The state's three research universities are putting aside old rivalries to fight a brutal enemy feared by rich and poor, black and white, male and female South Carolinians.

It's cancer, and merely treating the disease is not what these researchers have in mind. They want to use the emerging science of chemoprevention to discover, test and market methods that might keep you from getting cancer in the first place.

"Already this new science is crossing the frontier into patient care," said Mike Wargovich, professor of pathology at the University of South Carolina's medical school.

If you take saw palmetto for prostate health, calcium to ward off colon cancer or echinacea to boost your immune system, you're dabbling in chemoprevention already.

There's keen interest in these "natural" remedies in South Carolina though synthetic sources of cancer solutions are being sought, as well.

Just as feverfew is promoted for migraines and valerian as a sleep aid, some natural supplements are touted for cancer prevention. But it's hard for consumers to know whether a particular product is pure, let alone whether it works.

In parallel research projects, scientists at USC, Clemson University and the Medical University of South Carolina plan to isolate cancer-fighting compounds, test them for effectiveness and even cultivate some of the products in S.C. soil.

Five years from now, there could be a homegrown line of natural remedies with a brand name like "Palmetto Gold."

"What we would like to do is develop a Carolina brand ‘.‘.‘. which would be recognized by the industry as a superior product," said J. David Gangemi, professor of microbiology and molecular medicine at Clemson.

Among goals that extend from test tubes to tobacco fields, here are some scenarios:

- At Clemson, scientist Lyn Larcom has found the tasty little raspberry contains powerful compounds that can help the body fight cancer and skin aging. Meanwhile, Clemson agricultural specialists say the soil that produces those oh-so-evil tobacco plants also is ideal for growing some of the oh-so-trendy herbal remedies increasingly sought by consumers.

- At USC, Wargovich is studying whether the anti-inflammatory qualities of curcumin, which comes from the root spice turmeric, might prevent colon cancer. And USC's Arnold School of Public Health expects to be a bridge between laboratory and community, educating health professionals and the public on which remedies work.

- At MUSC in Charleston, researchers are trying to zero in on the places where nutrition and cancer prevention intersect. For example, Thomas Walle, a professor of pharmacology, is working with bioflavonoids found in apples, onions, tea and red wine, among other things. He hopes they can help prevent, detect and fight hard-to-treat cancers of the head and neck, for which the state's death rate is second in the nation.

Cancer research is being done all over the world, of course. What S.C. researchers find particularly promising are efforts to meld the strengths of all three institutions into a savvy approach that benefits patients and, by the way, brings in research money.

"Agencies handing out grants really like collaborative research," said James Chapman of USC, an associate professor of medical chemistry and co-founder with Wargovich of the South Carolina Alliance for Cancer Chemoprevention.

"We want to unite the researchers in the state and put ourselves in a strong competitive position for the grant dollars that exist," Chapman said.

WHAT IS CHEMOPREVENTION?

The science of chemoprevention is about 20 years old.

Yet in a way, chemoprevention has been around since people figured out they could chew on a root or brew a plant and get relief from symptoms such as pain. An agent for chemoprevention can be a complex as a multisyllabic, synthetic chemical compound or as simple as a stalk of broccoli.

Finding new uses for old medicines is another key element in cancer chemoprevention. The most recent and much celebrated example is last week's news from the 10-year Prostate Cancer Prevention Trial, for which Palmetto Health's S.C. Cancer Center was a study site.

That study found finasteride -- a synthetic compound already prescribed as Proscar for prostate enlargement and Propecia for male-pattern baldness -- reduced the risk of prostate cancer by almost 25 percent.

But when he spoke to Alliance members in March at USC, Vernon Steele of the National Cancer Institute lamented that he can count on one hand the cancer chemoprevention drugs that have been approved.

The best-known is tamoxifen, used to prevent breast cancer in high-risk patients.

Ideas for chemoprevention come from plant samples sent to scientists from anywhere in the world, searches of scientific literature or suggestions from scientists and pharmaceutical companies. The National Institutes of Health has a new center with a $100 million budget for doing clinical trials in chemoprevention -- testing, for example, whether shark cartilage could help prevent lung cancer.

While some chemoprevention agents end up on store shelves with the vitamins, others from natural and synthetic sources are developed into prescription drugs.

Seven years may pass between the discovery of a possible chemoprevention substance and approval by the Food and Drug Administration. The substance is examined in laboratory cell cultures to test properties such as tumor-fighting ability. Then it is tested in animals, usually rodents.

The animal stage is not as simple as, say, giving a mouse a pill to prevent skin cancer and putting him in a tiny tanning bed to see what happens. For some cancers -- brain cancer, for example -- there is no good animal model.

Then there are other complications. Say, for instance, that a drug for breast cancer is tested in rats. The formulation creates a bad taste in the rats' mouths and they eat less. They don't complain, but they lose weight.

So when the study shows a decreased rate of breast cancer, what is the reason? Was it the medicine? Or did reduced body fat cut the rats' rate of cancer?

After wrestling with problems like this, researchers design clinical trials for humans. The high rates of several types of cancers in South Carolina mean there should be ample volunteers for these studies.

The state's almost 30 percent black population also is a plus. Researchers hope to zero in on troubling public health issues such as the higher rates of some cancers in minorities.

A prime example, Wargovich said, is that "black women tend to get earlier, more aggressive breast cancer and we don't know why."

UNIVERSITIES ALL HAVE ROLES

All three universities are involved in basic medical research -- think petri dishes and test tubes. But for collaborating on cancer chemoprevention, each has additional, specific roles and opportunities.

- Clemson's traditional expertise in agriculture makes it a logical venue for hands-in-the-dirt research and products-for-the-store development.

Work in botany and biotechnology aims to find ways to purify and standardize natural remedies. A product that claims to have the active ingredient in saw palmetto should be just as dependable as aspirin. "There's a lot of snake oil out there," Gangemi said.

Nutraceutical Center, of which Gangemi is executive director, aims to identify, refine and market plant-based remedies that can substitute for tobacco crops and help the state's rural economy.

Examples of promising herbals are valerian, touted for sleep disorders, and feverfew, touted for migraines. Another is echinacea, used by many to boost their immune systems. "They grow very well in the tobacco belt," Gangemi said.

For cancer chemoprevention, an exciting possibility may be taking shape in the laboratory of Clemson's Dwight Camper, who has been working with echinacea.

"There's some evidence for anti-tumor activity," said Camper, a professor of plant pathology and physiology.

He said he definitely can envision his work with echinacea leading to a cancer chemoprevention project on which the three universities would collaborate.

There's also a role for Clemson entomologists such as Merle Shepard. Watching over a field of echinacea at Clemson's Coastal Research and Education Center in Charleston, Shepard is working on ways to control insect pests.

"No one wants to take a natural remedy with pesticide on it," he observed.

- USC, with its medical school, will work in training and research, adding research faculty who can mentor young scientists. Grants are being sought to pay for student and postgraduate fellows to work in cancer prevention.

The plan is to concentrate on colon and breast cancers, both among the top five causes of cancer deaths in the state.

Chapman's special interest is finding new uses for existing drugs. For instance, Susan Fischer of the University of Texas -- who addressed the S.C. chemoprevention group's March meeting -- has found that the arthritis drug Celebrex also fights sun-induced cancer in rodents.

Nonsteroidal anti-inflammatory drugs (NSAIDs) show great promise because inflammation can be a component of so many ailments, including cancer. "We're finding that NSAIDs are good for a lot of things," Chapman said.

Wargovich is fascinated with finding cures from nature. When he went to Africa recently with his wife, a breast cancer epidemiologist, he sought out experts on traditional folk cures such as using African basil to treat inflammation.

USC's Arnold School of Public Health will provide networking and training for health professionals.

"As doctors learn more, they will incorporate more chemo-prevention into their advice to patients," Wargovich said.

The public also will need information on the risks of natural products and chemoprevention, Wargovich and Chapman said.

"Natural" doesn't necessarily mean "safe." Substances from nature can have potentially dangerous side effects and can interfere with other medications, which doctors and patients need to be aware of.

- MUSC is expected to build on its capabilities for bringing experimental treatments to people who desperately need them.

Well-designed clinical trials in humans will be necessary for any cancer chemoprevention methods to make it from the field and lab to the pharmacy.

MUSC's Walle is close to starting human studies with the bioflavonoids, found in apples, onions, tea and red wine, said Steven Rosenzweig, associate director for basic science research at the Hollings Cancer Center. Another researcher is studying antioxidants, which are found in fruits and vegetables, as a source of chemoprevention for blood cancers.

MUSC also is in the process of seeking National Cancer Institute designation for the Hollings center, an accolade that provides more money for taking research "from the bench to the bedside," Rosenzweig said.

The submission to the Cancer Institute is planned for 2005. The designation would be the first among S.C. cancer centers. (There are two designated centers in North Carolina, two in Tennessee, one in Florida and none in Georgia.)

Upon approval, "we become a magnet for attracting individuals who are interested in doing cancer research, and more importantly, cancer patients interested in receiving treatment," Rosenzweig said.

SLAYING THE CANCER DRAGON

A hot topic among scientists involved in chemoprevention is the lack of uniformity among "natural" remedies crowding the shelves of pharmacies, supermarkets and health food stores.

"People like to take their health care into their own hands and there's no question that many of them do work," Gangemi said.

But while natural remedies claim to fight everything from colds to cancer, their quality and potency can vary wildly, scientists say.

"There's very little proof about how they function and whether they are safe," Walle said.

This is not just a drawback for the consumer. It also makes research more difficult.

A researcher testing the effects of aspirin, for example, must ensure that every subject receives an identical dose. The same is true of research on something like garlic or ginseng: Variations in quality or potency could taint the research.

Thus, success at verifying and standardizing the active elements in these remedies could have effects far beyond South Carolina.

In any case, it seems consumers are a long way from being able to take a pill that will offset the cancer-causing effects of smoking or sunbathing for decades.

As scientists are better able to determine who is genetically susceptible to cancer, they will be able to target chemoprevention to those most at risk, researchers say.

It's also likely that effective chemoprevention will involve combinations of substances, said Steele of the National Cancer Institute, "because cancer develops following multiple pathways."

He encouraged scientists in South Carolina to keep looking for answers.

Cancer chemoprevention, he said, is like slaying a dragon in its egg -- before it grows into a fire-breathing monster.

-------------------------------------------------------------------------------- Reach Lamb at (803) 771-8454 or llamb@thestate.com.