Photo by Dean Dixon The crab on the cover of this issue of Lens magazine represents all that is old and new about cancer, the nation’s second leading cause of death after heart disease.
Old, because cancer goes back to the dinosaurs; evidence of malignancies has been found in fossils dating back 80 million years.
New, because fields as disparate as genomics and embryology are providing new hope that a war declared 35 years ago by President Richard Nixon one day will be won.
In this issue, Eric Lander, Ph.D., a driving force behind the Human Genome Project, predicts that cancer patients soon will be able to have complete genomic workups to determine exactly what subtype of the disease they have, and which treatments are most likely to work.
The sequencing of the 20,000 or so genes that make up the human being already has improved our understanding of the genetic “switches” that turn on tumors. One benefit: discovery of new compounds that can switch off malignant growth without harming normal cells.
Also on the horizon: screening blood tests that harness the power of proteomic “fingerprints” to detect early cancer, even before symptoms occur.
This issue of Lens focuses on the spectrum of research—from basic laboratory studies to clinical trials of new drugs—undertaken by scientists at Vanderbilt University Medical Center, the Vanderbilt-Ingram Cancer Center and colleagues from Boston to Shanghai.
The story would not be complete, however, without mentioning epidemiology, that non-flashy field of medical research that is crucial to understanding what causes disease and how to prevent it.
By recording the incidence of lung cancer among Americans over time and correlating the numbers with smoking rates, researchers were able to establish conclusively the role that cigarettes play in the disease.
Cohort studies, which track the development of disease in large groups over several decades, also may help solve the riddle of cancer disparities—why cancer incidence and death rates are disproportionately high, for example, among African-Americans.
“It’s where research always starts,” says Jane Weeks, M.D., chief of Population Sciences at Boston’s Dana-Farber Cancer Institute. “It generates hypotheses. It generates ideas.”
Charting cancer in cohorts, uncovering proteomic fingerprints, discovering clues to cancer in the development of an embryo—all avenues are important.
“By pulling all of this information together into a symphony of knowledge, we will be able to exponentially expand the rate of effective cancer treatment over the next 10 or 20 years,” predicts Raymond DuBois, M.D., Ph.D., director of the Vanderbilt-Ingram Cancer Center, who later this year will become provost and executive vice president of academic affairs at the University of Texas M.D. Anderson Cancer Center in Houston.
Continued support of cancer research is crucial, he adds. So is nurturing the next generation of scientists.
“What makes me most impatient and most frustrated is when I hear young people’s proposals being criticized for being too ambitious,” says Lander, who directs a genomic research powerhouse, the Broad Institute of MIT and Harvard.
“There’s nothing wrong with young people being too ambitious. They should be too ambitious… the desire to try to do something important is a great fuel, it’s a great resource.”
This, incidentally, is the raison d'être for Lens magazine—to explore, to explain, to inspire… to follow, if you like, the double helical trail left in the sand by an ancient animal.