7 massive questions about cancer, he answered

Every day, billions of cells in our body share or die. All this is part of complicated processes that keep blood from our heart, food moves through the intestine and regenerating the skin. However, from time to time something goes wrong, and the cells that should stop growing or dying simply. Other unquestionable, these cells can turn into cancer.

The question, when and why this is exactly happening – and what can you do to stop – has long -surprised scientists and doctors. Despite the other unanswered questions, they made great progress in the understanding and treatment of cancer.

“We are much less afraid to tell patients what we do and do not know because we know much more,” said Dr. George Demetri, senior vice president for therapeutic experimental at the Dana-Farber Cancer Institute in Boston.

Here are some of the biggest questions about cancer, which scientists began to answer.

Why do some genetic mutations lead to cancer while others don’t?

Scientists thought that genetic mutations – changes in the letter sequence of your DNA – were the basis of all cancers.

They were only partly right. “Mutations are very essential – but they are not a whole explanation of the tumor,” said Douglas Hanahan, an outstanding scientist at Ludwig Institute for Cancer Research in Lausanne, Switzerland. Some mutations remain dormant throughout our lives, never leading to cancer.

It is now clear that, separated from the DNA mutation, there are other factors that change the way gene expression. This is called epigenetic changes, and scientists have found that they play a huge role in conducting cancer.

Scientists do not fully understand what leads to epigenetic changes, but aging, dietary and environmental exposure and chronic inflammation are everything considered possible culprits.

Can pollution give people cancer? What about microplastics?

Scientists have long known that some chemicals, such as asbestos and radon, or such as those in cigarette smoke and alcohol, can cause cancer. But in recent years, some emerging studies have aroused alarms about the risk of air pollution and microplastics, as well as polyphluoralkilic substances and PFA.

The science of them is still far from the established one.

“There are signals that these things can be carcinogenic, but which cancers, when and how we need to get much more information,” said Dr. W. Kimryn Rathmell, former director of the National Cancer Institute.

Evidence is the strongest in the case of air pollution. It has been shown that diminutive particles known as PM 2.5 boost the risk of lung and breast cancer, said Dr. Loretta Erhunmwunsee, a professor of chest surgery at City of Hope, the National Organization for Cancer Research and Treatment.

How much pollution was exposed and how long it matters. Research shows that blacks in the United States are exposed to disproportionately High level of air pollution; Also have Higher lung cancer indicators AND death from illness than other racial groups.

We now understand that “the social context really drives many cancer results that we see, and even the development and risk of cancer,” said Dr. Erhunmwunsee.

How is inflammation associated with all this?

Over the years, scientists have been looking for chemicals in our diet and environment that caused genetic mutations. But it becomes clear that if such exposures affect our risk of cancer, they probably do it, causing inflammation – not directly damaging the DNA, explained Robert Weinberg, a professor of biology at the Massachusetts Institute of Technology.

Take the intestines: eating an unhealthy diet can upset our microbiome balance, allowing some bacteria to become unquestionable. Scientists believe that this can cause chronic inflammation that can lead to colorectal or pancreatic cancers, said Dr. Davendra Sohal, an oncologist of the University of Cincinnati Cancer Center, who specializes in digestive tract cancers.

Inflammation can also promote cancer in cells that have already mutated. For example, PM 2.5 particles have been shown cause inflammationBy waking up sleeping mutated cells to drive a tumor.

What gives tumors to become unquestionable?

Cancer is not only a group of abnormal cells growing in a way they should not. Scientists are now aware that tumors are convoluted tissues of cancer cells, as well as normal cells that were employed to support their growth.

Many of these normal cells are the same type of immune cells that put the place of injury or infection to facilitate heal the wound – helping to multiply fresh cells, generating blood vessels, stimulating fresh connecting tissue and avoiding attacks from other parts, the immune system. These are possibilities that cancer cells can cooperate indefinitely to support their own growth.

“Tumors are wounds that are not treated,” said Dr. Hanahan, citing Observation changing paradigm First produced in the 1980s by the pathologist Harvard Dr. Harold Dvorak.

A lot about how metastasis cancers – spread and live in distant places – still remains a secret, said Dr. Kevin Cheung, a professor of hematology and oncology at the Fred Hutch Cancer Center at Seattle, Washington. His research showed this recently dead and dying cells In the tumor, it can create an environment that makes it easier for the living with cancer cells getting out and spreading. Other studies suggest that immune cells can Move their contents to cancer cells to make them more invasive.

What risk factors are actually under our control?

Many cancers arise for reasons that are completely outside our hands. “There will always be some cancer, even if we had the best prevention,” said Dr. Rathmell. But prevention can have a huge difference.

Epidemiologists will now estimate it 40 percent of cancerAnd a similar share of death from cancer can be attributed to risk factors that people can solve. The largest of them is smoking, but the list also includes exposure to the sun, alcohol consumption and excess weight.

Some infections, including those caused by hepatitis B and C viruses, human papillomavirus virus and H. pylori bacteria, can also cause certain cancers. Vaccinations for HPV and testing of tests for viral hepatitis and H. pylori can reduce risk.

What is the right way to treat?

Just a few decades ago, cancer treatment included a lot of guessing. “We just pressed the poisons and counted on the best,” said Dr. Demetri.

Now, however, oncologists have a more pronounced idea of ​​who can exploit chemotherapy – which provides toxins that kill vigorous cells in addition to cancer cells – and who can exploit more targeted treatment, such as a medicine that passes after a specific defective protein in the middle of cancer.

Doctors also have better treatment, partly thanks to a more advanced understanding of the role of the immune system in cancer.

“How the immune system works, which distinguishes these cells, which makes them lively, which makes them dormant when they are tuned and tuned – you had to know all this before you could try to play with control elements,” DR, “Rathmell said.

The possibility of playing with these controls opened a completely fresh field of cancer treatment, known as immunotherapy. Doctors can now remove the brakes from T cells – immune system fighters that kill cancer cells – with point inhibitor therapies used to treat lung and skin cancer, among others. They can also design T cells to find and fight cancer. This approach behind T Car cell therapy, which was most effective in the treatment of blood cancer.

Is cancer ever curable?

Although people may think about cancer as a “cure” when someone is in remission, doctors are historically reluctant to promise that they can completely get rid of cancer. “We have never dared to exploit the word” medicine ” – said Dr. Marcel Van Den Brink, president of the City of Hope National Medical Center. But newer treatments, such as stem cell transplants and a car, gave him more hope and other doctors.

“It was a change in the sea with” you will die because of this cancer “,” We have a litany of available, exhilarating therapies we intend to work through, “said Dr. Rathmell.

Even without evidence of the disease, some cancer may come back – in these cases doctors are more cautious about potential results.

Still, there is a reason for optimism. The death rate due to cancer has dropped over the past 30 years. We now have drugs focused on genes that cause cancer, which have long been considered impossible to treat.

Some cancers were “death sentences,” said Dr. Sohal. Now they are more similar to diabetes, a complicated disease that can be treated with the side effects that can be controlled: “People live with the disease for a long time,” he said.