Sixth floor, Holiday Inn, Edinburgh: dawn.

I was invited to Edinburgh to give a talk about Merkel cell carcinoma

Edinburgh from Holiday Inn (5)

This skin cancer is more aggressive than melanoma but occurs more rarely.

It occurs more frequently as we age or in people with damaged immunity.  Sometimes it nestles in the same tissue with other cancer types.

Fascinatingly, in 2008, Drs Moore and Chang discovered that Merkel cell carcinoma harbours a novel virus.  Merkel cell polyomavirus turned out to be a common harmless inhabitant on our skin.  It gets into the predecessor of the cancer cell by an unhappy accident, perhaps helped by ultraviolet light.  When it does so, it is crippled, no longer able to make new viral progeny, forever integrated in stunted form in the cellular DNA. It encodes four genes and makes just six proteins.   Just one of these genes, mutated and truncated, contributes to the cancer.  The virus subverts its hosting cell but is itself subverted to drive and shape an evolving cancer.

Cancer is complex, driven by a myriad of dysfunctional and  repurposed pathways.  How do you break the Enigma, the encrypted cipher, the code of the Merkel cell carcinoma?  We need a crib or key: a simple message we already understand as a way in.  Merkel cell polyomavirus provides us with that key.