On World Cancer Day 2012, we speak with Dr Lauren Pecorino, author of Why Millions Survive Cancer: the Successes of Science, to learn the latest in the field of cancer research. – Nicola
Cancer is a disease of the human genome. Many agents that cause cancer cause permanent changes to your genes. These permanent changes are called mutations. Cancer is usually caused by the accumulation of mutations over time. This is why cancer risk increases with age. The altered genes may produce faulty proteins that lead to abnormal cell growth and this appears as a tumour. Cancer is characterized by abnormal cell growth and the ability of tumour cells to spread throughout the body. It is this second characteristic, called metastasis that is the most difficult aspect to treat.
It is said that cancer now affects one in three people over a lifetime. What’s the latest progress in the field of cancer research?
There has been tremendous progress in the field of cancer management. The good news is that trends in death rates are decreasing for many cancers though that is not to say for all cancers. There are millions of cancer survivors who have had their diagnosis ten or more years ago. Many people are now living with cancer. Conventional treatments such as surgical procedures have been refined and new drugs that target tumour-specific molecules have proved efficient and promises less side effects.
In addition, we are learning to make lifestyle choices that science has shown reduces cancer risk — the most obvious being not smoking. We also have cancer screening programmes that can catch cancer early and even prevent cancer by treating pre-cancerous growths. The latest means for preventing a specific type of cancer is a cancer vaccine. Interestingly the vaccine designed to prevent cervical cancer vaccine also prevents several other cancers caused by the human papilloma virus such as some head and neck cancers.
What do you see as the priorities for future cancer research? Where will the next great advances be?
I see four main priorites for future cancer research.
1 – To develop better and less invasive diagnostics so that we can detect cancer earlier. It is well-known that catching cancer earlier gives a better outcome or prognosis.
2 – To expand our understanding of the individual molecular differences between tumors and to be able to fully practice personalized medicine which allows a better match between a patient and a drug. This understanding will need to be supported by technology that allows a patient’s tumour DNA to be sequenced (similar to the methods used for the Human Genome Project).
3 – To understand if we can turn a cancer cell back into a normal cell. This may sound strange but lessons from stem cells and cloning tell us that changing one cell type into another is possible.
4 – To better understand metastasis and how we can better treat it. The spreading of cancer cells throughout the body is the most difficult aspect of treating cancer and so this must be a priority.
Do you have any recommendations on how we can reduce our own cancer risk?
The media is full of headlines about what affects cancer risk. The best advice is evidence-based recommendations published by scientific journals and professional organizations such as the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR). The following recommendations are evidence-based:
1 – Maintaining a healthy weight throughout life may be one of the most important ways to protect against cancer (see 2 and 3 below).
2 – Be physically active.
3 – Eat a healthy diet containing real foods vs. processed food.
4 – Don’t smoke.
5 – If consumed at all, limit alcoholic drinks to two for men and one for women a day.
6 – Participate in cancer screening programs.
7 – Ensure daughters receive the cervical cancer vaccine. But note this only protects against approx. 70% of all cases. Participation in cervical screening is still necessary.
8 – Get symptoms checked by a physician: early detection leads to a better diagnosis.
9 – Protect against extensive sun exposure.
10 – Women should consider having children younger and avoid sources of excess estrogen.
In your view, is it possible that one day we will have a cure for all cancers?
Although it may be far away in the future, I, with my rose-colored glasses, think it may be possible to find cures for many cancers with the aid of a deeper understanding of how cancer spreads. Technology will also aid our quest for better treatments. The age of affordable and timely genome sequencing is upon us and will enable individual tumor DNA to be analyzed. As personalized medicine becomes a reality in the clinic, we will be able to better match treatment to individuals.
Some people now have a good quality of life after a diagnosis of cancer. There are millions of cancer survivors and living a good quality of life with cancer may be the next best thing to a cure. We have started to become better at preventing cancer (for example by not smoking and vaccination) and also by detecting and treating pre-cancer growths through screening.
Prevention is better than a cure.
Lauren Pecorino was born in New York City and grew up on Long Island, NY. She received her PhD from the State University of New York at Stony Brook in Cell and Developmental Biology. She crossed the Atlantic to carry out a postdoctoral tenure at the Ludwig Institute for Cancer Research, London. She is a Principal Lecturer at the University of Greenwich where teaches Cancer Biology and Therapeutics. The teaching of this course motivated her to write The Molecular Biology of Cancer: Mechanisms, Targets, and Therapeutics, now in its second edition. Feedback on the textbook posted on Amazon from a cancer patient drove her to write a book on cancer for a wider audience: Why Millions Survive Cancer: the Successes of Science.