Five promising advances that are transforming the way we think about cancer.
Many cancers are fueled by biochemical changes of histones, the proteins that serve as spools for DNA in our cells (histones are shown in green with their cancer-induced changes in purple). New epigenetic therapies that reverse these changes are showing early promise in clinical trials.
Although the history of attempts to understand and control cancer is littered with disappointments, many significant advances in research and treatment have been made in recent years. Despite the challenges, Memorial Sloan Kettering scientists and doctors firmly believe we’re on the cusp of a brighter era in cancer care and research. Today, we have more reasons than ever to be hopeful. These are five of them.
Precision Medicine: Interpreting the Story of Genes
Dr. Stegall’s comments: The main focus of cancer research today involves identifying genetic changes in cancer and finding novel ways to target those changes. I feel that identifying each patient’s cancer “fingerprint” is important, as evidenced by the genetic testing I perform in my office. This allows us to personalize treatment in a very unique way. However, the genetic aspect of cancer cells is only part of the story. In conventional oncology, the prevailing belief is that cancer is a genetic disease which results from damage to DNA. I disagree with this, because I believe that cancer is a metabolic disease which occurs due to repeated damage to the cell membrane and mitochondria. The genetic changes we see are not the cause of cancer, but rather a symptom of the cancer. Addressing these symptoms (genetic changes) is important, but we must simultaneously address the causes as well.
CANCER’S SUPER-SURVIVORS – How the Promise of Immunotherapy Is Transforming Oncology
Tom Telford’s stomach ached. The New York City teacher had been drinking cup after cup of coffee as he labored to finish year-end grading and coach his high-school baseball team through the playoffs. He worried he might have an ulcer.
When school let out, though, Mr. Telford looked forward to relaxing on a 25th anniversary cruise with his wife. But once in the Caribbean, he struggled to swim and climbing from one deck to another exhausted him. Back at home, he collapsed while running a TV cable in his bedroom.
His family doctor told him he had lost two pints of blood. Further tests revealed a tumor the size of a quarter on his small intestine. He had surgery at Memorial Sloan Kettering Cancer Center, followed by months of chemotherapy. But the disease spread to his liver and kidneys. The diagnosis: Stage 4 melanoma, a skin cancer typically fatal within a year.
“Death is not an option,” he told his doctor.
Nine years later, against all odds, Mr. Telford is still alive. What saved him was an experimental immunotherapy drug—a medication that unleashes the body’s own immune system to attack cancer.
Dr. Stegall’s comments: In addition to cancer genetics, immunotherapy is the other hot topic in oncology research today. Immunotherapy recognizes the immune system’s role in cancer formation and progression. We know that most cancers have figured out a way to “cloak” themselves and evade immune system detection. With immunotherapy, invisible cancer cells become visible, and the immune system can do its job. In my practice, I have seen mixed results from immunotherapy. Some patients do very well, while others do not respond to treatment. Most of these drugs are extremely expensive, and the challenge for many patients becomes insurance coverage. For these reasons, I do not prescribe these immunotherapy agents in my practice. Thankfully, there are other ways to stimulate immune system function, and these are what I focus on with my patients.
Cancer: The Final Frontier – Landmark breakthroughs in cancer treatment and a policy structure where those advances can flourish have given fuel to the ambitious “Moonshot” to cure the disease. But is it really possible?
Radical new advances in science provide hope that seemed impossible before, and newly developing partnerships among public entities, private companies, academic researchers, patients, and insurers provide a staging ground for that science to take off. In this instant, there might finally be a window.
Immunotherapy is a fancy description for treatments designed to get your body to do what it already does for many diseases. For microbes that your body recognizes, antibodies attach to antigens on the offending cells and the immune system kills the invaders. Vaccines train the body to recognize potentially deadly viruses so it can react quickly if ever infected by the real deal; vaccination is itself a kind of immunotherapy. But cancer is different. Tumors derive from a person’s own cells and are much trickier for the immune system to find and destroy.
Dr. Stegall’s comments: President Obama has waged war on cancer, which sounds very similar to the one waged by President Nixon in 1971. In both instances, increased government funding for cancer is being pledged to find a cure. While continued research efforts are vital, I do not feel that we will ever find one single cure for cancer. Rather, we will find that our greatest successes against cancer will include a multi-faceted approach consisting of medications, nutritional supplements, dietary changes, stress reduction techniques, and probably other treatment modalities as well. We know that research will never seriously look into an integrative combination such as this, due to a variety of factors. Thus, I am confident that these continued “wars” being publicly waged on cancer will largely prove to be ineffective.