A relatively new issue of Science (4th of April this year) has an interesting editorial about the value of cancer research.
He claims that some people would like to see the money that is invested in the most fundamental of cancer research directly into the design of treatments and therapies. Something like we know enough about Cancer so let’s stop wasting time and money and let’s start doing things with what we already know. That is for me a rather surprising attitude: since I started working with cancer researchers what I found most surprising is not the amount of things we know, but the opposite, how little do we know after all the time and money invested in research. This is, of course, not the fault of cancer scientists but more the result of the extreme and incredible complexity of cancer as a disease. If there is something we need now is more fundamental research, and if you keep asking me, more theoretical research so we can knit all this knowledge into a cohesive set of laws.
Bruce Alberts, Science’s editor in chief describes examples of how a better understanding of the fundamental mechanisms could go a long way on improving cancer therapies. Specifically he mentions apoptosis and DNA repair which he identifies as two of the most promising areas of research with a potential impact in treating cancer.
The importance of the first one is not difficult to grasp. Cells in multi cellular organisms have a tendency to commit something akin to suicide and only constant reassurances from the environment that they are doing ok prevent them from doing so. Avoiding apoptosis is one of the most important milestones of a tumour cell, otherwise its chance of provoking havoc is somewhat limited.
The second mechanism is less straight forward in my opinion. A flawless DNA repair mechanism should prevent harmful mutations in the first place and will lead to apoptosis if the reparation is not doable. Thus a tumour cell should aim to have a less than perfect DNA repair mechanism in order to accumulate the necessary genetic mutations. For that exact same reason, a therapy that could re establish the functionality of the DNA repair mechanism would go a long way in making sure that abnormal cells die (due to apoptosis) whereas healthy cells stay.
These two are only a sample of things that the author argues we don’t know well and which deserve ample funding even when the hope of getting a therapy out of the money invested is not in the short term. I’d argue that I know a few more areas worth investing on but that might not be entirely unbiased…