By Anudeep Deevi.
Given the current technology and knowledge, many people wonder why there is no cure for cancer yet. Is there one single aspect that, if known, will revolutionize the fight against cancer? Is there some private corporation that is holding back the cure to gain more revenue from treatment? Is cancer, despite best intentions, simply incurable? Well the answer to these questions is No. The cure for cancer has not been found because society, and even the scientific community have approached this matter in the wrong way. Cancer is not a single disease, but instead an umbrella term for several diseases with similar characteristics such as oncogene defect and uncontrollable cell growth. Specifically, the scientific community has not found a cure for cancer, because of the diversity and complex mechanisms of the causes and pathways of cancer.
The diversity of numerous types of cancer makes it difficult to find a single cure. Diversity means not only the exact cause but also the unique pathways taken for a normal cell to become cancerous. To date, scientists have categorized over 100 types of cancer afflicting different parts of the body. However, they are in and of themselves different diseases with different causes, and not merely manifestations of a single disease. The simple cause of cancer includes “alterations in the same gene, often…associated with different forms of cancer. These malfunctioning genes can be broadly classified into three groups. The first group, called proto-oncogenes, produces protein products that normally enhance cell division or inhibit normal cell death. The mutated forms of these genes are called oncogenes. The second group, called tumor suppressors, makes proteins that normally prevent cell division or cause cell death. The third group contains DNA repair genes, which help prevent mutations that lead to cancer.”(Hartwell, “Cell Biology and Cancer”). That being said, each cancer has a different gene mutation, which makes a single cure difficult to procure, as some drugs will fix some oncogenes while neglecting to take care of or even aggravating other oncogenes. Each type of cancer contains a distinctive array of unique oncogenes that leads to that specific form of cancer. “For example, the BRCA1 and BRCA2 breast/ovarian cancer risk genes are both involved in DNA repair,” and are known to lead to the development of both breast and ovarian cancers. (Osborne, “Oncogenes and Tumor Suppressor Genes in Breast Cancer: Potential Diagnostic and Therapeutic Applications”). Another example is non-small cell lung cancer, the most common type of lung cancer, whose development can be attributed to “Acquired changes in certain genes, such as the TP53 or p16 tumor suppressor genes and the KRAS or ALK oncogenes.”(A.C.S, Do we know what causes non-small cell lung cancer?). Even though genes for both of the cancers are tumor suppressors, they are found on different parts of a different chromosome and even the abundance of the gene changes from cell to cell. Although cancers have some unique oncogenes that can be predictable in diagnosis of the patient, there are still rare cases and exceptions where a completely different pathway from the same oncogene, or even a different oncogene is totally mutated. For example defects in the spindle cells of interior tissues of the body can lead to an issue called sarcomatoid carcinoma, in which common cancer strains, like breast and prostate are caused by the aforementioned spindle cell defect which affects a different proto-oncogene. Aside from the cell biology of cancer, there are outside forces that deliberately activate proto-oncogenes into oncogenes.
Another reason for the lack of a cancer cure is that the mechanisms of unique carcinogens are complex, involving several mutations and distinctive defects on unique genes. Although genetics and radiation are the two most common causes of cancer, other carcinogens such as toxins and even certain lifestyle choices can lead to cancer. The fact of the matter is that “exposure to different cancer-causing agents can influence which type of cancer will form. For example, chemicals present in cigarette smoke cause specific kinds of mutations in the p53 gene. These lesions are frequently seen in lung cancer but not other kinds of cancer. Aflatoxin, a toxic molecule produced by a mold that grows on improperly stored peanuts and grains, generates a different mutation in the p53 gene—one associated with liver cancer. UV radiation causes yet a different type of p53 mutation that is found in 90 percent of patients with skin tumors but rarely in cancers of the liver or lung.”(HHMI, “Understanding Cancer Diversity”). Here it can seen, three different carcinogens acting upon a single gene, resulting in three different cancers in three different areas of the body. Thus just looking at a single gene will not tell the whole story about the exact carcinogen that caused this cancer. In addition to the lack of ability to determine the exact carcinogen that caused a form of cancer, just the sheer diversity of carcinogens causes confusion. Especially within drugs, which range from stimulants to depressants, it is difficult to figure out what single mutation causes cancer. For example, “alcohol (ethanol) is converted into a toxic chemical called acetaldehyde. It can cause cancer by damaging DNA and stopping our cells from repairing this damage.”(C.R.UK, “How Alcohol Causes Cancer”). However, cancer is not caused by one simple malfunctioning gene. The process in which a healthy cell turns into a cancerous one is known as carcinogenesis. This process actually takes at least 5-6 steps to fully manifest itself into cancer. At each step, a different mutation occurs, and another event happens as a result. Since there are hundreds if not thousands of pathways that a cancerous cell can take, it would be almost impossible to map out the exact pathway of the cancer. Also it would take weeks if not months to figure out the exact sequence of mutations of a single person, at which time the cancer could progress to a later stage in which a cure or even common treatment could be simply useless.
Finally, the possibility and even the degree of cancer relapse is subject to many different characteristics including type and treatment of cancer. Primarily the amount of risk and the extent of cancer relapse is dependent upon the type of cancer. There are two type of cancer relapses. Distant cancer relapses are relapses that occur in a different part of the body than the original cancer, that usually has little to nothing to do with the original cancer. Local cancer relapses are just the opposite, which is a result of a single cancer cell that has been left over from the treatment, which then divided and increased into becoming a tumor. While local relapses can be easy to diagnose, because it is the same as the original cancer, distant relapses are a little more difficult to understand. It can be difficult to deduce whether or not the distant relapse is actually connected to the original cancer, or if a completely different source has caused the cancer, especially since no one gains “immunity” from cancer. In addition different cancers require different interventions to prevent relapse. For example, in breast cancers the cells may grow because of estrogen–therefore some medicines to block estrogen will decrease risk (a common medicine is known as tamoxifen). Finally, another type of relapse is actually not a relapse but a development of a second type of cancer. Unfortunately, some cancer treatment can actually cause other types of cancers. One example is the radiation therapy that is used to destroy cancer tumors, can sometimes miss the cancerous cells and even hit healthy cells, which could cause mutations in the proto-oncogenes to activate into oncogenes which therefore would cause cancer. Even though most cancer relapses happen in adults, some occur in children as young as four years old. In the diary entry of a boy named Charlie Rider, a now 8-year old who has fought cancer since the age of four, it accounts the time when “Charlie’s leukemia…returned. Needless to say [Charlie’s Parents] are all – including his doctors – stunned. His new protocol [was] most likely include stronger drugs than he took the last time, and it may even entail a bone marrow transplant.”(Charlie’s Story). The parents indicate that it was surprising that such a disease would come back, even to the doctors who were convinced that the cancer had been totally eradicated. They also expound on the fact that this relapse has led to a more aggressive treatment protocol, that includes more potent drugs, as well as the possibility of a bone marrow transplant surgery.
Despite the complications of determining the exact cause and pathway of cancer, some still claim that cancer is actually curable with a single miracle drug. The rationale for these people includes three assumptions about cancer that these people make. One, since cancer is just clones of a single cell, it’s easy to apply the medication to one cell and have it work for all cells. Two, there are fruits and vegetables out there that have been “proven” to alleviate or even prevent cancer, so therefore we can simply derive some medication from one of these miracle foods. Third, the main cause of cancer is actually microbes and viruses, such as HPV, where it is easy to cure, since antibiotics and other microbial medication can be effective. However, the assumptions made, are just that, assumptions. First of all, the fact that every cell is identical to the same cancerous cell that started the tumor is false. As stated before, carcinogenesis requires at least 6 different mutations in order to fully become cancerous. Therefore, one cell may divide with one mutation, while the daughter cells may undergo another mutation, which will result in the case of each of the six mutations happening in six different cells, making the process of tracing the pathway of the disease much more difficult, by going from cell to cell. The other assumption that there are such miracle foods such as cherries, and the prominence of Indian Ayurveda promoting certain herbs as being preventative measures for cancer, is sometimes just absurd. While there are studies that certain fruits prevent cancer, most of these “common” fruits are only effective when they are only raw and fresh. Most of the food purchased by consumers today are coated by pesticides and treated with loads of GMO chemicals. As a result, not only are the nutrients being lost in the process, but also potential carcinogens and proto-oncogenes activators can enter the food and ingested by the person. Even organic foods may have traces, and those that are truly free of all GMO’s are at times expensive for the average consumer to afford compared to the less expensive kind. Finally the argument about the microbes is also false. While HPV is a prominent cancer-causing virus, the amount of cancer in sexually transmitted forms of cancer (i.e. anal and cervical), outside of that realm, it accounts for less than 1% of the total cancer cases.
It is necessary to look at cancer, not through the lens of misconceptions and widely faked assumptions, but from scientific fact and concrete evidence.
Although cancer may seem like a relatively recent discovery, the first documented case of cancer dates back to the Ancient Egyptians. However, despite all of the past millennia, the cure for cancer still has not been found. Although modern treatment has ameliorated some of its symptoms, for the most part, cancer is just as deadly today as it was thousands of years ago. While many people are outraged at the inability to procure a permanent solution to the problem of cancer, it is worth noting that cancer in and of itself is a peculiar issue. If curing cancer is really as easy as procuring a miracle drug or generating a preventative vaccine, the world would have eradicated it a long time ago, just as was done with smallpox and malaria. The real reason for why cancer has not been cured yet is due to the fact that not much is known about the exact causes of cancers and also the esoteric unpredictability of the exact pathways that healthy cells take in order to become cancerous. Despite these drawbacks, it is actually not right to assume that cancer will take generations to cure and will therefore not be available in the lifetimes of the current world population. Millions of dollars and countless hours of research by competent professionals make a cure more accessible day by day. Some day, within a lifetime, cancer will follow the faith of other plagues, and will merely become a chapter in humanity’s efforts to tame the world around us.