One in two of us will develop cancer at some point in life, according to the latest predictions. But, although a cancer diagnosis is never welcome, it is not as devastating as it was not that long ago.
‘Half of those diagnosed with cancer today will survive for at least ten years – double the number in the 1970s,’ says Dr Justine Alford, senior science information officer at Cancer Research UK. And that’s not all. ‘Greater understanding of the nuts and bolts of cancer is enabling us to diagnose the disease earlier and therefore treat it more effectively.’
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The universal test for cancer
The earlier cancer is picked up, the greater the chance of curbing it. So recent reports from the USA’s Johns Hopkins University of a blood test, CancerSEEK, which can detect signs of eight different kinds of cancer – ovarian, liver, stomach, pancreatic, oesophageal, bowel, lung and breast – is welcome. Known as a ‘liquid biopsy’, it detects fragments of mutated DNA shed by dead or dying cancer cells. More work is needed but, says Dr Nitzan Rosenfeld, who heads a lab investigating liquid biopsy at Cancer Research UK’s Cambridge Institute, ‘data so far is encouraging’.
And it is not just diagnosis that looks set to be transformed. ‘We can also use liquid biopsy to monitor the course of cancer, see how patients are responding to treatment and to check for relapse, enabling doctors to fine-tune treatment,’ explains Dr Rosenfeld, who is also chief scientific officer at Inivata, a company working to bring its own liquid biopsy to the market in the near future. It is likely to be used first to aid treatment decisions in lung cancer.
1. Breathlessness, persistent cough and/or coughing up blood
2. Heavy night sweats
3. Croaky voice/hoarseness
4. Persistent heartburn and/or indigestion
5. Non-healing mouth or tongue ulcer or other non-healing sore
6. Difficulty swallowing or persistent bloating
7. Change in bowel habit, such as constipation, looser and/or more frequent stools, blood in stools
8. Appetite loss and/or unexplained weight loss
9. Problems passing urine and/or blood in your urine
10. Unexplained bleeding from anywhere
11. New mole or change in a mole
12. Unexplained ache, pain or unusual lump or swelling anywhere
The revolutionary therapy for cancer
Cancer cells have evolved cunning ways to evade our immune system, which normally protects us against disease. ‘With a short-term infection such as flu, once the virus is in retreat our immune system puts on “brakes” to restore itself to its normal resting level,’ explains Daniel Davis, Professor of Immunology at Manchester University, and author of The Beautiful Cure, a new book about harnessing the power of our immune system. ‘In cancer, new medicines that block these brakes can enable the body to mount a stronger, longer-lasting immune response.’ Called checkpoint inhibitors, they are already used to treat melanoma skin cancer and lung cancer and are being trialled for other types of the disease.
Another promising approach, meanwhile, is in trials for the treatment of leukaemia and myeloma, a blood cancer that develops in the bone marrow. ‘By taking immune cells called T-cells and genetically modifying them in the lab, we can coax them to search for and destroy cancer cells,’ Professor Davis explains.
Elsewhere, researchers are investigating a cancer vaccine, although as yet only in mice. ‘We’re perhaps now at a tipping point for immune-based medicines, which is reason to be excited,’ he says.
The cancer research breakthrough
Cancer treatments such as chemotherapy and radiotherapy work by killing cancer cells via a process called apoptosis. The trouble is that they can cause unwelcome side effects such as nausea and vomiting, hair loss, easy bruising and bleeding, and fatigue. What’s more, they don’t always scotch cancer cells completely, which can lead to cancer returning.
The chief executioners in apoptosis are chemicals called caspases which, though effective, have a darker side: they have a dual effect and they can actually promote cancer. So news of an innovative way of killing cancer cells that bypasses caspases is an exciting prospect. Called Caspase-Independent Cell Death (CICD), the process contains a hidden bonus in that cells in the throes of death prime the immune system to finish off any stragglers. So far, it’s been used on bowel cancer and is showing promise in prostate cancer cells, too.
‘We hope it could be effective in a wide range of other cancer types,’ says research leader, Dr Stephen Tait of the University of Glasgow’s Cancer Research UK Beatson Institute. ‘The next hurdle is to find a drug that blocks caspases – something that could take ten years from bench to bedside.’ If successful, however, it could offer a radically new way to treat cancer. Watch this space.
The surprising new risk factor for cancer
Some 42% of cancers are linked to our lifestyle. But while we’re all familiar with the importance of not smoking, being active, eating a healthy diet and moderating alcohol, new risk factors are now emerging. One of the more surprising is the discovery that gum disease could be a potential culprit.
In one of several recent pieces of research, a study involving 7,466 people found that over a 15-year period those with severe gum disease had a 24% higher risk of developing any kind of cancer than those with no or mild gum disease. It echoes an earlier study, published last year, which showed that post-menopausal women with a history of gum disease had a 14% increased risk of cancer, including oesophageal, gallbladder and melanoma skin cancers.
‘More research is needed to establish whether gum disease really causes cancer, and if so how,’ says Karen Coates, dental adviser to the Oral Health Foundation. ‘But it underlines the importance of brushing your teeth twice a day with a fluoride toothpaste, flossing or using interdental brushes and paying regular visits to your dentist and hygienist.’
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