Nerve-wrecking: ‘New way of attacking cancer’

Sanford Health's Paola Vermeer hopes to slow cancer by disrupting nerves

nerves on cancer: Sanford Health Dr. Paola Vermeer in her lab at Sanford Research

Two top science publications recently featured a Sanford Health researcher because of her promising, unique approach of understanding the impact of nerves on cancer growth.

“It’s introducing an entirely new way of attacking cancer, a way that people are just now starting to look at and think about,” Patrick Kelly, M.D., said of the work by Paola Vermeer, Ph.D. “Historically, we’ve attacked cancer by killing cells. The problem is we kill cancer cells and our healthy cells too. But the thought here is that we might be able to attack cancer by silencing tumor-infiltrating nerves.”

Dr. Vermeer is a principal investigator and assistant scientist in the Cancer Biology and Immunotherapy Group at Sanford Research. She and Dr. Kelly are among more than 50 inventors at Sanford Health who develop and test new approaches to medicine that help patients. Science Magazine and Cancer Discovery published interviews with Dr. Vermeer about her work with nerves in cancer.

In the body, cancer cells manipulate and change healthy cells and the environment around them. Tumors can reroute blood vessels, dampen an immune response and connect with the nervous system. All these cancer-induced changes are aimed to ultimately promote the survival and spread of cancer.

“When I first found out there were nerves in tumors, I was intrigued because that brings another element into cancer research that I didn’t know was there,” Dr. Vermeer said. “Clinically, physicians have known for a long time that patients with highly innervated tumors do worse — a lot worse — than those that have less innervated disease. I wanted to understand why that was so. Can we understand this process and define how it contributes to disease progression? If we can understand how and why tumors induce their own innervation, we can potentially use this information to design new therapeutics, or utilize existing ones, to help patients.”

‘A lethal disease’

Dr. Vermeer spends every day focused on helping cancer patients behind the scenes. As a researcher, she tries to better understand the process behind metastatic cancer.

Metastatic cancer is when a cancer spreads from its primary location to a new area of the body. Yet despite being the main cause of cancer death, little is understood about the molecular mechanisms causing metastasis. She has concentrated on learning how tumor cells change themselves as well as their environment during the metastatic process. She is now focusing on how tumor-infiltrating nerves may contribute to metastasis. While the density of nerves is different for each person and each type of cancer, Dr. Vermeer has found that ovarian and prostate tumors are especially infiltrated with nerves.

“We’ve homed in on ovarian cancer because it’s such a lethal disease and we feel that the nerves are contributing to the aggressive nature of these tumors. Therefore, we want to understand it better,” Dr. Vermeer said. “There could be a physiological effect of nerves on tumor growth. Silence the nerves and you may slow or even stop tumor growth. This is one aspect of tumor innervation that we are trying to define.”

Dr. Kelly, a vascular surgeon and executive director of commercialization at Sanford Health, said it’s too early to know what impact Dr. Vermeer’s work will have. But it’s promising, and she’s on the leading edge.

“It’s an emerging field in cancer research,” he said. “I can tell you it won’t be the be-all, end-all for cancer therapy. But it’s one more potentially major treatment for cancer that Pay is a thought leader on. She’s getting in at the ground floor of this. It’s pretty exciting stuff for Pay and for Sanford Health.”

Helping patients truly live

Currently, Dr. Vermeer is in the early bench, or basic, research stage. Her ultimate goal is to develop new therapeutic interventions and approaches leading to clinical trials.

“My vision as a scientist has always been translational. This means you take what you learn from the bench, that is the molecular underpinnings of a disease process, and bring that to patients by utilizing this knowledge to develop treatments which go to the clinic. We are always thinking: What have we learned and how can we apply this knowledge and help patients?” she said.

Dr. Vermeer also studies head and neck squamous cell carcinoma. “Because head and neck cancers occur in your oral cavity, patients often become unable to speak drink, eat or even swallow. Human beings are very social. Much of our interactions occur around the kitchen table, eating, drinking and talking. This gets very much compromised for head and neck cancer patients. That’s one of the reasons we have focused on this type of cancer. Simply put, we have to do better for these patients.”

Dr. Vermeer is just as passionate at impacting cancer care for ovarian cancer patients. Losing her college roommate to the disease fuels her fire even more to make a difference for these patients. Today, ovarian cancer is an almost universally fatal disease. Dr. Vermeer works for and hopes that in the near future it no longer will be.

This story was originally published on Nov. 5, 2018, and was updated on Oct. 23, 2019.

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Posted In Cancer, Health Care Heroes, Health Information, Innovations, Research

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