Talking blood cancers with Dr. Zohar Sachs

What are blood cancers? We sat down with MCC’s Zohar Sachs, MD, PhD to chat about all things blood cancers from signs and symptoms, to research happening here at the University of Minnesota. Dr. Sachs, alongside Taylor Kadlac and Kevin Jansen, was a special expert guest at our September Fireside Chat—watch the video recording from the event. 

What is your educational background? What intrigued you about your field of specialty, and what brought you to the University of Minnesota?

For college, I attended the Massachusetts Institute of Technology where I majored in engineering. I liked being able to define everything according to precise measurements and predict outcomes using mathematical equations, but I also felt that I wanted to do something that was more closely tied to people and the human experience. After college, I enrolled in the Medical Scientist Training Program at Tufts Medical School to earn an MD/PhD dual degree. This training allowed me to practice medicine (in other words directly take care of sick people) and to do scientific research that would impact the field of medicine. The University of Minnesota has a thriving cancer center, which allows me to continue my work in oncology: the field of medicine that needs the most intense care and where scientific discoveries are having the most impact these days.

What are blood cancers and how are they typically diagnosed?

Blood cancers happen when the cells that typically help create normal blood components do not develop normally. These immature blood precursors also reproduce too much, leading to too many of them. These excessive cells can form tumors that cause problems because of where they are growing, or they can cause problems because they can interfere with normal blood production. Interference with normal blood production can cause anemia (due to insufficient red blood cells, the oxygen-carrying cells), bleeding (due to insufficient platelets, the clot-forming cells), and infections (due to insufficient immune cells). Blood cancers can be diagnosed from the blood sometimes, but often we need a biopsy. The biopsy may have to come from a tumor (if there is one) or from the bone marrow, which is where blood is produced and where a lot of blood cancers originate.

Are there any preventative measures that people can take against getting blood cancers? 

I wish I knew! Seriously, most blood cancers do not have a known or preventable cause. Or, they have a known cause that is hard to avoid. However, there are a few things everyone can do to reduce their risk of blood cancers. Smoking increases blood cancer risk. There are a few environmental exposures, such as toxins from certain manufacturing and factory processes that also increase the risk of blood cancer, so good practices regarding ventilation, masks, and protective clothing are important. Other causes of blood cancers are harder to avoid. For example, chemotherapy and radiation therapy, given as a treatment for other cancers, increases the risk of blood cancers. Interestingly, there is evidence that growing up in overly-clean environments can increase the risk of some blood cancers! Therefore, early exposure to dirt during one’s childhood may be beneficial.

What health disparities exist regarding blood cancers?

There are so many at every step of the way. Early diagnosis and intervention are critical to good outcomes, so having a good relationship with one’s primary care provider is essential. The treatments are very expensive and even more time-consuming, so people need both good insurance and a lot of flexible time and social support to receive the treatments. Blood cancer treatment relies heavily on clinical trials, which can be historically off-putting to medically under-served populations who, because of past injustices, can see these trials as exploitative—something we are working to repair. Finally, people who are not well-represented in clinical research are also not well-represented in designing effective assays—or analytical processes—and treatments for these.

How is your research at the Masonic Cancer Center advancing understanding of blood cancers and how we prevent/diagnose/treat them?

My research is focused on a type of blood cancer that is both rapidly and inevitably fatal, called acute myeloid leukemia (we call it “AML”) with mutations in the gene, TP53. My lab is using the latest technological advances to understand what makes this type of AML so resistant to treatment. These latest technological advances make heavy use of my early training as an engineer. So far, our work revealed a possible answer to this question and, most importantly, a drug that could potentially work in this AML subtype. We are working to develop this discovery into a clinical trial. In addition, we are trying to understand how this type of leukemia develops and how we might be able to stop it from developing. Finally, we are developing a clinical assay—or analytical process—to help us identify patients whose leukemia behaves as if it has a mutation in TP53; these are patients who do not actually have this mutation but whose leukemia ends up progressing rapidly as well as if it did have the mutation).