Cancer Research – Forward Or Backward?

“Fight cancer”, “Beat cancer” are very popular expressions these days, and it is good so. Although October, the Breast Cancer Awareness Month is over, one can still see many people wearing pink ribbons on their jackets, which is a demonstration of their will to help those women who suffer from this disease. And this is very much appreciated and should be acknowledged. Fundraising and information events, websites, donations, merchandise, advertisements all over the media, groups on social networking sites, individuals spreading the word – attention is certainly given to the subject and considerable amount of money is collected.

However, looking a little bit closer, as a cancer survivor myself who studied the subject from the most various resources available for public, I personally have some questions, doubts and reservations about these research programs and might be a bad person, but I did not donate one single cent and not intend to do so. Tell you why.

Fight. A key word when talking about cancer.

How do you best fight so that you win? You know your enemy.

A problem – any problem – can be only handled if one knows the exact cause of it. This should be clear – how else do you solve a situation, if you don’t know what is it exactly?

Let’s take breast cancer, it looks like this: each year $ millions are spent to find out the causes of cancer AND more importantly, develop new treatments. Let me suggest: treatments can be only effective when they target the root of the problem… “The exact causes of breast cancer are not known.” In fact, according to the publicly available statements, causes of cancer are a mystery for the medical profession.

The theory of changed or damaged genes is wide spread, and an information video on the Medical News Today site gives a little hint on why does it occur: “Damage or change in the genetic material of cells by environmental of internal factors sometimes results in cells that do not die and continue to multiply until a massive cancer cell or tumor develops.”

Excellent. The next step would be then to investigate these environmental or internal factors that damage or change the genetic material of cells, wouldn’t it?

The environmental factors are pretty much known for the scientists and for the public: bad nutrition, tobacco, certain chemicals that we use, etc. Cancer research should go then in the direction of eliminating these factors: educating the population on correct eating habits, cutting back the use of harmful chemicals, and so on. And cancer treatment would primarily consist of targeting the cause of cancer, the reason why those genes got changed or damaged: increasing certain vitamins and other nutrition supplements, cleansing and physical exercise that helps the body push out the accumulated toxins, boosting the own self defense of the body, the immune system and so on.

But this is not how it goes. Cancer researches deal mostly with developing the standard therapies by official medicine: new drugs, radiation, hormones and surgery. And cancer treatments available in hospitals are mainly about giving chemotherapy and such to the patients. Can anyone see how adding extra chemicals into the already overwhelmed and weakened system would help the body to recover? Because it will not.

So why then chemotherapy is a preferred and highly promoted method, when it has very many known harmful side effects? The answer is easy: pharmaceutical companies have vast interests in introducing and marketing drugs. As Clinical Study Results.org openly admits: “Clinical studies designed for approval of a new drug are sponsored primarily by pharmaceutical and biotech companies.” Surprise, surprise! One can predict the outcome of a clinical study on breast cancer treatment, if one-fifth of the Swedish Cancer Society researches are financed by Pfizer – can you guess from what pharma company will they recommend medicine to the patients? (Latest news: Pfizer Hid Evidence That HRT Causes Cancer)

Another suggested treatment is hormonal therapy. About that, only one word: “Hormonal therapy can cause a variety of side effects including:… Increased risk for cancer of the uterus” – from the information video on the National Breast Cancer.org site. Pardon me??? Treating one cancer by increasing the risk for another one??? Someone must be kidding here and it’s a very ugly joke.

Same for radiation therapy.

So what’s the solution? To invest more money in research? The above mentioned Swedish Cancer Society (Cancerfonden) held a nice event in Stockholm in October where people bought ten thousand candles or so and contributed to the funding. This organization alone has a target to spend more then 400 million SEK each year on research. That’s a nice sum of money ($57M approx. and it’s only in one country), one can imagine to do great things with it. I wonder though why does cancer research need so much money to find out for example that tobacco or alcohol is not good for your health and there are certain vitamins that are vital for the normal operation of cells, when this has been already known for a good while.

I am more inclined to listen to what the so-called alternative methods recommend, because I believe that by well-balanced nutrition with supplements if needed and a general good care of the body physically and mentally, one does not need to be afraid of even such a threatening disease as cancer. Therefore I intentionally didn’t referred here to alternative practices, natural remedies, viewpoints or products, only mentioned information provided by the standard medicine, which is adopted and promoted by governments of the developed countries.

Well, I am inviting you, dear reader, to look at the facts and the controversies they are giving and make up your own mind about it.

Cancer Research in Biotechnology Part II – Genetic Analysis

Gene expression profiling (GEP) is a powerful tool to identify genes and pathways that are abnormally expressed during carcinogenesis. While these discoveries enhance our understanding of molecular pathogenesis, they can also suggest novel therapeutic targets, provide information about drug resistance pathways, and refine prognostic classifications.

A major problem in clinical oncology is the heterogeneous response of histologically similar tumors to treatments such as cytotoxic chemotherapy. With the exception of estrogen/progesterone receptor, and HER2 (c-erbB-2) expression in breast cancer (for hormonal therapy and trastuzumab, respectively), EGFR kinase domain mutations and genomic amplification in lung cancer (in EGFR targeted inhibitors gefitinib or erlotinib), and K-ras mutations in colon cancer (lack of response to EGFR-targeted antagonists), there are no other single molecules that are clinically useful predictors of response validated for any form of anticancer therapy.

Encouraging emerging data suggest that prediction of response to chemotherapy or biologically targeted agents may be possible by analyzing gene expression profiles (GEPs). With rapid advances in the DNA microarray technologies and more sophisticated studies, microarray analysis has started to make ways into clinical trials and practices in oncology.

Several examples of the potential application of GEPs in clinical oncology are described here to illustrate the utility of this technology in common solid tumors and hematologic malignancies.

Acute leukemia – The first report to show that GEPs could be used to classify tumors analyzed a group of acute leukemias. Based upon gene expression patterns, acute myeloid leukemia (AML) could be distinguished from acute lymphoblastic leukemia (ALL) without standard histology information. Similarly, B-cell versus T-cell ALL could be separated based on GEP. This study served as proof of principle that clinically useful classifications could be made simply by gene expression patterns. In another report, a case with equivocal histology by standard criteria was accurately classified by gene analysis, demonstrating the potential utility of GEP beyond standard histologic and immunocytochemical methods.

Others have shown that GEP can distinguish among prognostically important subgroups of children with ALL and adults with AML, in some cases identifying those who eventually fail therapy. If these findings are confirmed by others, the logical next step is to apply a more intense initial treatment strategy to such patients, selected on the basis of their GEP.

It may also be possible to screen for agents capable of inducing leukemic cell differentiation through changes in their GEP. A major caveat is that gene expression profiles of clinical samples may differ significantly from those seen in cell lines representing the corresponding leukemia.

Prostate cancer – A potential application of GEP in men at risk for prostate cancer is the identification of biomarkers that can help select men with a borderline elevation in serum prostate specific antigen (PSA) for biopsy. In addition, GEP might be used to identify men whose early stage tumors are destined to recur and thus would benefit from more aggressive therapy.

GEP has been used to identify several genes (e.g., hepsin and pim-1) that are upregulated in prostate cancer compared to benign prostatic hyperplasia and normal prostate tissue, and some are highly correlated with clinical outcome [25-30]. Investigators have found a ≥3-fold difference in expression in over 3000 genes when nonrecurrent prostate cancers were compared to metastatic tumors.

Colon cancer – The serine phosphatase PRL-3 is consistently upregulated in metastatic as compared to non-metastatic colorectal cancers [31]. The finding that metastatic potential appears to be encoded in the primary has challenged the notion that metastases arise from rare cells that have acquired the ability to metastasize.

GEP is under study as a way to improve prognostication, and perhaps, individualize adjuvant therapy recommendations. An area of intense study is the use of GEP to predict which patients with node-negative resected colon cancer are at a relatively higher risk of relapse, and thus, might benefit from adjuvant chemotherapy, as is typically recommended for patients with node-positive disease.

Breast cancer – A molecular classification for breast cancer has been proposed based upon GEP. Luminal (mainly estrogen receptor [ER] positive), basal-like (mostly ER-negative), normal-like, and erbB2+ (mostly HER-2 overexpressing, ER-negative) subgroups have been identified, and have different prognoses.

A major area of investigation is the use of such molecular profiling to predict response to therapy. The GEPs of breast cancers that respond best to neoadjuvant (preoperative) chemotherapy (ie, basal-like, erbB2+) differ from those of nonresponding or resistant tumors.

Analysis of GEP can also distinguish sporadic breast cancers from those associated with BRCA mutations. Perhaps more importantly, GEP can also permit stratification of defined subgroups (ie, those with axillary lymph node-negative breast cancer or grade 2 tumors) into prognostically separate categories. In at least some reports, outcome prediction by GEP outperforms existing prognostic classifications. This topic is discussed in detail elsewhere.

GEP analysis by DNA microarray is available in patients with breast cancer (the 21-gene recurrence score assay, like Oncotype DX) to quantify the likelihood of a breast cancer recurrence in women with newly diagnosed, node-negative hormone receptor-positive early stage breast cancer. The assay is designed to identify those women whose risk of recurrence is low enough to justify the omission of chemotherapy and use of tamoxifen alone as systemic adjuvant therapy.

Although commercially available, the benefit of using 21-gene recurrence score assays (e.g, Oncotype DX) to select the adjuvant therapy strategy has not been tested in a prospective trial. Such an approach is being evaluated in the phase III Trial Assigning IndividuaLized Options for Treatment (Rx) (the TAILORx clinical trial), sponsored by the National Cancer Institute and led by the Eastern Cooperative Oncology Group (ECOG).

Radiation Oncology and Advancements in Cancer Research

As medical breakthroughs are discovered every day and preventions, cures and treatments become available for hundreds of diseases, cancer remains the number two cause of death for men and women in the United States behind heart disease.

This does not mean that cancer research is void of major breakthroughs or that it is not coming along as fast as advancements in other fields. It simply indicates that while new treatment technologies, such as radiation therapy are being developed and researched, they are not being accomplished at the same rate as diabetes, influenza, and cardiovascular disease treatment and preventions.

One of the problems with cancer treatment is that it is difficult to establish prevention techniques, to some degree. While doctors and scientists have learned that tobacco, asbestos, and other carcinogens can cause the disease; there are no strict guidelines that can guarantee a person will be free from cancer.

Some people have even argued that cancer is not a disease, but a “condition” and that, while avoiding tobacco and cancer causing agents can help, there is really nothing that can be done to reduce your chances of developing cancer beyond that.

Radiation Oncology — Advanced Treatments

Though the number of diagnosed cases of cancer may not be lowering quite as much as hoped, the number of deaths per diagnosed case has fallen dramatically in the past few years. As a matter of fact, cancer mortality rates have dropped dramatically since 1993, and a report by the New York Times states that in 2007, 12,000 fewer cancer patients died than did in 1993. Also stated in the article is that much of the progress comes from “early detection and treatment of some of the leading causes of cancer death — lung, colorectal, breast, and prostate tumors.”

One area in which the most improvement has come is radiation therapy. Radiation Therapy is — just as it seems it would be — the process of treating cancerous tumors via radiation. Radiation Oncology, the practice of physicians who use radiation therapy, involves dozens of different specialized treatment methods, which implement highly sophisticated technologies and equipment to deliver precise beams of radiation to the affected area without coming into contact with the surrounding tissues. An oncologist can use a multitude of specific therapy methods, only a couple of which are IMRT, or Intense Modulated Radiation Therapy, and TomoTherapy – each of which has its advantages and both of which are effective for issuing precise doses of radiation.

Only a radiation oncologist can help you decide exactly which form of radiation therapy might work best for a particular type of cancer, but overall advancements in oncology gives new hope to cancer patients across the world. As science continues to develop new tools and treatment methods, society can inch closer to a world that is cancer-free.