09 November 2008

Redefining Cancer: A chronic condition similar to AIDS?

Interesting article today from Scientific American on the connection between the development of cancerous cells and inflammation.

The six-page article sites numerous studies including, importantly, two recent ones, which suggest that the prevailing view of cancer and thus how it should be treated - that a cancerous growth is like a diseased organ which needs excision - may be wrong.

Instead, it may be better to view and treat cancer more like a chronic condition.

I quickly read all six pages - well, more scanned the last one and a half - and extracted these bits as the most relevant for the non-health techs among us.

Inflammation, its hallmark characteristic, has gained recognition as an underlying contributor to virtually every chronic disease—a list that, besides obvious culprits such as rheumatoid arthritis and Crohn’s disease, includes diabetes and depression, along with major killers such as heart disease and stroke. The possibility of a link with a third major killer—cancer—has received intensive scrutiny in this decade...

As some researchers have described the malignant state: genetic damage is the match that lights the fire, and inflammation is the fuel that feeds it....

Rooting out every last cancer cell in the body might not be necessary. Anti-inflammatory cancer therapy instead would prevent premalignant cells from turning fully cancerous or would impede an existing tumor from spreading to distant sites in the body. Cancer sufferers might then be able to survive, in the same way that new drugs have let HIV patients live longer. “I don’t think a cure is necessarily the goal. It doesn’t need to be,” comments Lisa M. Coussens, a cancer biologist at the University of California, San Francisco. “If you can manage the disease and live your natural life span, that’s a huge win.”

...In recent years a body of evidence has accumulated to show that chronic inflammation can play an important role in the progression of some types of tumors from a premalignant state to full-blown disease. A link between cancer and inflammation has long been suspected... Cancer biologist Harold F. Dvorak of Harvard Medical School remarked in 1986 that tumors are “wounds that do not heal.” The status quo, though, lay elsewhere. Even a decade ago many biologists still hewed to the idea that the immune system serves not only to eliminate pathogens but to ferret out cells that are the abnormal precursors of cancer....

Cutting into tumors, such as for a prostate biopsy, sometimes seems to encourage metastasis [suggesting that] the inflammation generated by the intervention could be at fault....

Instead of just killing cancer cells—the goal of current drug therapies and radiation—new approaches may supplement existing drugs by slowing inflammation. Without the involvement of macrophages and other innate cells, the premalignant tissue would remain in check.

Cancer could, in essence, become a chronic disease akin to rheumatoid arthritis, another inflammatory condition. “Keep in mind almost no one dies of primary cancer,” says Raymond DuBois, provost of the University of Texas M. D. Anderson Cancer Center and a researcher of anti-inflammatory agents for cancer. “A patient almost always dies from a metastasis.”

... it seems likely that a new generation of anti-inflammatory agents will join the chemotherapeutic arsenal. Chronic diseases—and their underlying inflammatory conditions—are hallmarks of an aging population. “We’re all a little bit overinflamed,” Pollard observes. Treating the smoldering embers that surround the tumor rather than just mutant cells could make cancer a disease we can live with.

Call me a cynic, but I do wonder how well the cancer industry has received this news.

I mean, oncologists and others related to the industry - including certain charitable foundations whose admin costs absorb the largest share of all donation dollars - have made whole careers on the existence of cancer as a condition which needs a huge investment in research, and whose treatment is surgery and/or drug and radiation therapy.

Recommend this post