“Why haven’t we cured cancer yet?”
How many times have you heard this question, or variants thereof, being asked repeatedly? This question, for which Google has about 1, 570,000 results, and which is probably already worn down?
This question has never failed to raise the general public’s interest, concern, and criticism. It has splayed on the cover of practically every major publication in the past century or so, plastered over a photo of a cell or a doctor.
For the general public, this million-dollar question is one that can be easily answered, despite the fact that any attempts at explaining this tend to be taken with a grain of salt.
However, for oncologists – doctors who specialize in cancer – and researchers who have spent decades and millions of funds only to repeatedly lose patients and conduct experiments that ultimately fail, having this question shoved into their faces can be quite frustrating and disheartening. It’s even worse when it’s accompanied with a statement like, “Ang tagal na niyan, hindi pa nagagamot hanggang ngayon.”
While it is unsurprising for people to want answers to this long-standing question, a proper and conclusive answer to this may never come, simply because it’s the wrong question to ask.
Because you’re asking the wrong question.
How does cancer start?
The first thing to learn about cancer: It originates in the cells.
The human body is made up of millions and millions of cells. These cells are divided into different specialized types that have distinctive structures and are well-suited for what they do. For instance, the red blood cells carry oxygen from the lungs to the tissues, and the nerve cells (neurons) transmit information to the brain for processing and storage.
Cells are controlled by chemical compounds called proteins. And in order for cells to function properly, proteins must be produced correctly. This is done inside the nucleus, the control center of the cell which stores the instructions for making proteins inside the helical molecule called deoxyribonucleic acid (DNA).
Proteins within the cells are responsible for nearly every task of cellular life. These include the cell’s shape, function, routine maintenance, and waste cleanup, as well as when it will divide or die. In a nutshell, proteins guide the cells to grow and reproduce in orderly and controlled ways.
However, when a cell divides, a change called mutation may sometimes happen in the genetic sequence of its DNA. This means that the cell is now abnormal; it can no longer understand its instructions, and can even grow out of control. It could produce too many proteins, triggering a cell to divide continuously. It may also completely cease producing proteins responsible for stopping cell division.
Mutations as small as being substituted, deleted, or replicated can still be repaired by the cells themselves. But the damage might build up over time, causing the mutated genes to become tougher to repair. At this point, the abnormal cells will start growing too fast and pick up further mutations. As you can probably tell, this leads to the manifestation of cancer.
A cancer by any other name
To make a long story short, the reason why we haven’t cured cancer yet is because there are many kinds of it.
Cancer cells are all results of a sudden change within the genetic sequence of the DNA. However, though they may all look the same on the outside, they actually develop in their own unique ways, and can originate in any type of tissue. Brain cancer, for example, originates in the brain tissues. Lung cancer starts in the lung tissues. And so on.
In other words, the pathology – the way cancer progresses – of each cancer is very different from the other. This is mostly because every cancer is caused by a different kind of mutation. This practically makes it a different disease in every patient.
Thus, “Why haven’t we cured cancer yet?” is founded on the unspoken misconception that cancer is a singular enemy. Quite incorrect, as there are countless cancers to be cured, not just one. And to beat them all, they all need to be dealt with individually.
Catching cancer early on
In a TED talk given by David Agus, he admitted that even a highly accomplished doctor like him cannot treat advanced cancers. The only effective way to fight these diseases (so far) is to catch them early.
However, the fundamental problems (from where the misconceptions arise) have been a great concern for treating the disease.
Case in point: The dictionary for describing cancer is very poor – consisting of just symptoms and manifestations. Similarly, a Fortune magazine article titled “Why We’re Losing The War On Cancer” points out that much of the failure in fighting cancer – and much of the potential to win the war – has to do with a definition.
Fortunately, the need to improve and develop much more refined ways for treatment is being addressed through personalized medicine. Instead of using blunt treatments like chemotherapy that have detrimental side effects, projects such as The Cancer Genome Atlas (TCGA) are at the forefront when it comes to this new approach.
TCGA is the idea of sequencing all of the genes in the cancer cells, figuring out exactly where and how their genes mutated, predicting what drugs will be effective against a certain type of cancer, and creating a new lexicon to describe cancer.
While it’s true that we still haven’t found a cure for cancer in its various forms yet, advances in the medical field and new technologies like DNA sequencing could mean that we are seeing a glimmer of light from the future.
Hopefully, we would someday wake up to a world where all kinds of cancers are curable. Until then, let’s keep asking the right questions, and working towards finding the right answers. –MF