10 new things we’ve learned about cancer
Cancer's sweet tooth. Turning cancer cells into fat. Unveiling genetic secrets. Scientists are learning about cancer every day.
- Cancer is a leading cause of death among Americans, second only to heart disease.
- Researchers are unearthing cancer's genetic secrets and, with it, potential new treatments.
- Their efforts have seen the cancer death rate for men, women, and children fall year after year between 1999 and 2016.
The 21st century has been, and will continue to be, shaped by cancer. Although heart disease remains the United States' number one killer, cancer is quickly closing the gap and may soon surpass it. Some oncologists claim a cure is five, 10, certainly no more than 20 years away. Others aren't so sure because, in a way, cancer is the price we pay for evolutionary success.
"It is no coincidence that the very genes that allow our embryos to grow — our hands to grow, our feet to grow — if you mutate them in inappropriate contexts, [they] will ultimately release the disease that kills us," said oncologist Siddhartha Mukherjee, who dubbed cancer the Emperor of All Maladies, also the title of his Pulitzer Prize-winning book.
Whether for five years or forever, cancer won't be going anywhere any time soon. Yet, the more doctors and scientists discover about it, the better we can learn to live with it.
A love-hate relationship: Cancer and antioxidants
Contrary to what many believe, cancer enjoys a nutrient-rich diet as much as the next cell because it helps it grow, even those legendary antioxidants.
In two independent studies published in Cell, Swedish and American research teams found that lung cancer utilizes antioxidants to activate a protein called BACH1. This protein stimulates the cancer cells to metabolize glucose and accelerate metastasis. Even without a ready supply of dietary antioxidants available, the tumor would simply produce its own.
Professor Martin Bergo, who led the Swedish study, hopes this research will help develop new treatments. "We now have important new information on lung cancer metastasis, making it possible for us to develop new treatments, such as ones based on inhibiting BACH1," he said in a release.
Does this mean you should abstain from antioxidant-rich foods? Not at all. Antioxidants do neutralize the free radicals that cause oxidative stress on cells. Preventing such cell damage can help prevent cancer.
However, it's best to avoid antioxidant supplements unless prescribed by a doctor. As reported by the National Cancer Institute, of nine randomized-controlled clinical trials, none provided evidence that such supplements lower cancer risks. A few even found that beta-carotene supplements increased the risk of lung cancer so severely that the trials had to be ended prematurely.
Get your antioxidants from fruits, veggies, and beans instead. Research suggests that these antioxidants work in combination with additional molecules found in the whole foods. It's this tag-team effect that ultimately give antioxidants their salubrious power.
Cancer costs (in more ways than one)
It goes without saying that cancer is costly. The physical strain of treatment. The potential loss of life, whether one's own or the life of a loved one. And even if one survives, there's the emotional cost of the ordeal.
But the toll imposed by cancer is more than physical or psychological. A study released last year found "that 42 percent of patients deplete their life savings during the first two years of treatment." Of the 9.5 million newly diagnosed cancer patients surveyed, the study calculated average losses at $92,098.
Its authors dubbed the effect "financial toxicity" and concluded: "As large financial burdens have been found to adversely affect access to care and outcomes, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance."
Cancer's sweet tooth
A recent study found a positive association between a daily sugary drink and an increased risk of cancer.
Researchers asked more than 100,000 people to complete surveys looking at their usual consumption of 3,300 foods and beverages. The results? A positive association between daily consumption of a sugary beverage and an increased risk of cancer. The sugary drinks not only included soda but also 100 percent fruit juice and artificially sweetened drinks.
"These data support the relevance of existing nutritional recommendations to limit sugary drink consumption, including 100% fruit juice, as well as policy actions, such as taxation and marketing restrictions targeting sugary drinks, which might potentially contribute to the reduction of cancer incidence," the researchers stated in a release.
Don't go trashing the OJ just yet, though. As an observational study, the data could not establish a cause-effect relationship, and the researchers note the results are only preliminary. Additionally, the results hinge on the memories of the participants. (What exactly did you eat for breakfast the Monday before last?)
But the study helps stress the American Institute for Cancer Research's (AICR) suggestion to limit sugary beverages. Try to remove soda from your diet. Drink 100 percent fruit juices with no added sugar sparingly. And of course, enjoy an active, healthy lifestyle.
Cancer on the grill
It's a summer tradition to throw some meat on the grill alongside a good beer. But grilled meats hide a few furtive carcinogens: polycyclic aromatic hydrocarbons and heterocyclic aromatic amines.
The hydrocarbons are carried in the smoke after fat burns on the flame, while the heterocyclic amines form when sugars, amino acids, and creatine react at high heats. Neither has been proven to cause cancer, but they are known mutagens that can damage DNA after being metabolized.
"Research shows that diets high in red and processed meat increase risk for colon cancer," said Alice Bender, AIRC Senior Director of Nutrition Programs. "And grilling meat, red or white, at high temperatures forms potent cancer-causing substances."
Like sugary drinks, however, you don't have to forever hang up your "Kiss the Cook" apron. The institute has several suggestions for safe summer grilling, such as limiting red meat, marinating foods beforehand, keeping a low flame, and throwing more vegetables into the mix.
A unified theory of leukemia
Acute lymphoblastic leukemia (ALL) afflicts about one in 2,000 children, and Mel Greaves, at the Institute of Cancer Research, London, believes he's found the cause. Researching 30 years of data and medical literature on childhood leukemia, he argues the "delayed infection" is the culprit.
According to this theory, children develop a pre-leukemia mutation in utero. The mutation remains inert until later in life when the child encounters a common infection. The microbes then trigger secondary genetic changes that led to overt leukemia.
Does this mean children are safe only in cleanrooms? Strike that, reverse it. Greaves believes exposure to germs in the first year of life is proactive. It trains the immune system to deal with pathogens, therefore preventing the secondary mutation from triggering.
"Childhood ALL can be viewed as a paradoxical consequence of progress in modern societies, where behavioral changes have restrained early microbial exposure," Greaves writes. "This engenders an evolutionary mismatch between historical adaptations of the immune system and contemporary lifestyles. Childhood ALL may be a preventable cancer."
The future of cancer treatment is genetic
A major stride toward our understanding of cancer came with the Human Genome Project. Why? At its core, cancer is a genetic disease.
Our ability to sequence and read cancerous genomes will be a major step toward cancer treatments. As Eric Green, director of the National Human Genome Research Institute, told Big Think:
"[The] standard of care for many types of cancer is going to be: Get that tumor, read out its DNA, sequence its genome and based on what you've seen what's wrong with that tumor -- not by looking at it under a microscope only or by looking at it in a sort of a gross fashion but actually looking inside its blueprint -- you will be able to have a much better way of deciding what types of treatments to pursue and have a much better idea about what's wrong in that kind of tumor."
A future treatment? The "cancer vaccine"
An airman receives a vaccine. Could the future of cancer treatment be as easy as a shot?
Rather than using chemotherapy to combat cancer with the subtlety of an atomic bomb, immunotherapies aim to uncloak cancer cells, so the body's immune system can go on the offensive
One example of an immunotherapeutic approach is the so-called "cancer vaccine." During its clinical trial, 11 patients had a tumor injected with a steroid to bolster the site's dendritic cells — immune system cells that specialize in processing antigens.
Following a light dose of radiation and a stimulant, the patients' dendritic cells directed T-cells to attack the cancer cells. Once the T-cells could recognize the tumor, they became able to locate cancer cells throughout the body.
Of the 11 patients, three saw their cancer go into regression or remission. Six others had their cancer stymied for at least three months.
"It's really promising, and the fact you get not only responses in treated areas, but areas outside the field [of treatment with radiation] is really significant," Dr. Silvia Formenti, chairwoman of radiation oncology at Weill Cornell Medicine and New York Presbyterian, told CNBC. (Dr. Formenti was not involved in the study.)
Turning tumors into fat
Cancer cells spreading to other parts of the body through the circulatory system.
A deadly tool in cancer's arsenal is cell plasticity, a cell's ability to alter its physiological characteristics. It is one of the reasons cancers can metastasize throughout the body, and it helps the disease resist treatments.
Researchers at the University of Basel, Switzerland, have hijacked this ability and turned it against cancer. Using a drug therapy that combined an anti-diabetic drug and MEK inhibitors, they attacked cancer cells and turned them into adipocytes (a.k.a. fat cells).
While this did not remove the tumor, it did make the cells post-miotic, meaning they could no longer divide. This inhibited the cancer's ability to spread.
"In future, this innovative therapeutic approach could be used in combination with conventional chemotherapy to suppress both primary tumor growth and the formation of deadly metastases," senior study author Gerhard Christofori told Medical News Today.
An image of the E. coli bacteria. Will these become the next breakthrough in cancer therapies?
Another advancement in cancer treatment is synthetic biology, a field in which scientists use the principals of engineering to redesign biological systems. In one example, researchers genetically programmed a non-pathogenic E. coli strain to attack tumors in lab mice.
Once injected, the rewired bacteria took refuge in the tumor, where they self-destructed. These dead bacteria leaked from the tumor, and thanks to encoded nanobodies, drew the attention of T-cells which devoured the bacteria and tumor alike.
Of course, lab tests in mice do not guarantee a successful transition to human patients, but it remains a promising avenue for treatment.
"At some point in the future, we will use programmable bacteria for treatment," Michael Dougan, an immunologist at Massachusetts General Hospital, told the New York Times. "I think there's just too much potential."
A new attitude toward cancer
Medical professionals originally viewed cancer as a disease to be destroyed with extreme prejudice; the treatment was only better than the disease because the disease ended in death.
But as David Agus, professor of medicine and engineering at USC, told us, there are better ways to approach cancer:
"Well, to me cancer is a verb and not a noun. You're cancering, it's something the body does and not that the body gets. And so that philosophy needs a very different way of approaching disease, and it means changing the system in addition to trying to target the cancer."
One way is to approach treatment holistically. Agus points to a trial that gave premenopausal women with breast cancer a bone-building drug. The drug didn't target the cancer, yet it reduced recurrence by 40 percent because breast cancer metastasizes in bone.
Another method is psychosocial oncology. In this relatively new field, the practitioners' goal is to enhance the quality of life for cancer patients through mental health care as a part of physical care.
Living with cancer
Cancer death rates in the United States by cancer type, male and female, age standardized.
Scientists have learned a lot about cancer, but there remains much we don't know. Does that mean we should despair for the future? Quite the contrary. Thanks to the knowledge accumulated by scientists, we have much to be hopeful for.
Headlines are correct that the total number of new cancer cases and deaths continue to increase. However, the rates of cancer diagnoses and death have declined year after year. This is because absolute numbers don't account for metrics like population growth and increased life expectancy. In fact, the Annual Report to the Nation on the Status of Cancer found that the cancer death rate for men, women, and children fell year after year between 1999 and 2016, as did cancer incident rates.
"Death in old age is inevitable. The job of science is to prevent unanticipated deaths in unanticipated times. I find that is a perfectly reasonable goal," said Mukerjee. "If you're saying to me that we will have a more profound, more proximal reconciliation with cancer in the next few decades, I think the answer is absolutely yes."
We may not be able to eradicate cancer as we did with diseases like smallpox and polio. But we're learning how to live with it more and more every day.
- Organic food reduces cancer risk by 25% - Big Think ›
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An open letter predicts that a massive wall of rock is about to plunge into Barry Arm Fjord in Alaska.
- A remote area visited by tourists and cruises, and home to fishing villages, is about to be visited by a devastating tsunami.
- A wall of rock exposed by a receding glacier is about crash into the waters below.
- Glaciers hold such areas together — and when they're gone, bad stuff can be left behind.
The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.
Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .
The Barry Arm Fjord
Camping on the fjord's Black Sand Beach
Image source: Matt Zimmerman
The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.
Not Alaska’s first watery rodeo, but likely the biggest
Image source: whrc.org
There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.
The Barry Arm event will be larger than either of these by far.
"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."
Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.
What the letter predicts for Barry Arm Fjord
Moving slowly at first...
Image source: whrc.org
"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."
The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.
Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.
Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.
While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.
Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."
How do you prepare for something like this?
Image source: whrc.org
The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:
"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."
In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.
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