I have a good friend who, like me, was diagnosed with cancer about 10 years ago. We often tell each other: “We are so ‘lucky’ that we got sick in this day and age.”
“Lucky,” of course, is in quotes because nobody feels lucky to have gotten this horrible disease. But it’s better to have gotten it in the modern era when the pace of discovery is so breathtaking and encouraging.
On May 1, two studies published simultaneously exemplify the strides made in understanding the role of genetics in cancer. A study of endometrial cancer and another of the type of cancer I had, acute myeloid leukemia (AML), in Nature and The New England Journal of Medicine, respectively, provided more evidence that cancers can be more usefully classified by their gene mutations than where they originate.
The studies were part of a project by the National Institutes of Health to look at DNA aberrations linking common cancers. The findings suggested that drugs developed to fight one cancer might be useful in fighting another that is related genetically.
Meanwhile, researchers in the leukemia study identified at least one mutation in nearly all AML samples, getting more information on the complex interplay of genetic events contributing to disease progression, and with it, the ability to determine the best way to treat different patients.
“The databases from this study are widely available to serve as a foundation for further investigations of AML pathogenesis, classification, and risk stratification,” the authors wrote.
A diagnosis of leukemia was once considered a death sentence, but now some leukemias have cure rates of 90 percent. It wasn’t so long ago – the late 1950s – when bone marrow transplant and its sister therapy, stem cell transplant, now considered common practice, were seen as a last desperate resort for patients with blood cancers.
The patients usually didn’t survive because their immune system would destroy the transplanted marrow as foreign matter. Enter Dr. E. Donnall Thomas, a Nobel Prize laureate. Through years of research he learned to match tissue types and use drugs to suppress the immune system. His team performed the first matched transplant from an unrelated donor, an “allogenic” transplant like I had, in 1977.
The emphasis in cancer research has changed since President Nixon declared the “War on Cancer” in 1971 and announced that the disease would be cured by 1976. The date for a cure was put off again and again.
“When people say they’re going to eliminate cancer, I don’t know what they mean by that,” Brenda Edwards, Ph.D., a surveillance expert at the National Cancer Institute, told me. “We still have a major health issue.”
The point of view is more complicated now.
“In an earlier time there was a simpler view of what cancer was. We thought that if we put enough money into what was a growing health issue it might go away. The goal of trying to find a magic bullet is inspiring but it was not necessarily realistic,” she said.
Discoveries about the role of genetics in cancer are an example of the newer emphasis on looking at disease specifics. With findings like the ones recently announced, there is plenty of hope to go around.
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