Cancer Treatment of the Future—Using Your Genes to Destroy Disease
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Imagine the horror of waking up from surgery to hear that the mass your doctor took out of your ovary was cancer. And, you learn that most of the cancer is gone, but you need more treatment.
Now imagine the talk with your gynecologic oncologist about chemotherapy. You might be expecting more horror. But, with future choices, this talk could be easier than expectedwhen your horror is eased. The future promise of cancer therapy lies within what is called a tumor fingerprint. That’s your tumor’s unique genetic profile.
Doctors can learn your tumor fingerprint from looking at a frozen piece of the removed tumor. In the future, doctors may use this profile to choose the best treatment for you with the least side effects. Here’s what the profile shows.
- What cellular mechanisms have failed
- What genes have "gone bad"
- What custom designed treatments will have the highest chance of cure for you
Now imagine this scene. It’s one where you may be spared hearing about cancer at all. In this tale of the future, doctors can use a Pap smear to learn when cells in your cervix have unhealthy genes. That means they are finding problems long before they can be seen as precancerous.
This story gets even better. Imagine that your doctor can use the same Pap test to learn how smoking or other environmental effects have harmed you. You’d now have the chance to change your habits before more damage leads to cancer.
These tales are dreams today, but they have the chance to be real within the next few decades and here is why…
- Information from the completion of the Human Genome Project (HGP)
- Advanced computer technologies that let researchers study genetic events involved in cancer and the differences between cancers
- Advanced computer technology to find genetic defects in ovarian cancer by using the findings of the genetic code of many cancers
- New treatments using genes, small molecules, and antibodies or nucleotides
- New ways of finding cancer such as hereditary cancer risk assessment and molecular diagnostics
- New ways of prevention with molecular-based cancer chemoprevention
The Human Genome project is already starting the pathway to specialized diagnostics and treatments. There have already been 24 gene therapy trials in ovarian cancer. A key one helped discover the BRCA1 gene. This gene is not active in hereditary ovarian cancers.
Another new field is microarray analysis. This field compares genetic information between cancer and normal tissue. Tens of thousands of genes can be compared all at the same time. The many genes that are up- or down-regulated in the cancer can be found, making the tumor fingerprint. Understanding the role of each gene in that profile is the start of finding new treatments.
The power and potential of the Human Genome database is limited only by our imaginations. There are three linked goals.
- To learn what actions in the cell are involved in the early steps leading to cancer
- To learn what changes are key to “feeding” the cancer
- To learn what changes let cancer spread
This knowledge about cells could help answer some long-held questions. Why do only some women with too much estrogen get uterine cancer while others do not? Why do only some smokers get cancer while others do not?
The role of so-called supporting cells near the tumor such as endothelial and immune cells is also being looked at more and more. These cells have been found to have many gene changes that could be use for treatment. In fact, one of the first biological therapies in humans was the drug bevacizumab. This drug targets the blood supply to tumors. It is expected that tumors may shrink if the supporting cells could be targeted by new treatments.
The possibilities for cancer prevention, screening, and treatment are endless. Ideas that seemed far reaching only a few years ago are becoming reality in clinical trials today.
