Cancer is one of the most complex problems in modern medicine. There is no one way to stop it, as it manifests in more than 100 ways and can arise from numerous causes. Thousands of cancer-causing gene problems have already been identified, but there are likely hundreds of thousands – if not millions more – that are yet to be discovered.
Gaining a better understanding of why and how this genetic damage occurs – and leads to cancer – continues to be a major goal of cancer scientists.
This is not to say that there has not been progress. In fact, researchers and health professionals have made great strides – inventing more effective and less destructive treatments, identifying more cancer causes (leading to new ways to prevent it), and developing a better understanding of how to manage all of cancer’s side effects – during and after treatment.
Still, cancer remains one of the leading causes of death worldwide. This is why governments and organizations across the globe continue to spend a significant amount of their resources – time and money – on cancer research, training, patient programs, and advocacy. The American Cancer Society is among these contributors. The Society has been conducting and funding cancer research since 1946.
Each year, the American Cancer Society funds a select group of researchers, doctors, and nurses – those who have presented the best ideas with the most potential – to pursue new avenues, as well as strengthen existing ones, in the fight against cancer. The Society announced its first set of new 2014 grantees Tuesday, awarding a total of $42,899,000 to 103 scientists and health professionals.
These grantees will work across all areas of cancer research – from investigating the way specific genetic mutations work to testing new methods and policies to help all populations gain equal access to the best cancer care. Here is an overview of some of that work.
Better Understanding How Cancer Cells Work – And Why They Come About
A cell becomes cancerous when its DNA is damaged. Such damage can happen for myriad reasons, some of which scientists currently understand – and some of which they do not. Cancer then occurs when damaged cells start to replicate and grow out of control, often invading other parts of the body.
Scientists have already uncovered many of the types of DNA problems that can lead to cancer. However, they have not yet found all of the ways in which DNA can become damaged, nor do they fully understand all of the known variations of DNA damage and the role each plays in the cancer process.
This is an area of focus for numerous new grantees. Ekaterina Grishchuk, Ph.D., a researcher at the University of Pennsylvania, is going to study an error that occurs when cells divide. When a normal cell divides, its chromosomes (which carry DNA) must be evenly distributed between the two new cells. Sometimes though, the chromosomes don’t split up evenly, leading to gene abnormality, which can cause cancer.
Grishchuk will conduct experiments to find out how chromosomes duplicate and divide correctly – and how incorrect separation can be prevented. Specifically, she is going to look at the role a protein called CENP-E plays in this process. Grishchuk notes that CENP-E has emerged as a valuable drug target in pediatric cancer in particular. She hopes that the findings will lead to the development of drugs that can force cells in which chromosomes are dividing incorrectly to die off.
Nathan W. Schmidt, Ph.D., at the University of Tennessee, is also investigating a type of DNA damage. While Grishchuk will study a normal cell process gone wrong, Schmidt is looking at another way that DNA can become abnormal – through a viral infection. Burkitt's lymphoma, a common pediatric cancer in sub-Saharan Africa, is linked to the Epstein-Barr virus. Simultaneous infection with malaria seems to speed the development of this cancer. Schmidt is going to research how malaria does this in hopes of devising ways to stop the process.
Emerging Treatments: Targeted Therapy, Personalized Care, Immunotherapy
The basic understanding of how and why cells become cancerous is the research step that leads to the development of cancer treatments. Some of today’s most promising emerging treatment areas include targeted therapy, personalized cancer treatment, and immunotherapy.
Targeted Therapy Taking Off
Targeted therapy has been around since the late 1990s, but remains a developing area in the world of cancer treatments. The concept is to develop drugs that target the specific molecules that have gone awry in cancer cells to stop the cells from growing and spreading. This is different from standard chemotherapy, which involves more of a blanketing approach – killing not just cancer cells, but also healthy cells as a consequence. Targeted drugs work to correct specific problems in the cancer cells.
Scientists are aggressively looking for more targets through which they can attack cancer with specially designed drugs. One new grantee, Christopher Willey, M.D., Ph.D., at the University of Alabama, Birmingham, is researching a target involved in glioblastoma, the most common and aggressive type of brain tumor.
Willey has discovered that when levels of the protein MARCKS are low, glioblastoma behaves more aggressively, but when the MARCKS levels are high, it is much less aggressive. He is going to study a MARCKS-targeted therapy in cell cultures and in human tumors placed in mice as well as look into other factors that control MARCKS. His findings, he hopes, will lead to drugs that use MARCKS to improve outcomes for glioblastoma patients.
Immunotherapy Gaining Steam
Another emerging area of cancer treatment is immunotherapy. These therapies either mimic or use the body’s built-in immune system to attack cancer.
Researcher Amy Moran, Ph.D., at Providence Portland Medical Center, is investigating a major player in immunotherapies, the killer T-cell – a type of white blood cell that fights against abnormal and infected cells, and is important in killing off tumors. The problem is that these killer T-cells don’t always naturally work against cancer because they often fail to recognize the tumor as an enemy.
Moran is using a new genetically engineered mouse that has in its T-cells a glowing protein, which will allow her to essentially watch how the protein behaves to figure out how killer T-cells respond to tumor cells. She believes the experiment will help her to identify immunotherapies with the greatest potential for attacking patients’ tumors across an array of cancers.
Personalized Cancer Treatment Takes Shape
Personalized cancer therapy is a rapidly evolving new strategy for treating cancer. It is not about developing a new type of drug, rather it is about picking the best drugs – or combination of drugs – to treat a specific person’s specific cancer. For example, researchers can now take a sample of a person’s tumor, test it to see which genetic defects are present, and use that information to figure out which drugs would be most effective against that tumor. The goal is to take some of the guess work out of cancer drug treatment.
Darren Roblyer, Ph.D., at Boston University, has come up with a new approach to personalized cancer therapy – using a technology that will allow doctors to monitor chemotherapy response and personalize treatments in real time. This first-ever wearable imaging pad will provide continuous optical measurements as patients receive their first chemotherapy infusion.
Roblyer believes this technology has the potential to transform cancer treatment by making sure patients only receive drugs that effectively treat their tumors – and by allowing doctors to make real-time treatment changes, thus avoiding drug resistance and unnecessary side effects.
Treating the Whole Patient – During and After Cancer
Researching how patients handle cancer’s physical and emotional side effects and what types of support they need to best manage these issues during and after cancer – often referred to as palliative care – is a growing area of focus for cancer scientists and health professionals. With 1,665,540 Americans expected to be diagnosed with cancer in 2014 and approximately 14 million cancer survivors living in the United States today, ensuring these people can not only survive, but actually live quality lives during and after cancer is a priority.
Several new Society grantees will be doing work in the area of palliative care. Tamara J. Somers, Ph.D., at Duke University, is going to test using mobile technology to help cancer patients manage their pain. Patients will receive pain coping skills training via a tablet computer and video conferencing. She will compare their experience to that of patients who get such training in person. Somers hopes that her findings will help lead to more wide-spread use of mobile technology for cancer pain management, which will be highly beneficial to patients who live far from medical centers, are experiencing cancer-related physical challenges, or are facing other practical barriers such as transportation issues.
Life After Colon Cancer Treatment
Quality of life after treatment is another palliative care issue. Jeanne M. Robison, M.N., at Washington State University is studying this issue in colon cancer patients. Robison will be surveying people diagnosed with colon cancer to find out the specific quality-of-life issues they face, including their energy level and bowel and sexual functioning. Her goal is to ultimately develop tools and interventions to improve the quality of life of colon cancer survivors.
Prevention and Early Detection: Obesity, Screening Tests, and More
One of the best ways to fight cancer is to prevent it all together – or detect it early, when it is easier to beat. Research has already uncovered numerous ways to help prevent cancer including staying away from tobacco, wearing sun protection, and leading an active life, among others.
The Obesity Issue
Obesity has emerged in recent years as a key cancer prevention issue. But there is still a lot more to learn about how and why obesity increases cancer risk. New grantee Lisa Tussing-Humphreys, Ph.D., at the University of Illinois, is going to explore the link between obesity and colorectal cancer. Humphreys is focusing on the issue of intestinal inflammation, which obesity can cause. She will study if inflammation-induced change to the way the body metabolizes iron is the reason obesity increases colon cancer risk. She believes her research will help identify whether iron is a risk factor that obese people could modify to reduce their cancer risk.
Increasing Screening Rates
Another grantee is investigating cancer screening issues. Sanja Percac-Lima, M.D., Ph.D., at Massachusetts General Hospital is going to study whether bilingual community outreach workers can help increase lung cancer screening rates among older current and former smokers. Her work will focus on patients who use community health centers, as they are much more likely to smoke compared with people who get care from a private practice. Percac-Lima hopes her study will reveal a way to prevent the development of lung cancer screening disparities.
Making Cancer Care for Everyone a Possibility
Disparities in general are a major issue when it comes to health and to cancer in particular. Just as advances in industry and technology don’t always immediately benefit everyone in society equally, knowledge of and access to the best tools to fight cancer aren’t always evenly distributed across the population. This happens for a wide variety of reasons ranging from the financial to the cultural. Many cancer researchers are working to reverse this problem.
Breast Cancer Disparities
New grantee Cary Gross, M.D., at Yale University is going to explore disparities in breast cancer care. Gross is going study how clinicians’ use of a beneficial, but expensive, personalized cancer care innovation – called gene expression profiling – differs by insurance status, hospital type, and patients’ sociodemographic characteristics. Gross hopes his findings will help to reveal what action could be taken to decrease disparities and excessive costs associated with gene expression profiling.
Disparities in Childhood Cancer
Socioeconomic issues are not the only causes of cancer disparities. Genetics, too, play a role. Jun J. Yang, Ph.D., at Saint Jude Children's Research Hospital is researching how much genetic make-up contributes to racial differences in cure rates for childhood leukemia, the most common childhood cancer. Yang is building on his previous research, which revealed that a specific version of a gene called ARID5B is a major driver of higher leukemia incidence and relapse in Hispanic children. Yang’s goal is to translate his research findings into improved care of children with leukemia and to “eventually eradicate racial gaps in this catastrophic disease.”
Training Cancer Fighters
For researchers and health professionals to make the biggest impact possible on the deadly disease, they need to be trained as cancer experts. The American Cancer Society provides grant funding specifically for this type of training.
One such grant is going to the Simms/Mann–UCLA Center for Integrative Oncology. The school uses the funding for a program aimed at teaching graduate social work students to provide clinical social work services to adults with cancer and their families. Through an in-depth internship, students learn about the psychological and social impact of cancer and its treatments – arming them with the knowledge and skills they need to best help those struggling with cancer.
With the addition of its newest grantees, the American Cancer Society is supporting nearly 1,000 of the nation’s top cancer researchers and health professionals. It will take their combined efforts – as well as those of researchers around the world – to continue to lessen the burden of cancer.