For decades treating cancer has been an enormous problem because unlike infection or intoxication, cancer is us. The problem of killing the problem without killing ourselves forced treatment down two channels – one, to cut it out physically or kill it (and its neighbors) with targeted radiation. The other approach, chemotherapy, takes advantage of the knowledge that unlike most of our cells, cancer cells stay in an endless growth phase. Almost all chemotherapeutics kill off or arrest any cells trying to pass through cell division, which is a problem for the small fraction of cells in our body which need to constantly divide. As a result most chemotherapy cannot be separated from very unpleasant side effects.
Having only two basic treatment options at this point in the twenty-first century, the principles of which date back decades or more, feels like a letdown. The good news is that at least four more approaches are in the testing phase. A quick rundown:
* Vaccines. The human papillomavirus causes 50% of all cervical cancers. Finally, despite some shockingly tin-eared protests we now have a vaccination which is nearly 100% effective and among the safest treatments ever tested by the FDA. Viral cancers are only a small subset, but more research will undoubtedly find more types which can quickly become a bad memory.
* Resveratrol, known around here as the second best reason to drink red wine, fights cancer by forcing cells to take more care in replicating DNA. Resveratrol treatment could slash the frequency of cancers which come from DNA mistakes (as I understand it, a significant majority). Treatment might also prevent a benign tumor from mutating into a malignancy but for now resveratrol should be considered largely a preventative treatment.
* On the therapy side researchers have begun using two unique characteristics of malignant tumors to bring treatment closer to the problem. First, researchers in Singapore have created antitumor drugs encapsulated in a nanocarrier (think, a high-tech version of the coating on an Advil) that only releases the drug when it enters the unusually acidic environment of a tumor.
* Second, tumors generally have a much lower oxygen level than the rest of our tissue. This forces tumor cells to switch their energy plan from the Krebs cycle inside the mitochondria to less efficient lactic acid fermentation, which happens throughout the cytosol. Unused mitochondria will go dormant in tumor cells, reduce in number and even disappear entirely. A remarkable new report suggests that a drug called dichloroacetate forces mitochondria to reactivate in tumor cells. Affected cells, lacking the ability to cope with both active mitochondria and an anoxic environment, eventually wither and die.
I have no illusions that technology will catch up with nature and the toxic by-products of our own civilization. Like the world of hackers and tech security medicine will always be trapped in a frustrating game of catch-up (ask, e.g., any friends working on an AIDS vaccine). The best that we can hope for is to knock over some problems that have stayed frustratingly out of our grasp. We won’t reach Eden but at least we’re moving in the right direction.
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This post is dedicated to Jane Hamsher, who needs to get better so that she can go on ticking off the John Coles of the apostate right.
Krista
Get well soon, Jane. Use that impressive scrappiness and kick cancer’s ass!
Pb
Note that dichloroacetate is often found in chlorinated drinking water, and may itself be a carcinogen–dichloroacetate has been linked to liver cancer in lab mice and rats, but in very high dosages, mind you. However, if it is a carcinogen in humans, I think it’s relatively weak, at least in the doses that we’re used to–there are stronger carcinogens usually found in chlorinated water, and so far they’ve collectively been estimated to cause roughly 5,000 or so cases of bladder cancer in the US per year, total, and not much else, at least according to the paper I linked.
Punchy
Ah…a post BUILT for me! Where to begin? Jane is in serious trouble. Cancer a third time is usually one time more than almost anyone is alive to experience. I wish her the best.
The question I pose to Tim and others: what efficient delivery system could be used to access the inner regions of solid tumors? Simple injections (does DCA passively or faciliatedly diffuse?) may work. I’m doubting oral, IM, subcut, or buccual systems would work, as what, exactly, is the extent of vascularization of solid tumors? I’m guessing it’s quite variable dependent largely on the origin of tissue gone oncogenic.
Face
Thymadine dimers, bitches! Looks like I’ll be suntanning this summer with a glass of Two-Buck Chuck at the ready.
ThymeZone
I’m sorry to hear that John is having trouble with his postate.
TenguPhule
I hear you have to clear it out every so often or an excess buildup of Darrells begin to clog the pipes.
ThymeZone
Ugh. A Darrell clot?
Keith
There was also a study released last week or the week before that found stem cells at the core of at least some tumors, and that implanting regular tumor cells in a rat led to tumor death, while implanting the stem “seed,” the tumor spread. There are all kinds of caveats (is this just one type of tumor? does this only happen in rats?), but it wound up sounding like one of those “oh, yeahhhh, that makes perfect sense” moments like when astronomers found supermassive black holes sitting in the centers of a bunch of galaxies.
rilkefan
Tim, my vague understanding was that some or much of the effectiveness of radiation (and maybe chemo-) therapy was to set off the body’s own repair mechanisms (P53 comes to mind) in response to damage.
There was a dKos thread or three about that report, with a number of expert-sounding people chiming in to say this dichloroacetate story is the-flavor-of-the-day-ish.
TenguPhule
More like constipation.
ThymeZone
Oh dear. Time to insert the Darrell Softener then.
demimondian
Is that a supposition?
Pb
It’s a supposition: before a colon.
scarshapedstar
In re: DCA, or lack thereof…
Best in the world, baby, and all because we pay for the R&D.
Krista
He could probably have that taken care of, but he’d once again have to turn the other cheek…