LONDON, ONTARIO - progress is made against many types of cancer, with more patients survive longer, thanks to research on two fronts: improved methods for the previous discovery and development of therapies that are more efficient and less toxic. In fact appreciated that there more than 10 million cancer survivors in the United States alone, and this number has increased steadily. Similar numbers in proportion to the population sizes, are found in other developed countries.
Cancer detected early - if you small and less likely to (spread from the primary tumor) - metastasized have are more treatable with local therapy to be as successful treatment ultimately unlikely once metastatic tumors develop. Improved treatments mean that patients can be treated with medications that work better (and uses that patients are more likely to the full dose to get).
But our dramatic advances in detecting and treating cancer tumor dormancy led to the growing awareness of the problem: a patient appears to be cured only by the same cancer back have years or even decades later. Breast cancer or melanoma for example reported recurrence 25 years after the first treatment.
With a growing number of cancer survivors, we need the twin processes tumor dormancy and metastatic recurrence to understand. While significant progress made has the part on the development of leading cancer - new, less toxic drugs biology – metastasis and the development of metastases after a long time of tumor dormancy our understanding of the biology of tumor understanding has lagged behind.
We know that metastasis a very inefficient process, with the most cancer cells to form into the bloodstream, the otherwise metastatic tumors in distant organs to escape. Recent studies - both the laboratory and the clinic - suggest that many cancer cells that can leave the primary tumor go into new bodies lodge and a suspended state.
We have evidence that says that these resting cells can resist current treatments. This means that cancer adjuvant treatment, designed around the suspected Micrometastatic disease to kill an important fraction missing widespread cancer cells may some of them finally can wake up.
Furthermore, we are beginning to identify molecular mechanisms that regulate the presence of cancer cells, a dormant state as well as your reawakening again later. Our knowledge of the regulation is the tumor dormancy really still in its infancy. But given the growing number of cancer survivors, the need for this knowledge is becoming increasingly urgent.
In fact, there is evidence that suggests that tumor dormancy a valid target for therapy. For example, in some types of breast cancer, patients can be treated, work for over a decade with anti hormone therapies and these long-term treatments – you're successful some of cancer repetitions that occur with shorter treatment prevent. But, are relatively safe during long-term treatments have side effects, and the number of cancer repeats prevent is small.
The challenge is now to understand better, exactly which patients benefiting more from long-term therapy tumor dormancy and metastasis processes. We have much to learn and know not even all the questions to ask at this point.
Intermittent therapy would be as useful as long-term treatment? There are features of the primary cancer or individual who can help us predict who will develop late recurrence and metastases? What if late relapses can be predicted simply diagnose? There are modifiable factors - such as lifestyle, immune status or environmental conditions, influencing whether patients develop late relapses?
The answers to these questions will require research and research into metastasis and tumour dormancy is difficult. It requires patience, development of models and willingness to make long-term studies. We need to understand the prevalence of long-term dormant disease in patients. How common is the phenomenon we study? It may be that many cancer patients disseminated tumour cells Harbor, and not all these cells to meat smuggling are intended.
In some ways, success of pressure cancer research, "Cancer cure quickly", steering is clinical and laboratory researchers away from the sensitive issues of metastasis and long-term tumor dormancy is fueling. This focus can be ultimately short-sighted as the increasing number of cancer survivors leads to an increase of late times.
Responsible for the most deaths from cancer metastases, not the primary tumor. If we continue to improve, must we learn on cancer survival, how to prevent delay or processes to thwart the cause for metastases.
Ann F. Chambers is Chair in Oncology and Professor of Oncology at the University of Western Ontario, London, Ontario, and Oncology scientist and Director of the Pamela Greenaway cabbage Meier translational breast cancer research unit at the London Regional Cancer program in London, Ontario Copyright: project syndicate, 2011.
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