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Wednesday, February 1, 2023

Cancer: Redefining the “cure” for cancer

Is there a cure for cancer? This is a very complex question.  Cancer is not a single unit.  It is comprised of numerous individual diseases that are formed together because of the abnormal proliferation or growth of certain cells.  Also, specific types of cancers, such as breast cancer, are made up of numerous different diseases that may require different management, although originating from the same general types of cells.  Unfortunately, almost any normal process in the body can go askew, and when that happens, we suffer from diseases.

As an example, in breast cancer, there are many differences in the expression of hormone receptors and HER-2 status that influence appropriate care. Testing for a variety of genetic mutations helps to direct whether some patients should be given chemotherapy.  The extent of a cancer (whether it is one small tumor as compared to many metastatic masses) has a great impact on what supervision is used.  Based on information doctors have about a cancer, it is decided whether radiation, surgery, medication, or some combination of all three is appropriate.

Many cancers can by now be cured.  These include cancers that can be completely surgically removed or killed with radiation, as well as cancers that can be wholly killed with chemotherapy, including some lymphomas and leukemia.  However, there are many more circumstances where it is not yet possible to kill every last cancer cell.

Breast cancer can be resected, lung cancer can be surgically detached (if caught early) or even cured with an EGF receptor antagonist much later. CML can be treated with Gleevec, Gastric MALToma can be treated with antibiotics, leukemia can be treated with bone marrow transplants, lymphomas with chemotherapy biologic treatments, colon cancer can be completely removed, squamous and basal cell and cell cancers can be removed, and many other cancers can be put into remission with radiation and/or chemotherapy.

In order to get a “cure for cancer,” we must be able to independently destroy all of the abnormal cells in every one of these possible scenarios, which is not something that is at present achievable, although there are continuing efforts to better treat as many of these cancers as possible. Most significantly, it is also the case that for the most part, we live in an era where we are fortunate to live long enough to even develop cancer. Humans did not develop to live to 100. In the 1850s most people died by their late 30s, owing primarily to fatal infections and other ailments. Now with plentiful food, clean water, vaccines and antibiotics, we live to our 80s. Something ultimately has to break, and unfortunately most frequently it is our own cells.

What causes concerns these days is that any cancer news, especially if pitched as a “breakthrough,” gains outsized media play, often headlined as a potential “cure.” Sadly, much of this is just high-sounding hype which raises false hopes.

In conclusion, what we must keep in mind is that most cancers are preventable. Prevention ultimately boils down to us, our choices. We’ve often heard about simple things anyone can do: Stop smoking and excessive drinking, eat healthy foods, get weight below obesity levels and exercise often. This helps and that is where the hope lies in “Cure for cancer”.

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