The war against cancer: A complete cure or live with control?
2017
Cancer is not one disease, but a collection of many diseases. It
threatens patients’ lives and reduces their life quality. As
scientific research on cancer advances and technology improves, more
and more cancers are being cured. For example, 70% cancers in children
are cured. In adults, most types of skin cancer, thyroid cancer, laryngocarcinoma,
testis carcinoma, Hodgkin lymphoma and some forms of leukemia are
cured. This is largely due to the constantly improved and innovated
treatments and therapies. Current treatments for cancer mainly include
surgical therapy, chemistry therapy, radiation therapy, targeted therapy
and immunotherapy. Immunotherapy is the most innovative one. After
being treated with immunotherapy, patients with malignant melanoma,
which was once believed to be incurable can now reach ten-year survival
rate. This means “curing cancer” is possible. However,
because of the complexity of cancer, no single method can prevent
all cancers and no single treatment can cure all cancers. Most importantly,
cancer cells can easily become resistant to current treatments. This
resistance can arouse from environmental adaptation, tumor heterogeneous,
and the physical position of cells within the tumor. Cancer cells
in area where blood supply is poor may survive from treatments which
require blood circulation to transport drugs or immune cells to target
area for killing. Tumor heterogeneous means other than the fast dividing
cancer cells in the tumor, there are also quiescent cells which do
not respond to therapies aiming at dividing cells, and there may also
present a small number of cells which originally bear resistance.
Based on this original heterogeneity plus the different micro physical
positions within the tumor, the diversity of the genome composition
and the phenotype of these cancer cells are further increased. Under
prolonged pressure from host, drug maintenance, host immune response
and the non-permissive environment, most of the cancer cells may have
been killed, but some cancer cells may get adapted to the environment
thus producing cancers that are even more resistant, resilient and
malignant. Therefore, we cannot say we can cure all types of cancers.
In fact, we are still long way off from curing all the cancers. Currently
we can control cancer by allowing patients to live with a balanced
small amount of cancer cells, which seem to give longer survival rate
than trying to get rid of all the cancer cells. As our knowledge accumulates
and treatments improve, we will have more and more control over cancer
and in the end we will solve all these problems and finally cure all
cancers.
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