Writer: Daneeya Sheeraz
Humankind has set foot on the moon, sent robots to the sun, successfully created artificial intelligence and eradicated several diseases. Yet we have been unable to find a cure for cancer. Why is that? What is the difference between treatment and a cure? Why is cancer so difficult for us to cure and what are some recent advancements?
What is Cancer?
Cancer is a term spanning over 200 diseases. It can occur in almost any organ or tissue of the body due to the uncontrolled growth of abnormal cells. It is caused by mutations that lead to the formation of oncogenes - a gene causing cancer. Some people may be predisposed to developing cancer due to genetic factors. Oncogenes may also form because of carcinogens, which are substances that can increase a person’s risk of developing cancer. Currently, there are around 100 known carcinogens including ultraviolet rays, the chemical asbestos, and tar in cigarette smoke. Certain viruses, called oncoviruses, may also cause cancer. Coming into contact with a carcinogen does not mean a person will necessarily develop a tumour, only that it increases their chance of developing one. A tumour is a clump of abnormal cells that may form lumps or growths. They may be benign (non-cancerous) or malignant (cancerous). Malignant tumours can spread (metastasize) to other organs or tissues in the body.
Cancer is a leading cause of death globally. According to WHO, it was responsible for 1 in every 6 deaths in 2018. In men prostate, lung, colorectal, liver and stomach cancer are the most common types of cancer. While in women breast, lung, colorectal, thyroid and cervical cancers are most prevalent.
Treatments for Cancer and the Lack of a Cure
People often talk about “finding a cure for cancer”. What does this mean? Don’t we already see people recovering from cancer? Is that not curing cancer?
What we currently see are treatments that can cure people of some cancers. These treatments are not definite - they may or may not be successful. The success of these therapies often depends on the type and stage of cancer being treated. Mostly, we also see that a mix of multiple treatments has to be used. Even so, there is always the dark cloud of cancer recurring after being treated looming above our heads. For example, if a person has gallstones and their gallbladder is removed, there is no threat of recurrence. That would be called a cure. Hence, we do not have a cure that can completely eradicate all known types of cancer.
However, there are currently more advanced treatments of cancer available than ever before. Billions of dollars go into cancer research every year. Advancements are being made at a rapid pace. Surgical treatments are often used, where a surgeon will cut out cancerous tissue. Chemotherapy may be used. These are medications that shrink and kill cancer cells. Radiation therapy uses targeted high energy rays to kill cancer cells. Hormone therapy is another cancer treatment - it blocks cancer cells from getting the hormones they need for growth. Immunotherapy helps the body’s own immune system kill cancer cells and reduces side effects from other treatments being given. Stem cell, or bone marrow, transplant may be used to treat blood cancers that originate from lymph nodes. This is done to replace bone marrow that may have been damaged or lost due to radiation or chemotherapy. Bone marrow can be donated to help cancer patients by giving them bone marrow transplants. If you are healthy, it can be a good idea to become a donor - after all, you can save a life. Contact your doctor for more information.
Obstacles - Why it’s Taking so Long to Find a Cure for Cancer
In 1910, US President William Howard Taft was promised, “Within five years, cancer will have been removed from the list of fatal maladies,” when he visited Buffalo’s Gratwick Laboratory. It has been over a century of cancer research since then. So the question arises: what’s stopping us from finding a cure?
Firstly, as established above, cancer is an umbrella term. Cancer is not just one disease, but hundreds of diseases. Furthermore, even the same type of cancer may be caused by different mutations. Hence, the DNA of the cancer will differ from that of the patient and may even differ from the DNA of cancer cells of the same type of cancer in another patient. That would mean even if two people have the same type of cancer in the same organ, they may not respond to the same therapies. This is known as heterogeneity. The vast variations in cancerous diseases makes it incredibly difficult to create a one-size-fits-all cure.
Secondly, cancer changes over time. A patient may respond to a treatment at first, but as the cancer grows and develops, this may not be the case. Cancer cells change very rapidly as they multiply very quickly and undergo cell division faster than normal cells - a cancer cell is 100 times more likely to mutate than a normal cell. They continuously develop new mutations.
Many cancer cells also have the ability to avoid naturally programmed cell death, apoptosis. Cancer cells are very resilient and may also resist treatment. For example, the hormone testosterone causes growth and multiplication of prostate cancer cells. Therefore, some patients with prostate cancer may undergo hormone therapy to block the production of testosterone. However, sometimes, the cancer cells may be able to start producing testosterone from cholesterol to feed themselves. Cancers also often hide and adapt while taking help from normal cells in their surroundings. These surrounding cells, macrophages and fibroblasts, can help tumours grow by growing blood vessels and providing a blood supply for the cancerous cells to feed them, or suppress the immune system to stop abnormal cells from being destroyed. This phenomenon is tricky to study in laboratories, hence scientists have a limited understanding of it.
Cancer treatments are also very harsh and have numerous grim side effects. A cure for cancer would have to effectively balance efficiency and toxicity. It must not be harsh enough to destroy normal body cells but must be effective enough to kill cancer cells. Finding this balance can resemble walking a tightrope and many treatments available today also toe the line bordering toxicity.
The cost of cancer research is also very high. Moreover, most research is done in a lab on animals and may be effective there but not on humans. According to a study done in 2018, around 90% of cancer treatments that are effective in laboratories fail on humans during clinical trials.
There are many obstacles in the foggy pathway to curing cancer. In fact, even the term “a cure for cancer” is a gross oversimplification. Currently, a cure for cancer is not a realistic goal with an end in sight, which is why we are not looking for a single cure. Therefore, it is more important to focus on advancements in treatments to make them more effective and to have a more widespread array of therapies from which to choose from as cancer differs greatly from person to person. Prevention must also be a primary focus. Educating the public on the importance of regular check-ups to be able to detect cancers in their early stages is also essential.
Advancements in Cancer Treatment
Advancements in cancer treatment aren't the same as a cure, but they are helping people live longer after a cancer diagnosis. Currently, new technologies are making it easier to detect and treat cancer.
Nanotechnology is a developing way for doctors to detect cancer in its very early stages. Scientists hope to one day be able to use nanoscale devices at the molecular level to find and treat early stage cancers. These devices are extremely miniscule, ranging from being 100 to 10,000 times smaller than human cells. These devices may be able to deliver targeted therapies to cancer cells and help surgeons locate cancerous tissues during their removal in the future.
There is also a possibility of cancer vaccines being developed. They use the same mRNA technology that was used in COVID-19 vaccines. An mRNA vaccine would be able to target particular proteins in cancer cells and could be tailored to treat every individual’s cancer differently. Theoretically, a cancer vaccine would teach the patient’s immune system to recognise cancer cells as foreign and eliminate them. Cancer vaccines have so far been tested on humans in clinical trials, producing mixed and unsatisfactory results.
While cancer has proven time and again to be a difficult and stubborn disease, we are further than we have ever been in terms of progress in treating it. Every day researchers are working hard to find new and better treatments. Though we are currently not looking for a single cure for cancer and probably never will be able to, we have made fascinating life-saving advancements to treat different cancers.
Sources:
“Cancer.” World Health Organisation, https://www.who.int/health-topics/cancer
“Carcinogens: What They Are and Common Types.” Cleveland Clinic, https://my.clevelandclinic.org/health/articles/25081-carcinogens
“Cancer Treatments.” CDC, May 15, 2023, https://www.cdc.gov/cancer/survivors/patients/treatments.htm
“A Cure for Cancer: What's Taking So Long?” Roswell Park, 30 September, 2019, https://www.roswellpark.org/cancertalk/201909/cure-cancer-whats-taking-so-long
“Will Cancer Ever Be Cured?” Verywell Health, 28 February, 2023, https://www.verywellhealth.com/will-cancer-ever-be-cured-4686392
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