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WHAT'S NEW
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Cancer treatment: yesterday, today and tomorrow
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New cancer treatments spring hope of finding a cure.
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By Dr. Patricia Mark
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The future of cancer: customized treatments
Imagine your cancer specialist can identify the best treatment for you by studying the characteristics of your cancer cells and reviewing your genetic makeup. Sounds a bit futuristic? It is today, but scientific research is moving ever closer to making it a reality.
Currently oncologists use well-researched methods to decide which cancer patients need chemotherapy and which don't. But uncertainties linger, and to resolve them, scientists are going to the heart of the matter - inside the genes themselves.
Researchers at Duke University in Durham, N.C., have developed a genomic test that indicates which patients with early-stage lung cancer are likely to suffer a relapse. A genomic test is conducted on tissue samples removed at the time of surgery. Thousands of genes are scanned to measure the level of certain kinds of activity. The results help doctors make a highly accurate assessment of which patients are at high risk of cancer recurrence and should therefore undergo chemotherapy. A genomic test for breast cancer and the likelihood of its recurrence is now being developed.
Tomorrow's cancer cures
Tomorrow's cures will get right into our cells for precise healing by working with genes to weaken cancer cells from the inside; creating anticancer "viruses"; teaching the immune system to destroy cancer; or training tumours to die.
Your genes are cellular chemical structures - DNA - that direct your entire body's development and functioning. Gene therapy means using "engineered" genes to regulate or correct cell functioning. Genetic engineering involves extracting, manipulating and then reintroducing specific cellular DNA into a target cell to alter the way that cell functions.
In some cases, the goal is to stimulate the body's immune system to attack cancer cells, making them more susceptible to chemotherapy or radiotherapy. Manipulated genes are generally transferred back into cells by a carrier or "vector." Vectors are specialized particles, often viruses, that are designed to invade cells and safely deliver the gene into specific cancer cells. Gene therapy is being intensively researched worldwide in order to find the safest way to use this therapeutic advance.
Viruses can themselves be engineered to kill cancer cells. Oncolytic viruses (onco means "cancer," and lytic means "killing") are used in an innovative cancer therapy called virotherapy.
In Canada, the Terry Fox Foundation, along with the Canadian Cancer Society, has been engineering viruses to kill brain cancer cells. Dr. William Wold and his colleagues at the St. Louis University School of Medicine have been at the forefront in engineering common cold and influenza adenoviruses to multiply only in the presence of certain cancer cells. The viruses then invade the cancer cells and reproduce so rapidly that the cancer cells burst and die. And, no, you don't get the flu as a byproduct, because the gene that causes the fl u has been removed and replaced by genetic material encoded with the cancer-cell destroying effect.
This type of therapy has great potential; properly engineered viruses almost completely spare normal tissue. Even better, they can proliferate in the body for a long time, destroying all developing cancer cells and eliminating the need for traditional treatment repetitions. As well, there is evidence that some of these viral treatments work together with more conventional treatments, such as chemotherapy, producing - for poorly understood reasons - a synergistic effect that leads to better outcomes. Still, in spite of encouraging advances, it will be years before this technology can be used safely and effectively.
How much do you know about breast cancer? Take our quiz and find out.
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