Distanced from the clamour and frenzy of city streets, the wooded hillock at Poojapura is quite the idyllic heaven for research. For over two decades now, the Rajiv Gandhi Centre for Biotechnology (RGCB) situated in Thiruvananthapuram, has been at the frontier of research in life sciences. Leading the cancer research programme of the institute is its director Dr. Radhakrishna Pillai. A man of peaceful disposition, Dr. Pillai’s sparkling smile outstrips his long and enduring fight against a formidable foe; a disease which author Siddhartha Mukherjee so metaphorically described in his Pulitzer Prize-winning book as the ‘Emperor of all Maladies’.
“Cancer is not a single disease,” explains Dr. Pillai. “It is a result of an otherwise well-regulated processes in the body going out of control. It manifests from the interplay between the body’s fundamental genetic features and the environment.”
The external triggers are often lifestyle habits such as use of tobacco, alcohol or exposure to chemicals that are carcinogens. Underscoring cancer’s genetic roots are findings that it runs in families and in ethnic groups. For example, the Parsi community in India has a high susceptibility to cancer. This is due to a certain gene mutation in their population. Parsis have, for generations, avoided marrying from outside the community, resulting in the spread of the mutated gene within the community,” he adds.
The absence of a genetic predisposition does not completely eliminate the risk either. “For example, we have a phenomenon called epigenetics, which is the modification of genes by an external agent such as a virus or a pesticide. An example is the human papilloma virus, sexually transmitted and identified as the source of cervical cancer in women. The virus may not do it directly; it may cause something else within the body to harm the cells. The pathways are multiple. This makes it really difficult to predict the risk of getting cancer,” explains Dr. Pillai.
Epidemiological data of the last five years shows a rising incidence of cancer in the urban population. In Kerala, the most common type of cancer among women today is breast cancer. The trend is similar to those in big cities in India and western countries. Dr. Pillai explains its close links to changes in dietary pattern on account of our changing lifestyles. “We are shifting from healthy eating habits to fast food which is high in fat. Fat produces estrogen, the female hormone, and a high level of estrogen is what drives the growth of breast cancer cells. Normal cells in a test tube when immersed in estrogen turn malignant. You can imagine the same happening to the body.” Pesticides in food can pose similar risks. “Precocious puberty in girls, a condition now common in cities, is the likely result of pesticide excess in the food that we eat. The chemicals in the pesticides mimic estrogen, tricking the body into a display of early signs of puberty,” he says.
Before taking over the reins of RGCB, Dr. Pillai had a long tenure at the Regional Cancer Centre (RCC) in the city, where he earned his doctorate in oncology under Dr. Krishnan Nair, the founder-director of RCC. Even before his PhD was in hand, he left the shores. “I did post-doctoral training at the University of Arizona, looking at the effects of drugs on the immune system.” Later he returned to RCC, in between he completed a fellowship in pathology in London.
Dr. Pillai feels that to do good cancer research it is essential to bridge the gap between reality and research.
“Clinical exposure is crucial for any scientist working in this field. Programming cell death in a test tube is a first minor step. It is the patient’s agony you have to cure”.
Lately, along with collaborators at the cancer centre, Dr. Pillai has been examining the use of Ayurveda drugs as support medicines for cancer treatment. A study they have just finished looks into the clinical benefits of an Ayurveda-based mouthwash for a condition called radiation induced mucositis.
“The radiation therapy given for oral cancer burns the entire mouth. Very often the treatment has to be suspended mid-way because of this. The Ayurveda physician at RCC tested out this compound with patients who were undergoing radiation therapy. The results are remarkable. The pain was regulated within weeks; infection rates were considerably lower and there was no need for antibiotics.”
Dr. Pillai and his team have also explored the healing qualities of turmeric. “Curcumin is the compound that gives turmeric its yellow colour. It works wonders in the lab. We have published a lot of papers from here as well as other institutes based on the lab results. What glaringly stands out is that turmeric has been part of our diet forever, and yet the rate of incidence of cancer in India is on a par with anywhere else. There is more to the story than we understand. We are now compiling results from a clinical study that looks at what happens to curcumin once it enters the body.”
Cancer research is a field where failures are frequent; most breakthroughs in the lab breakdown when tried on patients.
“It is more or less a given. Cancer has been around for a long time, it is better evolved than any of our quick fixes,” says Dr. Pillai. As a scientist how does he cope with that level of failure? “I see failure as a stepping-stone. It gives you a second opportunity to think in a better, wiser way.”
What guided you to a career in science?
The way science was taught to me from an early age was crucial to my decision. My school education was in Africa. Science was all project based. Our teachers would spend hours with us in the laboratory helping us with our work. Similar experiences later in the early 1980s, at University College in the city and at the Royal College in London were strong foundation builders for a science career. Back in those days we used to read a lot of books for developing our ideas. RGCB has an excellent library with the best of classic science books but I rarely see students spending time there. I worry whether the present culture of rummaging through the internet for quick answers is the reason for it.
Early detection is the key
“Despite its popular image of being an all consuming illness, the truth is, most cancers can be cured or sent into remission. The key to it is early detection. The standard advice is for men and women above the age of 40 to get a check-up done once in two years.”
