Cancer – getting more complicated ?

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Two weeks or so ago I wrote a long piece on how there has been little improvement over the last 50 years in the cancer death rate (though there has been some improvement in survival rate but this is balanced out by a higher incidence rate of cancer).

The question then becomes why hasn’t cancer research proved more successful? Well one reason might be the single molecule paradigm that has dominated almost all biological science research over the last 50 years – which might be misguided.

A piece covered in Wired magazine points to a new approach of looking at molecular pathways instead of  individual gene/molecule targets (the dominant paradigm). This point of looking at the ‘whole’ picture instead of isolated single molecule approach is something I have highly encouraged in my own avenue of science research. I personally don’t think we should stop at focusing on one pathways but take even a wider approach – but I understand the technical difficulties of looking at the whole picture.

The actual two scientific papers  (pancreatic and brain cancers) the article discuses were recent articles published in the esteemed Science magazine (both articles were science-express articles) that examined both pancreatic and brain cancers.

What the two papers found that of dozens of mutations that are involved in cancer for any given tumor only a few were found. So even if you have a successful treatment paradigm it will only affect a relatively small number of the tumors. And this is without going into the redundancy and compensation possibilities of these pathways.

From the Wired article:

“Virtually all drug development over the past ten years has focused on targeted therapies directed against individual genes or gene products,” said Bert Vogelstein, a Howard Hughes Medical Institute cancer researcher and co-author of the studies, both published today in Science. “It’s going to be even more difficult than previously expected to derive real cures from such therapies.”

He goes on to point out that most drugs developed for cancer (that were developed in the last 10 years) have failed in clinical tests and the ones that have made it to market produces have very little effect. And you would think the last 10 years with all the advances and money spent would bear more fruit.

The following quotes point out the problem with single molecule approach but also the difficulties with multiple pathway treatments:

“A simple reliance on dominant gene product mode of drug discovery will likely be fraught with disappointment,” said Lynn Hlatky, director of the Center of Cancer Systems Biology at Tufts University. She was not involved in the studies.

But other researchers say that pathway-targeting drugs are more complicated than they seem. Jackson Laboratory cancer researcher Tom Gridley agreed “you’ll never be able to come up with enough drugs to target each individual component,” but held out hope that high-profile genes could still be targeted.

Damned if you don’t and damned if you do – could be the take home message – but I am still hopeful if we can shake off the single gene approach that we are more likely to find answers by looking at the ‘bigger picture”.

And a final point by Vogelstein should be heeded.

“the history of medical research shows that the best way to control diseases in the long term is by prevention, not therapy.”

So make sure you are choosing the correct lifestyle choices that will not only reduce your chances of being diagnose with cancer but also give you MORE LIFE (the same old prescription: exercise and eat right).

2 comments for “Cancer – getting more complicated ?

  1. CC
    September 9, 2008 at 12:39 am

    Are there cancers ‘unpreventable’, those that come with age? If I live a healthy and long (the really long kind) life, won’t that increase the chances of getting those types of cancer?
    So be unhealthy and die with e.g. lung cancer, or be healthy and die with ‘old age’ cancer?

  2. Ward
    September 9, 2008 at 8:45 am

    I don’t know the exact specifics, but yes I think you have it right. You can live an unhealthy life and increase the possibility of getting cancer when you are relatively young 40-65, or if you live healthy you then can decrease your chances of getting cancer. Of course assuming you do not get any other major disease that kills you, as you age the probability of being diagnosed with cancer increases (but it would be still less likely if you live a ‘good’ lifestyle. If I had a choice I would rather delay the death and have many more healthy and active years.