Something about cancer
One of the greatest achievements and dreams that a medical student, a physician, and a medical scientist have in common is to cure cancer. Is it possible for us to find a single cure for this terrible disease that affects almost 40% of the human population? How can we defeat the biggest cause of mortality in the US, second only to cardiovascular disease? Haven’t we already spent billions upon billions of dollars and waited a few decades only to meet a stagnation in cancer research? I believe there are many myths on the internet, so we have to put cancer in context and explain a few key points concerning cancer research.
Firstly, we must explain what cancer is.
According to the National Cancer Institute,
“Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.“
Normally, our cells grow and multiply at different rates throughout our bodies, and due to the metabolic strain that they endure, they get damaged and eventually die.
But what is the difference between tumors and cancer? Tumor or neoplasm is simply a term to describe abnormal or excessive growth of a certain tissue and is derived from the Latin noun tumor, meaning swelling, ultimately from the verb tumēre, meaning to swell.
Tumors can be benign or malignant. Benign tumors usually do not invade nearby tissue and do not grow back once removed. Malignant or cancerous tumors invade nearby tissue and are hard to fully remove, so most often than not, they can grow back after removal.
While malignant tumors are far more dangerous, benign tumors are not always so benign after all. Although they don’t invade the tissue around them, benign tumors can grow to be quite big and push surrounding tissue, causing a myriad of different symptoms that require surgical attention.
The next question is, why is cancer so widespread nowadays?
To answer this question, we have to understand a few things about how cancer forms. In his book “The Emperor of all Maladies”, Siddhartha Mukherjee explains that the number one reason cancer is so widespread in the modern world is the fact that our lifespans have greatly increased in the last few decades.
Now we have to understand why cancer cells multiply uncontrollably. If we look at the molecular level, we can see that almost every cell in our bodies possesses a genetic component that serves as a conductor telling every other part of the cell how to function properly and control cell division. Thanks to all kinds of external factors such as smoking, air pollution, ultraviolet light, and genetic factors such as so-called cancer genes that we inherited from our parents, this precise control can go out of balance, causing improper conduction by our cells' conductor.
In case this happens, there are numerous mechanisms by which our cells ensure proper control of cell division. There are tumor suppressor genes, different mechanisms of DNA repair by different proteins, and even our immune system that recognizes potential cancerous cells with the same efficacy as it recognizes foreign organisms such as bacteria and viruses.
During the process of cell division, many mistakes are made and consequently repaired by different DNA repair proteins. If somehow this process goes undetected and faulty genes are made, tumor suppressor genes stop the cell from dividing any further and induce complex cascade events that lead to cell death. This programmed self-destruction of a cell is called apoptosis.
In case even this somehow goes unnoticed, our immune system sends all kinds of cells to stop this uncontrolled charade and kill all of the potentially cancerous cells. As we get older, so do these mechanisms, which are more and more prone to failure.
Thanks to advancements in hygiene and the discovery of antibiotics, the human race doesn’t fear infectious diseases as much as we did in the past. Cancer was very low on the mortality scale back in the day, with tuberculosis and pneumonia taking the spotlight high on this ladder. In other words, we didn’t live long enough to develop any form of cancer, or at least not die from it. So, in a pessimistic sense, we can thank modern medicine for all the cancer mortalities we have today.
So if we know so much about cancer, how come we haven’t cured it yet?
The second point I am trying to make is that there are more than 100 types of cancers that can affect almost any organ in our body, with a few of them taking the lead. All those cancers are very different in origin and thus require individual treatment. There cannot be one cure for cancer since cancer is not one disease but an umbrella term describing a multitude of conditions in which our cells’ mechanisms do not function as they should.
The fact that we might not be able to find one cure for all types of cancer may sound pessimistic, but like all human endeavors, we are getting better at it.
New screening methods to look for cancer combined with public education about its importance have contributed to a much earlier diagnosis of cancer when it is in a much earlier stage, and provide much better treatment outcomes.
New genetic and epigenetic research gave us much better insight into the origin of certain types of cancer, allowing us to create new forms of therapy based on that specific type of cancer.
Not long ago, we had chemotherapy and radiotherapy as the only forms of cancer treatment, and now we have developed immunotherapy as a consequence of the endless striving of many scientists and researchers.
Maybe even more important than genetic predisposition is the fact that we found many environmental risk factors for a lot of types of cancer, and public education about the prevention of cancer proved to be really effective in lowering the incidence.
To end it on a more positive note, we may never find one cure for all types of cancer, but a hundred of them for hundreds of types of cancer.
No matter how many years it takes us to find them, we will eventually, and hopefully, cure cancer as easily as we cure tuberculosis, the former Emperor of all maladies.
Summary:
Cancer affects nearly 40% of people and is a major cause of death, second only to heart disease in the U.S. Despite decades of research and massive funding, a universal cure remains elusive—partly because cancer isn't a single disease, but a collection of over 100 different conditions with diverse causes and behaviors.
What is Cancer? Cancer occurs when cells grow uncontrollably and can spread throughout the body. Tumors, which are abnormal tissue growths, may be benign (non-invasive) or malignant (cancerous and invasive). While benign tumors don't spread, they can still cause health issues due to their size and location.
Why Is Cancer So Common Today? The main reason is that people live longer. Aging weakens natural defenses like DNA repair mechanisms, tumor suppressor genes, and the immune system. External factors like smoking, pollution, UV radiation, and inherited genetic mutations also contribute.
Why Haven’t We Found a Cure? There’s no single cure because cancer is not one disease. Each type arises differently and requires tailored treatments. However, significant progress has been made through:
- Earlier detection via screening and education
- Targeted therapies based on genetic research
- Immunotherapy, which uses the immune system to fight cancer
- Public awareness of environmental risk factors helps in prevention
Hope for the Future While a one-size-fits-all cure may never exist, researchers continue developing many targeted treatments. Like tuberculosis in the past, cancer might one day be a condition we can consistently cure, just not with one solution, but with many.