Cancer is looking like something we will always have to live with, as 54% of men and 48% of women will get it at least once in their life in the UK. This figure is increasing, as there are 3% more cases every year (400,000 extra cases in 5 years).

This extraordinary, yet deadly, disease is a by-product of the very process that shaped us humans and every living organism on this Earth. Evolution! This is what makes it so hard to treat, as whenever there is an environmental selection pressure new tumours that are resistant to such drugs become resistant to it and replicate further. To further complicate the problem is the fact that no two cells in a tumour are identical (even though they share similar characteristics), making treatments harder.

Two genes heavily control cell division and we even have corrective genes that try to stop uncontrolled cell division occurring. However, mutations still occur and lead to the chaotic division and formation of a tumour. As no two cells in a tumour are genetically identical, some treatments may not work on all the cancer cells, and the only way to be completely cured is to kill ALL cells.

In theory a therapy that targets one of those base mutations to the gene should destroy every cell in a tumour. This is what scientists tried to do with the BRAF gene, which controlled cell division. A mutation to this gene would cause melanoma (skin cancer). A drug called EGFR, initially giving positive results, easily inhibited this gene. But the gene later mutated, stopping the effect of the drug, and the cancer returned even more deadly than when it first appeared. This is similar to antibiotic resistance, and is again another example of the evolution that occurs within cancer, making it hard to treat.

Many studies have gone into finding better ways to treat cancer via targeting base mutations, such as the one from Charles Swanton at the Watson Crick Institute. He and his team simultaneously targeted three base mutations, producing outstanding results. One of the only problems with this, as is with everything wonderful, is the huge cost. This method of treatment is very expensive, as each treatment is personalised, as they had to create person-to-person antigens, so the right cocktail of therapies was applied.

However successful treatments are, their cost will always be an obstacle to the majority of people, and this is why I feel the main way of stopping cancer is prevention. In 2013 one of the biggest genetic studies took an important step in hyperbolising just how important prevention was. Researchers scoured cancer patients’ genomes to look at signatures of the most common cancer mutations. They showed small chemical changes to the DNA in cancers including lung, skin and ovarian cancer. These all link to the causal factors of UV light, smoking but there is now a lot of effort in trying to work out what these causes for unusual cancer-forming patterns are.

If you have something like cancer, which has increased the number of deaths it has caused rapidly, compared to 100 years earlier, there is obviously a cause due to the modern life we live. In the US there has been a 25% decline in death rates in the last two decades, and more than half is due to prevention activities. Almost 1/3 of deaths form cancer has been due to cigarettes, making tobacco the most preventable cause of death in the world.

Who thought to win the war against cancer would entail having some common sense and slapping a bit of sun lotion on yourself when going on holiday?

Rushil Shah

Photo Credits due to: https://cancer.mercola.com/