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One Step Ahead of Cancer

Posted 10/20/2014

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  As we all know, once cancer recurs/metastisizes, it is no longer curable. For most kinds of cancer, it is quite treatable, but this means that the patient faces a life-time of treatment--with a lot of frightening anxiety re the length of that life-time. Doctors often refer to recurrent/advanced cancer as a chronic disease, but that always feels not quite right to me. When I think of a chronic disease, I think of things like asthma or diabetes or high blood pressure which can often be treated to insure a normal life span. Except in rare instances, that is not the case with advanced cancer.

  The central difficulty in treating cancer is how smart the cells are, how they mutate and become resistant over time to any one treatment. This promises that someone living with advanced cancer will periodically face moments when the treatment is no longer helpful and it is necessary to change to a new drug. This is always a very distressing experience as it is accompanied by the awareness that the list of possible treatments is shrinking, and the recognition that, generally, each subsequent treatment is going to be a little less effective than the previous one.

  This is an excellent article from The Guardian about this problem. It includes links to a few related articles and is worth your time. Again, the title is a bit misleading, because, very sadly, we can't stay one step ahead forever. That is the problem. Here is the start and a link to read more:

We can't 'cure cancer', but we can stay one step ahead of it
Cancer’s ability to evolve drug resistance makes it impossible to eradicate, but we may one day transform it from a killer into a long-term illness

Some of the best cancer treatments will only work for a limited time before resistance kicks in. But understanding resistance will help us to defeat it. Photograph: Alamy
Cancer. People speak about this extraordinarily diverse and complex group of diseases as if they were one illness and ask us impatiently when we are going to “cure” it.

The reality is that many researchers, myself included, don’t believe we will ever cure cancer. For a start, trying to develop a single “cure for cancer” would be like trying to develop a single cure for Aids, depression, the flu or a broken leg. We’re making progress in designing treatments for specific cancers, but they adapt quickly, with many of them evolving in such a way that they can resist being killed by drugs.

This presents an enormous challenge. Some of the best treatments will only work for a limited time before resistance kicks in. But understanding resistance will help us to defeat it.

One of the ways we investigate resistance is by studying cell lines. These are cancer cells that were taken from patients and then kept alive in the lab. These cells, which are fed with a sugar solution and grown in plastic flasks, are a long way from a human with the disease. But they let us quickly and easily get to know how a cancer works, and how its behaviour can be changed by a gene or protein change, or a drug.


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