Timing cancer treatment, growing tomatoes, Miami visit
Health: Cancer treatment efficacy depends on time of administration. Travel: Miami Vibes. Life: Growing Tomatoes.
Health: Cancer treatment efficacy depends on time of administration
Travel: Miami Vibes
Life: Growing Tomatoes
Health: An overview of pain and a new medication (New Yorker)
Climate: Coal use still high (FT)
Climate: Ocean carbon removal credits
Theatre: My friend Jane Bodie’s play: Company of trees
Links: Bending the Arc magazine; London Climate Week; Saloni podcast on HIV drugs; admin of novel writing; Japan land planning. Next meet-up pencilled in for Mon, 28 July - Theatre Deli. Note date.
This month, I’ve been to Miami; been deep in thinking about healthcare innovations, and growing tomatoes.
One advance which is intriguing and potentially very valuable is on the timing of cancer treatment. The big global cancer conference is ASCO and it just happened end of last month. Lots of advances, but this one on chronotherapy stood out.
Chronotherapy explores how our body’s internal clock — the circadian rhythm — affects how we respond to medications. Scientists have long known that the immune system is more active at certain times of day. And historic studies have hinted at drug timing being important, but it has not been studied prospectively in controlled trials much.
This study showed that lung cancer patients who received chemotherapy and immunotherapy in the morning lived significantly longer than those treated later in the day. Patients treated before 3pm lived nearly 14 months longer on average, and their cancers took longer to progress.
This effect is so large that I think it might well change practice guidelines and, certainly, if it was me, I would immediately change to this protocol. A few details for the science-minded.
Study design is good:
Randomized controlled trial (RCT) — the gold standard for clinical research.
Large enough sample size: n = 210 patients with advanced NSCLC (non–small-cell lung cancer).
Stratified randomization: Controlled for age, sex, PD-L1 expression, ECOG status, and other key variables.
Parallel-arm design: Patients were assigned to morning (before 3 pm) vs. afternoon (after 3 pm) immunotherapy–chemotherapy infusions.
(Sometimes a small n means you would be cautious.)
Results are really quite large effects.
Progression-Free Survival (PFS):~13.2 months (morning) vs. ~6.5 months (afternoon) (Overall survival trends also looks be significant but haven’t been reached in treatment group!) Consistent benefit across subgroups: Benefit held across PD-L1 levels, age groups, sexes, and performance status.
This effect is similar or larger than what the introduction of some new therapies have achieved.
Biology mechanism is strong. Immune function (e.g., T cell trafficking, cytokine release) is circadian-regulated. Prior preclinical studies and small trials have shown timing-dependent responses to cancer therapies. Chronotherapy has precedent in colorectal cancer and leukemia. But, this study is the first large RCT in lung cancer to test this hypothesis directly. It builds on dozens of circadian biology papers showing immune function peaks earlier in the day.
(Slight note of caution:
Single-country majority recruitment: Most patients were from China. Generalizability to Western populations remains to be fully tested.
Implementation challenges: Logistics of early-morning treatment slots for large oncology centers could be difficult.
Not yet peer-reviewed: Abstracts are not full publications. Awaiting full data and peer-reviewed publication.
I am not your doctor - caveats please etc etc. - but this looks very intriguing and important result. But I hear this was very well received at ASCO. Write up is here. And Abstract is here.
I was in Miami for a healthcare conference. In my small amount of free time, I went to Little Havana and Wynward walls.
I was struck by the contrast between the authentic and the curated there. Off the main parts, I found genuine glimpses of local life. One of the local domino parks had —older people chatting over domino deep in conversation and some of the restaurants had family gatherings. But on balance —about 60% of what I saw seemed designed for tourists: souvenir shops, themed cafes, and a vibe that would appeal to the tourist. Not necessarily bad - maybe the Notting Hill of London tends towards the same (much to the chagrin of locals). Still, the warmth of the Latino (especially Cuban) culture came through, even if packaged at times for visitors like me.
Public transport is still poor. What would be a 10 or 15 min Uber ride, would be 50 minutes on the bus. So I did Uber over to Wynward.
Wynwood and its now‑famous “Wynwood Walls” began life as a humble industrial enclave—warehouses, factories and a tight-knit, working‑class community—later dubbed “Little San Juan” as Puerto Rican, Cuban, Dominican and Haitian families settled there. The early 2000s brought an influx of artists who converted derelict buildings and blank walls into vibrant open‑air canvases, giving rise to a grassroots cultural scene organized by local art associations.
In 2009, property‑developer Tony Goldman formalized this creative energy with the Wynwood Walls: transforming the neighborhood core into a curated outdoor art park of global renown. (I think his son spotted the potential and Goldman bought a lot of cheap property in the area…in 2005, Joey discovered the gritty warehouse area and persuaded his father to invest. The family began acquiring properties and by 2007 they had purchased the six buildings that serve as the core of what became Wynwood Walls). Wynwood gentrified. Galleries and cheaper cafés gave way to condos, craft bars, boutiques. Rents are up. While the Walls remain a spectacular display, critics argue that this “urban revitalization” has also displaced original residents and diminished the area’s gritty, authentic character.
There is pushback. Cultural critics and some long-time locals lament that what began as vibrant street‑level creativity has morphed into a polished, tourist‑friendly façade—a development strategy rather than a community endeavor. Some accuse the Walls of being part of a “colonization” of space, where aesthetic appeal masks social displacement .Today, Wynwood is a paradox: a glitzy arts destination with spectacular murals and lively nightlife, yet one where rising rents and luxury developments challenge its working‑class history and cultural roots.
Still. I think on balance this has been a positive case for art and creativity-based rejuvenation of an area. The walls and the art there - though you can argue for the glitz or the chi chi - is worth a visit. Perhaps like Little Havanna it’s mix between the local and the tourist.
My favourite restaurant experience while in Miami was a cuban diner near South Beach, so good for its diner vibe as a solo traveller - I went twice for coffee and a cubano. I have a draft essay on it, which I will share later. In the meantime, if you want a throw back and are in the area. Try it - Puerto Sagua
Chef Michelle Berstein said this in the FT:
One of the city’s oldest and most traditional Cuban restaurants happens to be on South Beach. For me, Puerto Sagua’s food has always been something that vuelve a la vida (brings you back to life). Everything is delicious, affordable and you never know who might be sitting at the counter sipping on a café con leche or digging into the ropa vieja (beef and tomato stew). It’s old school, and I love that it doesn’t change (aesthetically or deliciously). I always get the fish soup; they specialise in seafood, but you can’t really go wrong. Stick to the classics as they are the best. puertosagua.org (700 Collins Av)
Growing Latah Tomatoes. I am hoping to grow a tomato from seed. I have done this before although I am trepidatious about announcing this intention before the outcome. This sentence, this tiny pronouncement is a commitment in words. Yet there is a lingering unease in a saying before a doing. ¶
I recall as a child buying a plastic yellow grow-bag. Heavy enough that I would pause before generating the effort to lug the bag and its soil into position. In those days—1980s London suburbia—there was a local hardware store. The store sold the paraphernalia of homewares. More expensive than the larger depots and garden centres but under a 10-minute walk away. A seemingly long walk with a grow bag. I managed to grow tomatoes, not enough to be remarkable, yet full of the small joy of nurture and care. ¶
The day I pronounced my engagement, I bought tomatoes. I made a commitment in thought and words, and symbol, my own hand-carved cedar wood ring adorned with a Sri Lankan shell - scavenged together - and a deed, of cooking dinner. The tomatoes were part of dinner ingredients bought from a specialist grocer off the Marylebone Road. Small, sweet and tangy; floral aroma. I saved the seed. ¶
For a few seasons, I grew those tomatoes from seed. Then I stopped. There was no grand metaphor on life for this. If this were a fiction story - the pause - would be a neat foreshadowing. The set-up of the story might suggest this. How there was no longer time for the small caring of a plant. How there was little space to grow. This is non-fiction. Strange, we call our lived reality as non-something - non-sense - non-consequential - non-fiction as the counterpoint to fiction. Lived experience both stranger than fiction and less strange. There is no crisp foreshadowing. Simply, I did not try many times. One time, I left the seeds too long and they rotted. Another time, the jar was accidently thrown away. Then there were no more seeds. We ate the tomatoes. And, little yes, I seemingly had less time for gardening, less space, less energy. I’d like to think that time went into being with children and the family.
I wish to show my children growing vegetables and to invite them to be with me in decisions we make. I’ve always attended to this to a degree but I found myself these last few weeks with a small feeling to make a plant grow again. ¶n defiance of politicians, in defiance of squirrels, in defiance of weather be that storms, drought or heat.
The history of the tomato plant has been disputed and re-written over the modern decades. This seems to happen with much of human history. Göbekli Tepe, in Turkey, re-defined in the 1990s what we thought we knew about early (9600 BCE) human civilization. Footprints at White Sands, New Mexico (dated to 22,000 years ago) and possibly stone tools at the Chiquihuite Cave, Mexico have re-drawn when we think humans were in the Americas. ¶
Scientists now believe that tomato domestication was not a single simple event. Instead of a straight shift from wild to farmed, the tomato went through multiple stages moving from wild to semi-domesticated before fully domesticated. To give the tomato a road trip, the wild tomato started 80,000 years ago around Ecuador and Peru. These were semi-domesticated about 8,000 years ago and then later these semi-wild forms came to the Mexico area where they fully domesticated about 3,000 years ago. ¶
The global spread of the tomato is an example of the Columbian Exchange. After Cortes’ conquest of the Aztecs, the Spanish brought tomato seeds to Spain in the early 1500s. By the 1540s, tomatoes were growing in Spain and Italy. Initially there was caution from Europeans as many thought tomatoes resembled poisonous nightshade plants. In the 1600 and 1700s Italy fully embraced tomatoes especially starring in stews and sauces and it spread into Europe. Later, Portugal in particular helped spread the tomato to India and Asia. ¶
Although original native to the Americas, North America did not widely cultivate tomatoes again until after they arrived back from Europe with Thomas Jefferson supposedly championing them in America. ¶
The tomato seed I bought this week is called Latah. The Latah tomato was developed at the University of Idaho in Latah County in the 1970s to 1980s and released for home growers for cool climates and short growing seasons. The Latah is not grown commercially as the fruits are fragile and the yields more modest compared to commercial hybrids. ¶
I hope the seeds sprout. If I can grow this tomato, in part, it will touch on human history, local adaption, time and love and care; in part to my mind, a tiny act of defiance - and in part perhaps most importantly a tasty fruit*1. ¶
On Pain:
Pain might flicker, flash, prickle, drill, lancinate, pinch, cramp, tug, scald, sear, or itch. It might be blinding, or gruelling, or annoying, and it might, additionally, radiate, squeeze, or tear with an intensity that is mild, distressing, or excruciating. Yet understanding someone else’s pain is like understanding another person’s dream. The dreamer searches out the right words to communicate it; the words are always insufficient and imprecise.
Suzetrigine, sold as Journavx, takes a new approach, avoiding opioid sensors in the brain; instead, it cuts off pain before it even gets there. Rivka Galchen for New Yorker.
FT on Coal:
“Today the world burns nearly double the amount of coal that it did in 2000 — and four times the amount it did in 1950. Every minute of every day, 16,700 tonnes of coal are excavated from the ground — enough to fill seven Olympic swimming pools. …”
FT report (Gated, but I can send copies if you are out of free ones)
Planetary Tech develops carbon removal credit via Ocean Alkalinity enhancement:
“Planetary, in collaboration with Isometric and 350Solutions, has officially delivered the first-ever independently verified carbon removal credits from Ocean Alkalinity Enhancement (OAE). These credits, totaling 625.6 tonnes of CO₂ removed, were generated at our project site in Halifax, Nova Scotia, and purchased by Stripe, Shopify, and British Airways.
This achievement demonstrates that OAE can be done safely, scientifically, measurably, and alongside community.
What Are OAE Credits and Why Do They Matter?
Ocean Alkalinity Enhancement is a climate solution that restores the ocean’s natural ability to absorb carbon dioxide from the atmosphere. By adding finely ground, naturally alkaline minerals to coastal waters, OAE restores and accelerates one of the critical geochemical processes that has been regulating Earth’s climate for millions of years.
This process reduces ocean acidity and triggers a chain reaction: as excess carbonic acid in the water is neutralized, the ocean draws down more CO₂ from the air to rebalance. The result is long-term carbon removal stored as stable bicarbonates in the ocean for tens of thousands of years.
Until now, no one has issued verified OAE credits….”
Reader Laura Baggaley writes in about her new project:
Bending The Arc: a Thrutopia Magazine — publishing stories, poems and articles that bend the arc of the possible towards a thriving future on Earth.
Each edition of this magazine explores ways through to positive futures, with a cycle of pieces in different genres and styles by writers from assorted backgrounds and writing traditions. The first edition features academic Rupert Read, bestselling author Manda Scott, award-winning science fiction writer Emma Newman, poets Jane Burn and Angela Cleland, and many more.
We tackle the dark and difficult challenges of the present day in a spirit of stubborn optimism. Check it out here!
In London theatre. The Company of Trees by Jane Bodie Wed 25 June
When new girl Willow moves into town, the popular gang at school don’t welcome her. But when gang leader, Taylor, has a spectacular gymnastic accident, leaving her bed-bound, her once loyal gang, begin to drop away.
Enter Willow, to share Taylor’s solitude, teach her about trees and poems that don’t rhyme and Taylor begins to heal.
A play about bullying, bravery, the power of nature, finding friendship, loneliness and Hanoi the giant tortoise.
Climate Week in London. Lots of things happening. Can check out things here.
Japan land planning. Japan faced some of the world’s toughest planning problems. It solved them by letting homeowners replan whole neighborhoods privately by supermajority vote.
Land readjustment of one kind or another accounts for 30 percent of Japan’s urban land, 12,500 kilometers of city road, 150 square kilometers of urban park (half the country’s total area of community, neighborhood and district parks), and 1,000 station plazas.
When I first started writing my silly little novel, it was a desperate attempt to escape the demands of what we call “real life.” A pragmatic job? Burgeoning adult responsibilities? I graciously declined the offer. Raised by a single-salary single mum, I saw the tiring routines of being a teacher, nurse or midwife. Now I watched with horror as my friends went off to build those same careers. Not me!
I had been writing since I was a child, mostly to turn away from the actual world and into one of my own making. I kept up this escapist pretense well into my early 20s, which is when I decided to turn my pastime into an actual book. Never mind “making a living.” I am a writer, thank you very much — I have a creative vocation. Being from a low-income family allowed me to milk various grants; between those and my retail job (I was a vicious time thief, scribbling notes under the desk as customers waited), the finances could work. I sat down and began.
I wrote and wrote, falling into a delirious state, the IV drip of my imagination funneling uninhibited into what I was sure was the next “Middlemarch.” In every spare hour, I typed ecstatically … until … things sort of halted.
… in NYT Mag.
Lenacapavir is a new HIV drug that blocks infections with an efficacy rate of nearly 100%, and it could completely change the fight against HIV worldwide. Saloni and Jacob talk about the development and prospects for this new drug, as well as the history of HIV, the initial discovery of retroviruses, and how HIV was transformed from a death sentence to a manageable condition.
Thanks for reading!
*Botanically, tomatoes are fruits because they develop from the ovary of a flower and contain seeds. More specifically, they are berries (like grapes). But, in the USA, legally for tariff tax and custom purposes they are classified as a vegetable. This US legal vegetable classification was codified in 1893 at the US Supreme Court (Nix v Hedden) where although the court agreed they are fruits botanically, for legal purposes they should be a vegetable as they usually served with the main part of the meal, not as dessert.
Brilliant read, as always!