concentration of that fine substance.

Young-Joon, who saw her confused face, began explaining.

“The human body is mostly made of water. An MRI involves applying a strong magnetic field on a patient’s body, which forces the protons of water to align in one direction. Then, the protons emit a certain wave of energy when you shoot electromagnetic waves at a specific frequency due to resonance. If you measure that, you can see the flow of water molecules in cells. That’s how an MRI works.”

“That’s right.”

Kim Chun-Jung nodded.

“I did a few simple experiments, and I found that I can track down the protons attached to the hydroxyl groups on glucose with an MRI.”

“How?”

“When you produce a magnetic field with an MRI, the protons of both glucose and water are aligned in a specific direction. Then, if you shoot an electromagnetic wave that matches the frequency of the protons on glucose, they will fall off of glucose, transfer onto water, and change the frequency value of water.”

“...”

“You can find where glucose is if you fire an electromagnetic wave that matches the frequency of glucose, then track where the intensity of the electromagnetic wave signal of water molecules drops.”

Kim Chun-Jung literally felt like someone had hit the back of her head with a hammer; she felt lightheaded after hearing Young-Joon’s explanation because it was so shocking.

The MRI, which was first invented in 1983, was being used for forty years, but no one had thought of anything like this. The basic way to use it was to fire an electromagnetic wave and measure the wave the body shot out in response. Even if they sent out electromagnetic waves to glucose, the signal that would be generated as a reaction would be very weak. As such, everyone thought something like this was impossible.

However, Young-Joon’s idea right now was to measure the decrease in the electromagnetic wave emitted by the body. He was proposing to measure how the water molecule changed due to glucose since the signal glucose emitted would be too small to measure. It was a simple way of thinking outside the box, but it was shocking.

“How much glucose can you measure with this method?” Kim Chun-Jung asked.

“According to my experiment, I was able to measure glucose levels as low as a micromole (μM),” Young-Joon replied. “I tested it by injecting glucose into a mouse’s veins, and I think it can work in the human body as the metabolic process of glucose is well-known.”

“...”

“Professor Kim, glucose concentrations are usually constant in the body except for the brain, while it is twenty times higher in places where cancer cells are present. If it has metastasized, there will definitely be a spike in the value. I’ll pay for the MRI scan, so please just try it once.”

* * *

Lee Yoon-Ah tensed up a little bit when Young-Joon and Kim Chun-Jung returned to her room. It was because Young-Joon left after discussing something with a serious face and her mother was upset. After predicting a few possibilities based on that situation, she came to the result that she was going to be receiving a very painful treatment.

Lee Yoon-Ah held Kim Hyo-Jin’s hand tightly out of anxiety. However, what Young-Joon handed her was candy.

“Yoon-Ah, do you want some candy?” said Young-Joon as he sat on the edge of her bed.

After hesitating a little, she took the glucose candy that was in his hand. When she paused, Young-Joon said, “You can eat it.”

“... Lemon...”

“Hm?”

“Lemon flavor...” said Lee Yoon-Ah as she pointed to the candy bag that was poking out of Young-Joon’s pocket.

“Oh, you want the lemon one?”

Young-Joon looked for the lemon flavored candy, but ended up giving her the entire bag. This time, Lee Yoon-Ah hesitated because of her mother.

“You can have it,” Kim Hyo-Jin said as she hugged Lee Yoon-Ah’s shoulder tightly. Only then did she relax and open the lemon candy wrapper.

She went to take an MRI after having two pieces of candy, but she didn’t look very scared.

“This one is loud, but I like it because it doesn’t hurt.”

Children were usually terrified of this equipment because of the loud roar when the chiller ran and the feeling of being trapped in a small space. A nine-year-old child who had come to like MRIs after suffering from all kinds of chemotherapy: this situation was ironically pitiful.

With the help of Young-Joon and the MRI operator, Kim Chun-Jung set the frequency of the electromagnetic wave to glucose.

“Lie down over here.”

The MRI operator laid Lee Yoon-Ah down on the table and put a towel under her arm.

“There aren’t any metals on her, right?” the operator checked again out of habit, then started the machine.

The table where the patient was laying went up and moved into the circular magnetic field. Kim Chun-Jung and Young-Joon nervously watched the data screen the operator was taking on their laptop. As the electromagnetic wave was fired, the image appeared on the screen like ripples on water.

The operator of the MRI tracked the signal by moving the image, which was by the millisecond. They put a filter on the intensity of the signal so that decreasing values would be highlighted.

“...”

Kim Chun-Jung’s jaw slowly dropped. A strong red signal was popping out from below the pelvis.

“It metastasized under the pelvis.”

“Hm...”

Kim Chun-Jung groaned like she was in pain.

“Let’s discuss this outside.”

Young-Joon took Kim Chun-Jung outside.

* * *

A million thoughts were racing through Kim Chun-Jung’s head on their way back to her office.

The very first emotion that popped up in her head was a sense of relief. It could have been a big problem if they administered Cellicure at that dosage without having diagnosed the metastasis to the bone.

The by-products of cells destroyed by necrosis, the cancer cell’s destruction mechanism, would be littered in the bone. But immune cells had a tendency to flock to clean up these messes; the bone marrow was also where immune cells were created. If they used Cellicure, the entire bone could be destroyed with a strong inflammatory reaction from the pelvis.

Or, there could be no reaction if the cancer cells already took over the immune system. In that case, the remains from cell necrosis could stick to nearby tissues and spread, causing another side effect. Plus, no one knew what this would bring as Lee Yoon-Ah was a child who still had to grow for a long time; no one could predict the outcome as this was a very unique clinical trial case.

When Kim Chun-Jung reached this conclusion, she relied on Young-Joon again.

‘Maybe he will be able to predict the consequences of Cellicure. Maybe he’ll be able to find the way with the least side effects.’

And when she was close to her office, the small sliver of hope turned into a stronger anticipation. Maybe...

‘Maybe Ryu Young-Joon will be able to cure bone metastasis.’

An effective treatment method for bone metastasis currently didn’t exist. There was a high possibility that even Cellicure wouldn’t be able to fully cure it. Even if it caused a strong inflammatory reaction as it destroys the affected area, including the bone, it wouldn’t be able to completely eliminate the cancer cells. After a few years, the cancer cells would return and grow in the bones. All Cellicure was going to do was prolong the patient’s life until relapse.

However, Young-Joon had cured pancreatic cancer, the most difficult one of them all.

‘Maybe this person can cure bone metastasis.’

Kim Chun-Jung, who began the meeting at her office with a sliver of hope, heard something shocking from Young-Joon.

“It’s a relief,” he said.

“A relief?”

“Since we caught it early.”

“... Can we treat it? Should we use Cellicure?”

“Using Cellicure right now could be a gamble. Let’s leave the liver cancer for a moment. We have to get rid of the cancer cells that spread to the bone.”

“Is there another way?” asked Kim Chun-Jung in desperation.

“What do we have to do?”

“This is also an experimental therapy, but it’s a technique that has gone through Phase Three of clinical trials in the United States. And it is very effective in treating blood cancer or myeloma. It’s a third-generation cancer immunotherapy. Since manipulated immune cells are used to directly remove cancer cells instead of chemicals like Cellicure destroying them, it will be taken care of neatly without the remains of the necrotized cancer cells flowing into the bone marrow.” This was a new cancer immunotherapy that had finished up to Phase Three of its clinical trial in the United States. Kim Chun-Jung’s jaw dropped.

“No way.”

“I bought this technology from Conson & Colson when I went to America. And A-Bio has the best scientists who are able to perform it.”

* * *

Carpentier was a scientist who had succeeded in regenerating bone marrow from stem cells. He was a Nobel Prize recipient and one of the greatest experts in immunology.

He entered the lab and called for Jacob.

“Jacob!”

“Yes?”

“What experiment are you working on right now?”

“I did a cell transfection yesterday, and I am maintaining other cells...”

“Can you go to Sunyoo Hospital right now as technical support?”

“Why?”

“Orders from the CEO. Come with me.”

“Orders from the CEO? What’s going on?”

“You know the Chimeric Antigen Receptor T-Cell Therapy, right? The third generation cancer immunotherapy that Conson & Colson had.”

“Yes. Isn’t that the one that he bought by selling the shares of our cancer lab?”

“We have a patient we have to treat with it. We are going to manipulate a target marker in the patient’s stem cell and make T-cells from it.”

Jacob seemed intrigued.

“Who’s the patient?”

“They have liver cancer, but apparently it metastasized to the bone.”

“Oh... Is it the nine-year-old kid that was on the news? The clinical trial patient for Cellicure?”

Jacob frowned.

“That’s right.”

“Oh...”

“End-stage liver cancer and bone metastasis. It’s the worst, right?”

“It really is.”

“This is the email from the CEO. Take a look.”

Carpentier showed Jacob the email.

[We are going to get rid of the trace amount of cancer cells that have metastasized to the bone with chimeric antigen receptor T-cell therapy, then treat the liver cancer with Cellicure. I think that this patient is past the current boundaries of current medicine, but it is our job to explore that territory.]