I can't say that I'm too concerned about the prospects of cancer in my future. Short of being very unlucky and suffering a rare early life occurrence of cancer, I, and anyone in their middle age in a developed nation, will mostly likely suffer cancer only after medical technology has advanced to the point at which cancer is a non-issue. Dealing with it will cost time and money, but you won't die and you won't suffer any of the trauma associated with today's destructive cancer treatments.

A number of trends in the field of cancer research have been moving rapidly in recent years, backed by large amounts of funding, and supported by large, self-sustaining scientific communities. There is a great deal of momentum inherent in the cancer research institutions of the world and the surrounding industries of biotechnology. Nothing is going to slow down or grind to a halt any time soon, and progress in fundamental research is if anything speeding up as the tools improve in lockstep with computing power.

Firstly, new biotechnology is making possible the effective detection and destruction of cancer cells. These cells are different from normal cells in ways that can be exploited to (a) identify cancers at the very earliest stages when even present day treatments can destroy them safely, (b) build new treatments that target and destroy even advanced cancers, harming only cancer cells and causing no side-effects or damage to healthy cells in the body.

A second, related line of research centers on cancer stem cells:

The promise - the hoped for possibility - of cancer stem cells is that they represent a small, manageable, less complex range of biochemical targets to prevent and destroy cancer. The biotechnology of this year and next can flip genetic switches and safely destroy cells with specific markers - if we just know where to look, what to destroy, what to change.

The promise of cancer stem cells is that cancer has a simple, easily severed root. This may or may not be the case, but you can be sure that this path will be well explored over the next decade.

As noted, a vigorous scientific debate is presently underway. Are cancer stem cells damaged versions of normal stem cells, and do they exist in all cancers? Or are there characteristic ways in which normal cells become reprogrammed into cancer stem cells? After all, induced pluripotent stem cells show that normal cells can be altered in just a few ways to give them the characteristics of embryonic stem cells - such as unchecked growth. Or is it the case that cancers, mutating rapidly, will generate a huge variety of stem-like cells to support their growth, and thus there are few if any commonalities to target?

All of these points of view presently have some experimental results to back them up. New results continue to be published at a pace that suggests it won't be too many more years before the contradictions are reconciled and the important question answered: are cancer stem cells a short cut to killing most or all cancers? At present it looks plausible that the answer is yes.

Here's a recent example of research that supports the damaged stem cell viewpoint:

n the new study, led by Berman's postdoctoral research fellow Xiaobing He, Ph.D., the researchers reasoned that if these stem-like cancer cells behave like healthy stem cells, they might be physically located in the same compartments in tissue where stem cells normally reside. Using a surface protein marker previously identified for healthy bladder stem cells, the Hopkins team searched for cells with the same marker in sections from 55 human bladder tumors. They found that cancer cells displaying the marker were localized in an area at the intersection of two layers of cells known as epithelium and stroma, the place where bladder stem cells are typically located.

Using cancer cell lines grown from other bladder cancer patients, the researchers separated cells displaying the stem cell marker from those without it and injected these two populations into different sets of mice. Mice injected with the cancer cells displaying the marker always grew tumors, but those injected with the other cancer cells rarely did, suggesting that the stem-like cancer cells have an ability to create new tissue much like healthy stem cells do.

I think it's fair to say that if the cancer stem cells in bladder cancer resulted from errant reprogramming of normal cells, you would not expect to find them localized where normal stem cells usually exist.

Posted by Reason

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