McArdle 'Blog' photoMcArdle Blog L7 ~ 11/21/2013

Personal Musings: Wither Cancer Researchers and Cancer Prevention?

[The opinions and views expressed in this blog post are my own and may not reflect the opinion of others at the McArdle Laboratory for Cancer Research]

Cancer is a terrifying disease, and what might be most frightening about it is the idea that it can strike out of nowhere. A significant goal of cancer research is to determine what the causes of various cancers are, with the thought that knowing these causes will allow us to better treat and maybe even prevent these malignancies from developing.

Of course identifying the causes of different cancers is a significant challenge, because there is a mixture of genetic, environmental and lifestyle factors that contribute to most cancers. However, if we can identify environmental and lifestyle factors that increase our risk of developing cancer, we can then take steps to counter these factors and reduce this risk of developing certain cancers.

As I continue to attend talks, read papers and think more about cancer biology during my life as a graduate student here at McArdle, it has struck me that we already know many of the environmental and lifestyle factors that increase an individual’s risk of developing cancer (see the image below). If we can alter or eliminate these factors, we would be able to significantly decrease the incidence of several different types of cancer.

Developed Countries

Developing Countries

In fact, the American Cancer Society estimates that close to half of all cancers worldwide are potentially preventable. That’s more than 6 million new cases of cancer every year and close to 4 million deaths due to cancer every year that can potentially be prevented! Preventing the development of cancer means eliminating lengthy, costly treatments and sparing the patients and their families much anguish and distress.

The challenges that we face in our quest to find safe and effective treatments for cancers are real and significant. Of course, that does NOT mean that we should not try or that we are not making remarkable progress. Here at the McArdle Laboratory for Cancer Research we invite a distinguished speaker to present his or her research every Wednesday at the McArdle Seminar in Cancer Biology.

There have been two recent speakers whose work got me thinking more about how far we have come in our understanding of disease development and treatment. But these talks also highlighted the important role prevention must play if we are to come close to fulfilling our ultimate goal to reduce the incidence of and damage caused by cancers.

The first speaker was Dr. John Coffin, who is a Professor of Genetics and Molecular Biology at Tufts University. Dr. Coffin talked about the reservoir of Human Immunodeficiency Virus or HIV-positive cells that remain in the bodies of individuals infected with HIV who are undergoing Anti Retroviral Therapy or ART. These viral reservoirs persist for years and if ART is stopped, the viral load in these individuals spike again. There is a lot of research being done to identify the cells that harbor this HIV reservoir and develop treatments to eliminate them, but completely curing individuals who are infected with HIV remains a difficult, complicated task. We know exactly how HIV is transmitted; shouldn’t we – as researchers who are fully cognizant of how challenging it can be to treat HIV-infections – lend our voices to measures that seek to reduce its spread?

The second speaker was Dr. Pete Nelson who works on prostate cancer at the Fred Hutchinson Cancer Research Center. Dr. Nelson presented his research into prostrate cancers that develop resistance to standard chemotherapy. His lab has found that certain proteins – such as WNT16B and SPINK1 – are expressed at a higher level in the cells surrounding the tumor when the patient is given chemotherapeutic DNA-damaging drugs. This increased expression of certain proteins in the surrounding cells seems to have a protective effect on the tumor cells. Thus, the treatment itself gives rise to resistant tumors. Dr. Nelson and his lab are now testing drugs that inhibit the DNA-damage response initiated by current chemotherapy.

As we can see, much elegant and creative research is being conducted to understand how cancers develop, how we can treat them, and even counter potential ill-effects of those treatments. But this may not be enough to reduce the physical, mental, emotional, social and economic costs of cancer. The question remains whether we – as members of the cancer research community – need to do more to communicate how environmental and lifestyle factors can contribute to cancers. Isn’t it our responsibility to advocate for particular personal choices if they lead to a healthier population with lower rates of cancer?

I think so, because it is no different than advocating for a vaccine (such as the HPV vaccine) or any effective preventative (such as screening for colon cancer) or therapeutic strategy. Cancer is a frightening disease and we might all be at risk of developing it at some point. But I truly believe that it will actually be empowering for people to know that there are everyday choices they can make, little things they can change about their lives that will reduce their risk of developing cancer. While there are no easy answers when the issue of personal freedom and healthcare is involved, I urge you to ponder on this complex, yet oh-so-important, issue.

~Adityarup Chakravorty