Recently I came across a video on YouTube titled 'Why is it so hard to cure cancer?'(which will be linked below) and I immediately thought of the number of people who would be interested in a similar question, wanting to know "so what has been happening in the scientific world to cure cancer?' That's how I landed with my second post on this blog. Hope this gives some insight and answers the above questions, though not in very much detail but definitely gives an overview.
LINK TO THE YOUTUBE VIDEO: https://youtu.be/h2rR77VsF5c?si=HpwZpV3k8qAPlFQO
Cancer. Just hearing the word can send chills down the spine. It is one of those medical mysteries that continues to battle and challenge scientists, doctors and patients alike. But why is cancer so hard to treat, even in 2024, when we have smartwatches that can track our heartbeats and robots that can perform surgeries? Let's dive into this intriguing topic to understand the complexitis and the significant progress we've made over the years.
- The Sneaky Shapeshifter: Cancer isn't just a single disease - It's a whole family of diseases with a common theme : Cells going rogue. These cells divide without control, ignore the body's stop signals, and even trick the immune system into protecting them. It just keeps constantly changing, for example in this very interesting article explaining how cancer can be a very "evolving and adapting enemy" (Childs, 2012)
- Why is it So easy to Tricky to Treat?
1. Uniqueness: Each person's cancer is as unique as their fingerprint. What works for one patient might not work for another.
2. Adaptability: Cancer cells can mutate rapidly, developing resistance to treatments. It's like they're constantly updating their defense software.
3. Hiding in Plain Sight: Cancer cells often look very simiar to healthy cells, making it hard for treatments to target only the bad guys without hurting the good ones.
4. Spread and Recurrence: Cancer can spread (metastasize) to other parts of the body and lie dormant for years before reappearing
- Evolution of Cancer Treatments:
- Early Years: Slash, Burn, ad Poison - In the early 20th centuary, cancer treatment was pretty brutal:
Surgery : Cut out what you can see.
Radiation : Burn the cancer cells ( and unfortunately, some healthy ones too)
Chemotherapy : Poison fast-growing cells ( including cancer and, sadly, some normal cells like hair follicles).
These methods were like using a sledgehamer to swat a fly- effective sometimes, but with a lot of collateral damage.
2. The Dawn of Targeted Therapies (1990s - 2000s)
As we entered the 21st centuary, we started smarter about how we fight cancer :
Targeted Drug Therapies: Medications designed to attack specific weakness in cancer cells. For example, Gleeva, approved in 2001, revolutionized the treatment of chronic myeloid leukemia( certain types of blood cells don't grow properly.) [1].
Monoclonal Antibodies : These are like guided missiles that can zero in on specific targets on cancer cells. Rituxan, approved in 1997, was a game-changer for certain types of Lymphomas [2]
3. The Immune System Awakens (2010s)
We realized we had a powerful ally all along- our own immune system. So why not use Immuno-Therapy?
Checkpoint Inhibitors: These drugs help remove the 'brakes' that cancer can put on our immune systems. The approval of Yervoy in 2011 marked a new era in cancer treatment [3].
CAR T-cell Therapy: This involves reprogramming a patient's own immune cells to fight cancer. The first CART T-cell therapy, Kymirah, was approved in 2017 [4].
4. Current Landscape (2024)
Now, we're combining multiple approaches and getting even more precise:
Precision Medicine: Using genetic testing to tailor treatments to a patient's specific cancer. The NCI-MATCH (Molecular Analysis for Therapy Choice); A trial started in 2015 to find if treating cancer based on specific changes in a person's tumor is effective, regardless of the cancer types. Now that the trial winds down, new precision medicine trials like ComboMATCH, MyeloMATCH are being launched to build on its success.
Liquid Biopsies: Advanced blood tests that can detect cancer DNA are becoming more sophisticated. Galleri multi-caner early detection test is being developed for use in cancer screening.
AI In Cancer Care: Artificial Intelligence is revolutionizing cancer diagnosis and treatment planning. In 2023 study in Nature showed how AI can enhance the accuracy of breast cancer screening, potentially reducing false positives and unnecessary biopsies [5].
mRNA Technology: Building on the success of mRNA vaccines for COVID-19, BioNTech's phase II trial of an mRNA-based individualized cancer vaccine showed encouraging results in 2023, paving the way for a new era in cancer immunotherapy [6].
Nanomedicine: Nanoparticle-based drug delivery systems are improving the efficacy of cancer treatments. A recent study in Nature Nanotechnology demonstrated a new nanoparticle design for enhanced drug delivery to brain tumors [7].
Phew that was a long read, wasn't it? But while we've made incredible progress, cancer remains a challenging foe. But with each passing year, we're getting better at understanding its tricks and developing smarter ways to fight back. The future of cancer treatments looks promising, with personalized therapies, early detection methods, and combination of different treatment modalities leading the charge.
It is also important to remember, in this high-stakes game against cancer, we're all on the same team. By supporting research, participating in clinical trials, and spreading awareness, we can all contribute to leveling up our defenses against this elusive enemy.
REFERENCES
Childs, O. (2012). Expert opinion: why are some cancers so difficult to treat? - Cancer Research UK - Cancer News. [online] Cancer Research UK - Cancer News. Available at: https://news.cancerresearchuk.org/2012/01/26/expert-opinion-why-are-some-cancers-so-difficult-to-treat/#:~:text=Expert%20opinion%3A%20why%20are%20some%20cancers%20so%20difficult [Accessed 30 Aug. 2024].
1. Druker BJ. Translation of the Philadelphia chromosome into therapy for CML. Blood [Internet]. 2008 Dec 15;112(13):4808–17. Available from: http://www.bloodjournal.org/content/112/13/4808?sso-checked=true
2. Maloney DG. Anti-CD20 Antibody Therapy for B-Cell Lymphomas. New England Journal of Medicine. 2012 May 24;366(21):2008–16.
3. Hodi FS, O’Day SJ, McDermott DF, Weber RW, Sosman JA, Haanen JB, et al. Improved Survival with Ipilimumab in Patients with Metastatic Melanoma. New England Journal of Medicine. 2010 Aug 19;363(8):711–23.
4. June CH, O’Connor RS, Kawalekar OU, Ghassemi S, Milone MC. CAR T cell immunotherapy for human cancer. Science [Internet]. 2018 Mar 22;359(6382):1361–5. Available from: https://www.science.org/doi/10.1126/science.aar6711?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
5. O’Dwyer PJ, Gray RJ, Flaherty KT, Chen AP, Li S, Wang V, et al. The NCI-MATCH trial: lessons for precision oncology. Nature Medicine [Internet]. 2023 Jun 1 [cited 2023 Dec 10];29(6):1349–57. Available from: https://pubmed.ncbi.nlm.nih.gov/37322121/
6. McKinney SM, Sieniek M, Godbole V, Godwin J, Antropova N, Ashrafian H, et al. International evaluation of an AI system for breast cancer screening. Nature [Internet]. 2020 Jan;577(7788):89–94. Available from: https://www.nature.com/articles/s41586-019-1799-6
7. Zheng L, Bandara SR, Tan Z, Leal C. Lipid nanoparticle topology regulates endosomal escape and delivery of RNA to the cytoplasm. Proceedings of the National Academy of Sciences of the United States of America. 2023 Jun 26;120(27).
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