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
  • 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

A photo pointing out a cancerous growth in a lung.

Photo: James Heilman/Wikimedia Commons

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.

Photo: Wikimedia Commons

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

The hydrocarbons and amines formed from grilling over high temperatures are known cancer-related compounds.

Photo: Pxhere

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?

Photo: Senior Airman Areca T. Wilson/U.S. Air Force

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.

Photo: NIH/Flickr

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.

Cancer-killing bacteria

An image of the E. coli bacteria. Will these become the next breakthrough in cancer therapies?

Photo: NIAID/Wikimedia Commons

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.

Source: American Cancer Society/ Our World in Data

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.

U.S. Navy controls inventions that claim to change "fabric of reality"

Inventions with revolutionary potential made by a mysterious aerospace engineer for the U.S. Navy come to light.

U.S. Navy ships

Credit: Getty Images
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Meet Dr. Jennifer Doudna: she's leading the biotech revolution

She helped create CRISPR, a gene-editing technology that is changing the way we treat genetic diseases and even how we produce food.

Courtesy of Jennifer Doudna
Technology & Innovation

This article was originally published on our sister site, Freethink.

Last year, Jennifer Doudna and Emmanuelle Charpentier became the first all-woman team to win the Nobel Prize in Chemistry for their work developing CRISPR-Cas9, the gene-editing technology. The technology was invented in 2012 — and nine years later, it's truly revolutionizing how we treat genetic diseases and even how we produce food.

CRISPR allows scientists to alter DNA by using proteins that are naturally found in bacteria. They use these proteins, called Cas9, to naturally fend off viruses, destroying the virus' DNA and cutting it out of their genes. CRISPR allows scientists to co-opt this function, redirecting the proteins toward disease-causing mutations in our DNA.

So far, gene-editing technology is showing promise in treating sickle cell disease and genetic blindness — and it could eventually be used to treat all sorts of genetic diseases, from cancer to Huntington's Disease.

The biotech revolution is just getting started — and CRISPR is leading the charge. We talked with Doudna about what we can expect from genetic engineering in the future.

This interview has been lightly edited and condensed for clarity.

Freethink: You've said that your journey to becoming a scientist had humble beginnings — in your teenage bedroom when you discovered The Double Helix by Jim Watson. Back then, there weren't a lot of women scientists — what was your breakthrough moment in realizing you could pursue this as a career?

Dr. Jennifer Doudna: There is a moment that I often think back to from high school in Hilo, Hawaii, when I first heard the word "biochemistry." A researcher from the UH Cancer Center on Oahu came and gave a talk on her work studying cancer cells.

I didn't understand much of her talk, but it still made a huge impact on me. You didn't see professional women scientists in popular culture at the time, and it really opened my eyes to new possibilities. She was very impressive.

I remember thinking right then that I wanted to do what she does, and that's what set me off on the journey that became my career in science.

CRISPR 101: Curing Sickle Cell, Growing Organs, Mosquito Makeovers | Jennifer Doudna | Big Think www.youtube.com

Freethink: The term "CRISPR" is everywhere in the media these days but it's a really complicated tool to describe. What is the one thing that you wish people understood about CRISPR that they usually get wrong?

Dr. Jennifer Doudna: People should know that CRISPR technology has revolutionized scientific research and will make a positive difference to their lives.

Researchers are gaining incredible new understanding of the nature of disease, evolution, and are developing CRISPR-based strategies to tackle our greatest health, food, and sustainability challenges.

Freethink: You previously wrote in Wired that this year, 2021, is going to be a big year for CRISPR. What exciting new developments should we be on the lookout for?

Dr. Jennifer Doudna: Before the COVID-19 pandemic, there were multiple teams around the world, including my lab and colleagues at the Innovative Genomics Institute, working on developing CRISPR-based diagnostics.

"Traits that we could select for using traditional breeding methods, that might take decades, we can now engineer precisely in a much shorter time."
DR. JENNIFER DOUDNA

When the pandemic hit, we pivoted our work to focus these tools on SARS-CoV-2. The benefit of these new diagnostics is that they're fast, cheap, can be done anywhere without the need for a lab, and they can be quickly modified to detect different pathogens. I'm excited about the future of diagnostics, and not just for pandemics.

We'll also be seeing more CRISPR applications in agriculture to help combat hunger, reduce the need for toxic pesticides and fertilizers, fight plant diseases and help crops adapt to a changing climate.

Traits that we could select for using traditional breeding methods, that might take decades, we can now engineer precisely in a much shorter time.

Freethink: Curing genetic diseases isn't a pipedream anymore, but there are still some hurdles to cross before we're able to say for certain that we can do this. What are those hurdles and how close do you think we are to crossing them?

Dr. Jennifer Doudna: There are people today, like Victoria Gray, who have been successfully treated for sickle cell disease. This is just the tip of the iceberg.

There are absolutely still many hurdles. We don't currently have ways to deliver genome-editing enzymes to all types of tissues, but delivery is a hot area of research for this very reason.

We also need to continue improving on the first wave of CRISPR therapies, as well as making them more affordable and accessible.

Freethink: Another big challenge is making this technology widely available to everyone and not just the really wealthy. You've previously said that this challenge starts with the scientists.

Dr. Jennifer Doudna: A sickle cell disease cure that is 100 percent effective but can't be accessed by most of the people in need is not really a full cure.

This is one of the insights that led me to found the Innovative Genomics Institute back in 2014. It's not enough to develop a therapy, prove that it works, and move on. You have to develop a therapy that actually meets the real-world need.

Too often, scientists don't fully incorporate issues of equity and accessibility into their research, and the incentives of the pharmaceutical industry tend to run in the opposite direction. If the world needs affordable therapy, you have to work toward that goal from the beginning.

Freethink: You've expressed some concern about the ethics of using CRISPR. Do you think there is a meaningful difference between enhancing human abilities — for example, using gene therapy to become stronger or more intelligent — versus correcting deficiencies, like Type 1 diabetes or Huntington's?

Dr. Jennifer Doudna: There is a meaningful distinction between enhancement and treatment, but that doesn't mean that the line is always clear. It isn't.

There's always a gray area when it comes to complex ethical issues like this, and our thinking on this is undoubtedly going to evolve over time.

What we need is to find an appropriate balance between preventing misuse and promoting beneficial innovation.

Freethink: What if it turns out that being physically stronger helps you live a longer life — if that's the case, are there some ways of improving health that we should simply rule out?

Dr. Jennifer Doudna: The concept of improving the "healthspan" of individuals is an area of considerable interest. Eliminating neurodegenerative disease will not only massively reduce suffering around the world, but it will also meaningfully increase the healthy years for millions of individuals.

"There is a meaningful distinction between enhancement and treatment, but that doesn't mean that the line is always clear. It isn't."
DR. JENNIFER DOUDNA

There will also be knock-on effects, such as increased economic output, but also increased impact on the planet.

When you think about increasing lifespans just so certain people can live longer, then not only do those knock-on effects become more central, you also have to ask who is benefiting and who isn't? Is it possible to develop this technology so the benefits are shared equitably? Is it environmentally sustainable to go down this road?

Freethink: Where do you see it going from here?

Dr. Jennifer Doudna: The bio revolution will allow us to create breakthroughs in treating not just a few but whole classes of previously unaddressed genetic diseases.

We're also likely to see genome editing play a role not just in climate adaptation, but in climate change solutions as well. There will be challenges along the way both expected and unexpected, but also great leaps in progress and benefits that will move society forward. It's an exciting time to be a scientist.

Freethink: If you had to guess, what is the first disease you think we are most likely to cure, in the real world, with CRISPR?

Dr. Jennifer Doudna: Because of the progress that has already been made, sickle cell disease and beta-thalassemia are likely to be the first diseases with a CRISPR cure, but we're closely following the developments of other CRISPR clinical trials for types of cancer, a form of congenital blindness, chronic infection, and some rare genetic disorders.

The pace of clinical trials is picking up, and the list will be longer next year.

Ancient megalodon shark was even bigger than estimated, finds study

A school lesson leads to more precise measurements of the extinct megalodon shark, one of the largest fish ever.

Megalodon attacks a seal.

Credit: Catmando / Adobe Stock.
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