In April of this year I attended the 100th Annual Meeting of the American Association for Cancer Research as part of their Scientist-Survivor Program. My involvement in the Scientist-Survivor Program has impacted me in several ways. I have come to truly appreciate the scientists who have dedicated their lives to ending cancer’s destruction in our lives. I learn so much at these conferences; and the more I learn about cancer, the more I understand why finding a cure is so difficult. Cancer cells are truly “intelligent” and have devised many ways to overcome our own natural defenses and those we use to attack them from the outside.
I am equally as amazed at the new and innovative methods and technologies scientists are using to work toward a cure, at seeing what the future holds in finding new ways to combat the age-old and destructive disease.
I want to share some highlights of what I learned at this conference:
Cancer Genomics: The study of genomics has led to the finding that cancer is usually not caused by single genetic mutations, but by a series of genetic mutations that occur over time. Studies are underway to identify groups of mutations common to different cancer types. It has also been discovered that there are often individual differences in the genetic mutations of patients diagnosed with the same cancers.
In the near future, every individual’s cancerous tumor will be genetically tested to identify both the common and specific mutations in their particular tumor. This will result in personalized cancer treatment- pharmogenetics. Based on unique genetic changes, physicians will one day be able to determine which treatments and chemotherapies will be most effective for a particular patient. This will also allow physicians to identify which treatments will have no effect on a particular patient’s cancer and which patients are likely to have a toxic response to a particular treatment. The types and dosages of cancer treatment drugs will be individualized. Cancer genomics has also identified genetic variations in cancer that are common in other systemic diseases, such as diabetes. This may lead to findings of common metabolic pathways that enhance the treatment of many other diseases in the process of eradicating cancer.
Nanotechnology: Nanotechnology involves the use of particles one-billionth of a meter in size. A sheet of paper is 100,000 nanometers thick; a single gold atom is about nanometer in diameter. Technology is using particles of this size in several ways to advance cancer science. Nanoparticles may be one day used to deliver toxic drugs directly to cancerous tumor cells, preventing some of the toxic reactions common with current systemic cancer treatments.
Nanotechnology will be the basis for new diagnostic technology that will detect cancers at earlier stages, when they are more easily treated and have better outcomes. It is possible nanotechnology will allow metastasis to be discovered when it is still in the microscopic stage. Nanotechnology will allow particular cancer promoting protein molecules to be targeted and destroyed.
Tumor Microenvironment: Often agents that are effective against cancer cells in a lab have little to no effect on patient tumors. This is because the patient’s body provides the environment in which cancerous cells grow. Inflammation, hypoxia, low glucose levels, and pH are all things that may affect tumor growth. Cancerous cells can recruit the immune system to support cancer cell growth; cancer cells can also secrete proteins that dissolve connective tissue to allow metastasis. Learning how to manipulate the microenvironment in which the tumor grows may have as a great of an impact on cancer growth as attacking the cancerous tumor cells.
Immunology and Cancer: Twenty-three percent of malignancies are associated with infectious disease, and twenty percent of human cancer deaths occur within the context of inflammation and infection. The bacteria Helicobacter pylori is associated with gastric cancer, Hepatitis B and C viruses are associated with hepatic cancers, the Human Papillomavirus virus with cervical cancer. While acute inflammation can have an anti-tumor effect, some cancers are more common in those with autoimmune disease. Up to 50% of cancerous tumors can be composed of white blood cells. Many areas of investigation into how inflammation affects the tumor microenvironment are in progress. Trials are in progress testing cancer vaccines.
Biomarkers: Cancerous cells can release unique proteins and molecules, called biomarkers, into the blood and bodily fluids. There is ongoing research into identifying these biomarkers, correlating them to cancer types and using the identified biomarkers to help diagnose and guide patient treatment. There are thousands of biomarkers. Nanotechnology will come into play in the identification of biomarkers; using nanotechnology, it is possible there will one day be a barcode chip that using blood from a finger prick will in 5 minutes be able to identify biomarker proteins at a cost of 20 cents per protein.
Targeted Therapies: As more genes, proteins and molecules are discovered that promote or hinder cancer cell growth, specific therapies are being developed to target these particular biological entities. These therapies will be effective at destroying cancerous cells and preventing tumor formation while having little effect on normal cells. Some are already on the market, many more are being developed. Targeted therapies will soon revolutionize cancer treatment.
Prevention: There are things we can do to prevent ever getting a cancer diagnosis. We should quit smoking, or better yet, never start. High fiber diets decrease colon cancer risk by half. Exercise helps prevent cancer occurrence and recurrence. The Western diet contributes to cancer risk, as does vitamin D deficiency. More than diet though, obesity is becoming recognized as one of the greatest risk factor for the development of cancer.
Besides lifestyle, there are other means to help prevent cancer. The HPV vaccine, Hepatitis B vaccine and the eradication of helicobacter pylori infections can reduce or prevent cancers of the cervix, liver and stomach. As some cases of oral cancer are also now being associated with the HPV virus, the HPV vaccine may come into play in preventing these cancers one day too. Research is also in progress as to chemoprevention strategies…using medication to prevent cancer in those who are known to be susceptible to certain cancers.
I think in the end, the biggest impact the annual meeting has had on me was to make me aware that the only way we will see cancer defeated is by working together as a worldwide community in an unprecedented way- combining our resources and technology, sharing our discoveries, becoming a global team battling our common enemy. While more are living longer with cancer, more are being diagnosed with cancer as populations age. In the past 30 years, cancer death rates per 100,000 population have not decreased. By the year 2020, cancers will increase by 30-50 percent, and undefeated, it will take a catastrophic toll on our populations.
The deputy director of the NCI said that they are now adding to their research teams mathematicians, engineers, and physicists. The public and private sectors are starting to work together to support each other. Advocates and survivors like myself are uniting with other advocates to support research, to educate patients, to increase awareness of resources. There are so many new discoveries and technologies available that we are entering a time when working together, we have the opportunity to see cancer eradicated as a threat to humanity.