For decades treating cancer has been an enormous problem because unlike infection or intoxication, cancer is us. The problem of killing the problem without killing ourselves forced treatment down two channels – one, to cut it out physically or kill it (and its neighbors) with targeted radiation. The other approach, chemotherapy, takes advantage of the knowledge that unlike most of our cells, cancer cells stay in an endless growth phase. Almost all chemotherapeutics kill off or arrest any cells trying to pass through cell division, which is a problem for the small fraction of cells in our body which need to constantly divide. As a result most chemotherapy cannot be separated from very unpleasant side effects.
Having only two basic treatment options at this point in the twenty-first century, the principles of which date back decades or more, feels like a letdown. The good news is that at least four more approaches are in the testing phase. A quick rundown:
* Vaccines. The human papillomavirus causes 50% of all cervical cancers. Finally, despite some shockingly tin-eared protests we now have a vaccination which is nearly 100% effective and among the safest treatments ever tested by the FDA. Viral cancers are only a small subset, but more research will undoubtedly find more types which can quickly become a bad memory.
* Resveratrol, known around here as the second best reason to drink red wine, fights cancer by forcing cells to take more care in replicating DNA. Resveratrol treatment could slash the frequency of cancers which come from DNA mistakes (as I understand it, a significant majority). Treatment might also prevent a benign tumor from mutating into a malignancy but for now resveratrol should be considered largely a preventative treatment.
* On the therapy side researchers have begun using two unique characteristics of malignant tumors to bring treatment closer to the problem. First, researchers in Singapore have created antitumor drugs encapsulated in a nanocarrier (think, a high-tech version of the coating on an Advil) that only releases the drug when it enters the unusually acidic environment of a tumor.
* Second, tumors generally have a much lower oxygen level than the rest of our tissue. This forces tumor cells to switch their energy plan from the Krebs cycle inside the mitochondria to less efficient lactic acid fermentation, which happens throughout the cytosol. Unused mitochondria will go dormant in tumor cells, reduce in number and even disappear entirely. A remarkable new report suggests that a drug called dichloroacetate forces mitochondria to reactivate in tumor cells. Affected cells, lacking the ability to cope with both active mitochondria and an anoxic environment, eventually wither and die.
I have no illusions that technology will catch up with nature and the toxic by-products of our own civilization. Like the world of hackers and tech security medicine will always be trapped in a frustrating game of catch-up (ask, e.g., any friends working on an AIDS vaccine). The best that we can hope for is to knock over some problems that have stayed frustratingly out of our grasp. We won’t reach Eden but at least we’re moving in the right direction.
This post is dedicated to Jane Hamsher, who needs to get better so that she can go on ticking off the John Coles of the apostate right.