Across the Expanding Universe
To get a handle on the state of cancer research today, you have to think big. Really big. Astronomically BIG.
“Biology is more complicated than great swaths of the universe,” says Michael Freeman, PhD, director of the Cancer Biology Program at Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute. “The chemistry of a star is pretty simple. But if you look at a single cell, it’s a complex organism.” And a tumor is a shape-shifting colony, one that displays an adaptive intelligence that continues to outsmart us in clinics and laboratories around the world.
Since President Richard Nixon launched the War on Cancer 41 years ago, battles have been fought and won. People are living longer and better with the disease, and some common forms have been eradicated. Targeted therapies, therapeutic vaccines, and improved imaging and screening technologies all give patients additional months and years of life. We are gaining ground.
Still, major victories are elusive, and the diagnosis is commonly received as tragic. Even if a winning therapy is found for a patient, it may fail after a year, or three, or 10. When the word “cure” is used, it is often accompanied by scare quotes and a wistful tone. About half of adults with cancer will eventually die from their disease. It makes Robert Figlin, MD, question whether the War on Cancer remains a relevant concept. “A war has a beginning, a middle, and an end,” says Cedars-Sinai’s director of Hematology/Oncology. “This war is longer than Vietnam, it’s longer than Iraq, it’s longer than World War II, and there are many more casualties.”
The long trudge of the not-war-on-cancer finally has arrived at a turning point. Excavating the human genome has thrown light onto the depths of the disease. Vulnerability does not lie in a single cell, gene, or mutation. Enlightenment and new technology have encouraged scientists to flip an old research paradigm on its head. Dr. Freeman, the cancer biologist, would say we are attacking the cancer universe as a whole instead of one star at a time, raising the possibility of novel treatments that endure. Whether the new approach brings us closer to a cure—and what that even means—is an open question.