Tag Archives: cancer

PROGRESS FOR TREATING AND CURING CANCER!! 

 

Cancer definitely is "The Big C" for many patients, doctors, and researchers! (http://dr-monsrs.net)
Cancer definitely is “The Big C” for many patients, doctors, and researchers!           (http://dr-monsrs.net)

 

The latest annual report from the American Cancer Society (ACS) surveys cancer in many years up to the present, and provides statistical data about the current status of neoplastic disease in the United States (US) [1,2].  The largest conclusion is that clinical progress against cancer definitely is being made, but further efforts are needed.

ACS cancer statistics for 2016 [1,2]! 

The new ACS report describes numbers for cancer incidence, deaths, and survival through 2015 [1,2].  These latest figures permit comparison to corresponding measurements for many previous years, and allow predictions to be made for 2016.  Several brief discussions about what these figures reveal now are available [e.g., 3-5].

The cancer death rate for men and women fell 23% in the 21 year period from 1991 to 2012 (the latest year for which complete data are available).  This progress should be  welcomed by everyone!  Death from cancer still is second to heart disease for the entire US, but in 21 states it now has become the leading cause of death due to use of new and better therapies against heart disease.  For 2016, around 1.7 million new cases of all cancers can be expected in the US, presumably due mainly to the many environmental carcinogens we all are exposed to.

Cancers of the lung, prostate, colon, and breast remain the most frequent neoplasms nationally, and result in nearly half of the cancer deaths for both genders.  The total incidence of cancer would be higher were it not for decreased smoking of tobacco products.  Despite all measures now taken for early detection, breast cancers in women are estimated to be about 29% of all new cancer cases for females in 2016.

Incidence and death rate for some cancers are decreasing [1,2]! 

New cases of several cancers now are decreasing.  Half of the decline in new cancer cases for men is caused by the reduction of reporting prostate cancer by clinicians; this is due to their recognition that the prostate specific antigen test for the presence of prostate cancer gives positive results even for those men not needing clinical treatment.  Observed decreases in new lung cancer patients are due to the increased numbers of men and women who choose not to smoke tobacco; of course, many people still smoke, and the incidence needs to be reduced much further.  The observed decrease in colon cancer is believed due to increased use of colonoscopies as an effective screening test.

Better treatments and high levels of enrollment in clinical trials is producing a progressive increase in 5-year survival rate for children with cancer.  Among children aged 1-14 years in the US, death from cancers is second only to the deaths caused by accidents.  Leukemias account for 30% of all childhood cancers, but brain cancer now is more frequent than leukemia due to more effective therapies for treating this blood cell cancer.

Is progress truly being made in fighting cancer [1-5]? 

Despite continuing complaints that too much money is spent on treating and studying this deadly disease, progress against cancer in the US clearly is being made every year.  Education, early detection, prevention, and improved therapy all contribute to decreasing the incidence and death rates, thereby raising the number of cancer survivors.

Hidden among the tables of numbers published in the new ACS report is the solid fact that for some cancer patients death now is postponed for many years due to the development and use of more effective therapeutic treatments.  Moreover, of the more than 100 different kinds of cancer, some now are being cured!  Both of these facts provide evidence that progress in cancer care indeed is being made.

Critical discussion about the value of cancer research! 

One of the most frequent complaints about spending many billions of dollars on cancer research is that this killing disease still remains without a general cure (see: “After Spending Billions Why Have Scientists Not Yet Found a Cure for Cancer?” ).  A very strong rebuttal to this complaint is given by the thrilling research success of Dr. James P. Allison (M. D. Anderson Cancer Center, Houston, Texas) (see: “A Very New Immunotherapy Wins the 2015 Lasker-DeBakey Clinical Medical Research Award!” ).  His combined laboratory, clinical, and industrial research investigations with experimental immunology discovered a new kind of treatment that cures many cases of the previously fatal cancer, malignant myeloma (see new video: “Why Don’t Our Bodies Fight Cancer for Us?” ).   This story proves that research does result in very wonderful advances in curing some cancers!

This dramatic example of research success also illustrates several important generalizations about research on cancer: (1)  progress in treating and curing cancer proceeds step-by-step and not all-at-once, (2) basic laboratory research is the major basis leading to clinical progress against cancer, and, (3) progress in curing any type of cancer is inherently slow and takes at least one decade of dedicated work, but it is pursued by determined basic and clinical researchers.

Due to advances in cancer research, a diagnosis of cancer no longer is a certain prediction of early death!  Cancer research is the biggest stimulus for clinical progress against this disease.  The President of the American Society of Clinical Oncology, Dr. Julie M. Vose, has just stated [5], “As a result of our nation’s investment in cancer research, we have made tremendous progress in prevention, chemotherapy, surgery, radiation, immunotherapy and molecularly targeted treatments.  Every cancer survivor is living proof of its progress.”

Concluding remarks! 

This 2016 ACS report [1] documents the considerable progress being made against cancer.  An increasing number of patients with certain types of cancer now even are being cured!  Cancer research does cost lots of money and typically takes many years of work, but that leads to development of good clinical progress against this disease (i.e., decreased incidence, increased survival, and outright cures)!

 

[1]  Siegel, R.L., Miller, K.D., and Jemal, A., 2016.  Cancer statistics, 2016.  CA: A Cancer Journal for Clinicians,  6:7-30 .

[2]  Simon, S., 2016.  Cancer statistics report: death rate down 23% in 21 years.  Available on the American Cancer Society website at:  http://www.cancer.org/cancer/news/news/cancer-statistics-report-death-rate-down-23-percent-in-21-years .

[3]  Mulcahy, N., 2016.  Continuous decline in US cancer death rate: ACS report.  Available on the internet at: http://www.medscape.com/viewarticle/856938 .

[4]  MedlinePlus, 2016.  Cancer death rates down 23 percent since 1991: Study that translates to an additional 1.7 million survivors, expert says.  Available on the internet at:  http://www.nlm.nih.gov/medlineplus/news/fullstory_156576.html .

[5]  Julie M. Vose, 2016.  Decline in cancer deaths result of decades of advancing cancer care.  Available on website of the American Society of Clinical Oncology at:  http://www.asco.org/advocacy/decline-cancer-deaths-result-decades-advancing-cancer-care .

 

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AFTER SPENDING BILLIONS, WHY HAVE SCIENTISTS NOT YET FOUND A CURE FOR CANCER?

 

Cancer Research is having some Good Effects, but even More Progress is Needed!   (http://dr-monsrs.net)

Cancer Research is having some Good Effects, but Much More Progress is Needed! (http://dr-monsrs.net)

 Just about everyone on this planet would dearly love to honor any research scientist who can find a cure for cancer.  Despite all the money and time already poured into extensive research efforts in labs and hospitals, the goal of curing this devastating clinical disease still remains elusive; about 589,000 cancer patients are expected to die from cancer in 2015 [1].  A big question thus arises, “What good is all the research and money spent on trying to conquer cancer, if a cure still has not been found after all these years?” The more you know about cancer as a biological phenomenon, the better will you be able to understand why attaining a general cure is so very, very difficult.  This brief essay will teach you about the reasons for this frustrating situation that seems to damn the efforts of dedicated researchers in both basic and clinical science.

A brief background of essentials about cancer

At its most fundamental level, the biological phenomenon of cancer takes place in our cells.  All cancers are thought to originate from one normal cell that changes into a cancer cell when it becomes “neoplastic”; this term means that the abnormal cell(s) divide independently of the regulatory mechanisms controlling cell growth and division.  Multiple causes for development of cancer are recognized (e.g., chemicals, chronic inflammation, genetic heredity, mutagenesis, radiation, viruses).  Unrestrained growth of neoplastic cells usually results in a “tumor”; this term specifically means some localized enlargement or swelling filled with the proliferating neoplastic cells.  A neoplasm can be benign, meaning that it enlarges but does not spread to distant locations; this is contrasted to malignant neoplasms, where the abnormal cells can metastasize (i.e., spread to other regions of the body and start growing there). 

About 1.67 million people are expected to be newly diagnosed with cancer in 2015 [1].  Cancer is not always lethal (i.e., some 14 million cancer survivors now are alive and kicking (see:  http://www.cancer.org/ ))!  Some cancer patients are being cured (i.e., their neoplastic cells can be removed, caused to die, or to stop proliferating).  Cures can be the result of surgical excision, localized exposure to lethal irradiation (i.e., radiotherapy), treatment with chemicals that cause cell death (i.e., chemotherapy), systemic exposure to high tech antibody treatments (i.e., immunotherapy), or, other newly developed experimental therapies.  When treated cancer patients retain their disease, therapy can slow its progression and ameliorate their quality of life.   Even if no treatments work, the situation for any cancer patient is never absolutely hopeless because there are some spontaneous remissions where the neoplasm miraculously regresses and disappears. 

“Cancer” is a very complex and variable entity  

Cancer ian extremely complex biological phenomenon showing enormous variability (e.g., age of patient, cell of origin, general health status, genetic background, location in an organ, nutritional status, presence or absence of continued development of neoplasia (i.e., carcinogenesis), presence or absence of enhancers, rate of growth and division, type and dosage of therapy administered, etc.). There are over 200 different types of cells in the human body, many of which can become neoplastic.  Neoplastic cells are very similar to normal cells, but show some changes that give rise to aberrant functional activities.  In particular, neoplastic cells reproduce without regard to the normal controls that restrict cell growth and division.  Almost all the different varieties of cancer cells divide more frequently than do their normal (non-neoplastic) counterparts.  In addition, neoplastic cells usually change their normal shape(s) and adhere to each other less strongly.  

The enormous complexity and variability of neoplasia are the fundamental factor making the search for a general cure of cancer truly difficult.  These features also make it wrong to refer to cancer as a singular term, e.g., “the disease, cancer”, because there are so many different cancers and each shows variability.  The term “cancer” thus can be thought of as being analogous to the generic term “paint”; that label says nothing at all about the type of paint, its color, what it is made of, which kinds of  surfaces it can be applied to, how it is applied, its durability, etc.  The great complexity of cancer is strongly evidenced by the fact that a chemical agent completely curing one type of cancer typically has few effect(s) on many other kinds of neoplasms.  

What can laboratory research do for cancer patients? 

The most essential reason why cancer can not presently be cured despite therapeutic advances and improved methods for early detection is that this family of neoplastic diseases involves multiple different causes, many different cell types, and numerous variable conditions of human existence (e.g., quality and quantity of nutrition, hygiene, exposure to dangerous environments, screening and early detection, clinical monitoring, availability of expensive therapeutic protocols, etc.).  The targets of treatments for cancer are the neoplastic cells; these are dynamic targets that change their status, properties, and metabolism as clinical therapy progresses.  Despite tons of research, there still is no accepted general or molecular distinction known between the normal and neoplastic states of each cell type; this essential information will become available later through additional laboratory research studies.  The complexity and variability of cancers, along with the absence of full knowledge about many key parts of neoplasia, have even led some to speculate that the long-sought goal of finding a general cure for cancer actually might be impossible. 

At present, basic understanding about the whys and wherefores of neoplasia remains very incomplete.   Once there will be much greater understanding about the nature of neoplastic versus normal cells, and about the mechanisms for carcinogenesis, then the chance for applied research to develop cures for cancer undoubtedly will increase.  The main hope for finding a general cure for cancer therefore is to continue basic research vigorously; in my view, especially needed are development of very new approaches for clinical therapy, and formulation of very innovative concepts or unconventional theories that can be tested experimentally by lab studies.  Any proposals that all research grants should be awarded only for cancer research, or that all scientists should work only on studies of cancer, are idiotic and as misguided as are proposals that it is pointless to spend more billions trying to find a general cure for cancer.  All of us, and particularly cancer patients, must have great patience while the needed enormous amount of experimental work by both experienced and new investigators progresses. 

What can clinical research do for cancer patients? 

The fight against cancer now involves current efforts by clinical scientists (i.e., oncologists, who are MDs specializing in treating cancer patients) to find: (1) ways for earlier detection, (2) more effective means to kill cancer cells while leaving neighboring normal cells intact, (3) the genetic and physiological conditions needed to allow cancer cells to proliferate, (4) prevention of metastasis, (5) induced modulation of the immune system for experimental immunotherapy, (6) invention of new and better ways to use chemotherapy, (7) invention of new ways to improve specificity and lethal effects of radiotherapy, (8) identification of anti-neoplastic nutritional effects upon cancer cells, (9) development of new very innovative mechanisms and approaches to target and kill cancer cells, and, (10) development of more effective and less toxic multimodal therapies for cancer patients, etc.  All this activity requires the work of doctoral scientists in many labs, and of clinical oncologists in many hospitals.  Adjunctive work for the production and research use of very special new materials (e.g., new antibodies and immunomodulators, new genetic strains of cultured cells, new chemicals, new nanostructures as targeting devices and carriers of toxins, new detections of small cancers via advanced imaging assays, etc.) also are needed.  Extensive clinical trials must be conducted to determine the efficacy and safety of all newly successful  research treatments for human cancer patients. 

Is research progress against cancer being made?  

All basic or clinical studies of cancer are neither easy nor inexpensive.  It is reassuring to know that good progress is being made in the clinical treatment of some previously untreatable cancers.  Clinical applied research often is based upon previous basic research findings.  Many cancer patients now live longer and more actively due to their new clinical treatment(s).  Research progress indeed is being made; all the money and time spent with cancer research is having some very good effects for cancer patients, even though the final victory has not yet been accomplished.

Many scientists and clinicians working with cancer have the feeling that if there was a much greater fundamental understanding of neoplasia at the cellular, molecular, and genetic levels, then improved therapies and better preventive measures could and would be developed.  Current research is looking closely at the interactions of different gene expressions and protein networks, within normal versus neoplastic cells.   Further progress towards the goal of curing cancer undoubtedly will involve tackling difficult questions in both very basic science (e.g., exactly how does the metabolism of neoplastic cells differ from that of their pre-neoplastic or normal counterparts?) and applied clinical science (e.g., how can oncologists cause repression or expression of certain target genes in a safe manner within human cancer patients?).  The road to a cure will be long, hard, and not straight; thereby it will take great determination, long persistence, and very creative experiments before success eventually can be obtained. 

Concluding remarks

The materials presented above should enable all readers to have a basic idea of the nature of cancer, and to recognize why cancer in human patients is a very difficult disease to understand and to cure.  Although the ultimate goal has not been reached yet, cancer research continues to progress slowly and incrementally.  In my view, this will be made speedier by (1) more emphasis on cancer prevention, (2) evaluating completely new ideas for clinical treatment of cancer patients, and (3) development of innovative concepts about the fundamental nature of neoplasia.  Patience with the progress of cancer research now is needed more than is additional support money.  Cancer research requires intense dedication and long efforts by laboratory scientists, clinical oncologists, and cancer patients.  These efforts necessitate spending additional enormous sums of money to support the hospital and lab work.   Research results that do not produce a general cure for cancer still are valuable since the new facts acquired can be used subsequently for the generation of better experimental studies and of advanced clinical treatments

A  postscript from Dr.M

For those seeking further information or news about cancer, treatments for cancer patients, incidence, clinical cures and new trials, cancer research, costs, etc., I recommend that you visit the excellent websites of the Americal Cancer Society (see:  http://www.cancer.org/ ) and the National Cancer Institute (see:  http://www.cancer.gov ). 

 

[1]  Simon, S., for the American Cancer Society, 2014.  Facts and figures report: 1.5 million cancer deaths avoided in 2 decades.  See:  http://www.cancer.org/cancer/news/news/facts-figures-report-cancer-deaths-avoided-in-2-decades .

 

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