23. Some things to remember:
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CANCER IS OLD
CANCER IS NATURAL
CANCER IS COMPLICATED
CANCER IS WILY
CANCER IS NOT
UNBEATABLE, BUT IS HARD TO
“CURE”
• RESEARCH IS OUR BEST
WEAPON
• AND WE HAVE SO MUCH
MORE TO DO
23
Mummies around the world including children. Washington: A 2150-year-old Egyptian mummy, catalogued as M1, has been diagnosed with prostate cancer, a new study has revealed. The man, about 5ft 5in tall, was between 51 and 60 years old when he died. “It is the oldest known case of prostate cancer in ancient Egypt and the second oldest case in history,” Prates said. Oldest known case is 2,700 in Russia. Evidence in Neanderthal fossil: http://www.ncbi.nlm.nih.gov/pubmed/21798647 Dinosaurs: http://www.ncbi.nlm.nih.gov/pubmed/10437878 Melanoma in coral trout, fruit fly RET mutation (causes thyroid cancer in humans)
Egyptian papyrus 3000-1500 BC, Hippocrates 400BC,
Not just one type of cancer.
Not just one type of cancer.
Cancer is complicated! It’s not just cells dividing out of control that causes cancer. Scientists have identified 10 key features that set cancer cells apart from normal cells. Years of painstaking lab research now mean that scientists understand a lot about each of these areas. But we still have a long way to go, that’s why we are funding research into how to tackle them all. Some examples are included on the slide.Note to speaker: you don’t need to cover each hallmark - this slide is meant to demonstrate how complex cancer is, but also how much we understand about it and that we have researchers working in all of these fields. To find out more about the individual researchers please visit:http://www.cancerresearchuk.org/cancer-info/cancerandresearch/ourcurrentresearch/researchbygrantee/prof-karen-vousdenhttp://www.cancerresearchuk.org/cancer-info/cancerandresearch/ourcurrentresearch/researchbygrantee/prof-frances-balkwillhttp://www.cancerresearchuk.org/cancer-info/cancerandresearch/ourcurrentresearch/researchbygrantee/dr-kairbaan-hodivala-dilkehttp://www.cancerresearchuk.org/cancer-info/cancerandresearch/ourcurrentresearch/researchbygrantee/prof-julian-downward
Germline and somatic mutations. Pick up more mutations as they get more messed up – key driver is chromosomal instability. Evidence for catastrophic events (egchromothripsis). Balance between being mutated enough to keep living, and so mutated you die.
Selective pressures – the immune system, the local environment, chemotherapy, radiotherapy
Heterogeneity
Good news!– survival. Also childhood cancer success. Thanks to research.surgery, Radiotherapy and chemotherapy as well as prevention and screening. CRUK’s work has been at the heart of progress – all thanks to our supporters
The future? More of the same, but also step-changes. Moving from ‘flickering remissions’ to cures – combinations of new agents, companies working together, understanding how cancers are evolving and staying one step ahead. Better screening and understanding of risk, informed by genetics. Also moving towards “liquid biopsies” – eg blood tests for monitoring and even screening. Still a lot of mileage in the ‘old’ ways – radiotherapy and surgery (better imaging, intelligent knife etc). Make it more accurate, more informative. Targeting the tumour microeinvironment and blood supply, and kicking off the immune system, targeting key gatekeepers like Myc.
The future? More of the same, but also step-changes. Moving from ‘flickering remissions’ to cures – combinations of new agents, companies working together, understanding how cancers are evolving and staying one step ahead. Better screening and understanding of risk, informed by genetics. Also moving towards “liquid biopsies” – eg blood tests for monitoring and even screening. Still a lot of mileage in the ‘old’ ways – radiotherapy and surgery (better imaging, intelligent knife etc). Make it more accurate, more informative. Targeting the tumour microeinvironment and blood supply, and kicking off the immune system, targeting key gatekeepers like Myc.
Then not a lot happened
PercivallPott – 1775, 1st cancer hospital in Reims in the 18th C, Joseph Recamier coined the term metastasis in 1829, Wilhelm Rontgen 1895
Sidney Farber, Richard Doll and Richard Peto – smoking, 1962 LIFE magazine, New ICRF labs at Lincoln’s inn fields in 1963, Moon landings 1969, Nixon’s cancer act 1971, cisplatin 70s, Medical Oncology 70s
CT scanner – 1970s (also MRI, ultrasound and PET), End of the reign of radical surgery (Barts and others), David Lane p53 in 1979. 1986 – Bailar report, 1980s tamoxifen trials (incremental progress), Nurse/Hunt
Oncogenes and tumour suppressors – brakes and accelerators, Discovery of specific cancer genes in families, genetic research paving the way for targeted treatments – Glivec, Herceptin, antibodies and small molecules
Other important things – hospices, pain medication, information, cultural shift and ambassadors. . More and more people surviving, making sure that treatments are kinder with fewer long-term side effects. Mary Lasker, Betty Ford, Susan Sonntag and Cicely Saunders
