Cancer is one of the most feared diseases. Many of us have experienced it or seen a loved one suffer or die as a result. It’s the second biggest killer after heart disease. Half of us are at risk of developing cancer in our lifetime. Scientists and doctors have been trying to defeat it for decades.
And there has been progress. Some cancers can now be cured, such as early-stage prostate and breast cancer, and others can be treated to extend life somewhat. But we still have a long way to go with some of the bigger killers like lung, breast, pancreatic and ovarian cancer.
However, hope has never been greater. We know a lot about what goes wrong when someone gets cancer. Changes happen in the DNA of the cancer cell. The change is often caused by a chemical called a carcinogen, found in things like tobacco smoke, a known cause of lung cancer. Or a virus in cervical cancer, which is why getting vaccinated with the HPV vaccine is so important for young people. Or from sunlight, which can mutate the DNA in skin cells and cause melanoma.
The change in DNA boosts the cancer cells, which grow and grow, eventually forming a tumor that can kill you. Current treatments include surgery to remove the cancer or drugs that target the cancer cells and kill them directly.
A long-established approach is to stimulate your own immune system to kill cancer. Some people are lucky enough to achieve spontaneous remission from cancer, and that’s often because their immune system, for some reason, is waking up to kill it.
Over 100 years ago, a doctor named William Coley showed that stimulating the immune system with bacterial products could treat cancer in some cases, but it turned out to be too toxic. So there was always the hope that somehow stimulating the immune system might work. And after much trying, progress has been made.
Checkpoint inhibitors have been developed to work on some cancers that were previously fatal, such as melanoma and lung cancer. And a recent study reported that checkpoint inhibition cured 18 people with colon cancer. Current approaches using chemotherapy, radiation and surgery only work in a quarter of patients and have serious side effects, so this is real progress.
Checkpoint inhibitors work by raising the immune system’s checkpoint that tumors shut down to prevent your immune cells from entering the tumor.
Imagine the tumor lowers a checkpoint on the road that prevents your immune cells from entering the tumor. Checkpoint inhibitors prevent the barrier from falling down, allowing the immune cells to flood in and kill the tumor. However, they do not work in all cases and a lot of effort is being made to optimize them.
Another approach that uses your own immune system sounds futuristic. It involves taking your own blood and severing special cells called T cells. Then a gene is inserted into the T cells that turns them into cancer-destroying superheroes. They are then returned to your body where they seek out and destroy the cancer.
This technology, called CAR-T, has been shown for the first time to be very effective against certain types of leukemia, a cancer of the blood cells. But now it’s been shown to work in other types of cancer, too. Recently, a 71-year-old woman with pancreatic cancer received a single blood infusion containing cancer-killing T cells. They killed the tumor and saved the woman.
Checkpoint inhibition and CAR-T are called cancer immunotherapy – and I was recently asked to help organize next year’s International Cancer Immunotherapy Conference in the US, where the latest developments will be discussed.
One of my co-organizers said they have been meeting for over 30 years. Most of the time there was little progress, but that has changed with immune checkpoint inhibitors and CAR-T. You must hand it over to the scientists for their persistence.
All of these promising developments are why Joe Biden last week announced the Cancer Moonshot Initiative, which aims to cut cancer death rates in the United States by half within 25 years.
He gave a speech in Boston that consciously recalled John F. Kennedy’s famous 1962 “shot on the moon” speech and recommitted the goal of putting a man on the moon by the end of the decade. As we all know, this was achieved in 1969.
But Biden’s goal is more important because if it’s achieved, the cancer will finally be on the run. In his speech, he said that just like Kennedy’s time, America is very divided and that like Kennedy’s moonshot idea, a new goal is needed to unify the country, and that is the fight against cancer. He says cancer “doesn’t discriminate…it doesn’t matter if you’re Republican or Democrat. I give you my word as Biden: This Cancer Moonshot is one of the reasons I ran for President.”
He’s not the first president to talk about curing cancer. Richard Nixon declared war on cancer, and Barack Obama announced a plan to “make America the country that will cure cancer once and for all.” And it even made it The western wing, where a speech by President Bartlet actually compared the fight to JFK’s moonshot speech. Maybe Joe Biden was watching. He said the focus will be on finding cures, but also ways to treat cancer so that cancer “moves from being a death sentence to a chronic disease that people can live with.”
Will it work? There is much reason for optimism. There are always new discoveries that should translate directly into benefits for patients.
Another major cancer event in the past week was a simple blood test that can detect multiple cancers in patients before they even develop symptoms. This is an important goal in cancer diagnosis because the earlier cancer is detected, the greater the chance of stopping it either through surgery or anticancer drugs.
This Pathfinder study looked at how well the screening test worked in more than 6,600 people over the age of 50. Cancers that might otherwise have been missed were found in the blood of 92 people. The doctors were able to detect the altered cancer DNA. Cancers of the breast, liver, lung, colon, ovaries and pancreas have all been detected. Some of these, like pancreatic cancer, are often not recognized until it is too late, and some are not routinely screened.
Naser Turabi, who works for the Cancer Research UK charity, said: “Blood tests for different types of cancer used to belong in the realm of science fiction, but now it’s an area of cancer research that shows promise for patients.” transmitted to larger numbers of patients before hopefully becoming widespread.
Dare we dream that just like JFK’s hope of putting a man on the moon, Biden’s dream of preventing half of all cancers came true, and who knows, maybe all cancers will come true too? I think so. And that belief is based on science.
Luke O’Neill is Professor of Biochemistry in the Department of Biochemistry and Immunology at Trinity College Dublin
https://www.independent.ie/opinion/comment/a-cure-for-cancer-is-no-longer-just-a-dream-as-promising-discoveries-emerge-41997307.html A cure for cancer is no longer just a dream as promising discoveries emerge