Cancer spread is a huge challenge for patients, doctors and researchers.
No man is an island, and the same can be said of tumour cells. Previous posts in our ‘microenvironment’ series have discussed how the cells and structures around a tumour – known collectively as its microenvironment – are crucial to its survival.
In this article we explore how tumours draft in these surrounding cells to break free and spread to other parts of the body.
This process of cancer spread (or metastasis) is a huge problem for cancer patients and their doctors; most deaths from cancer are caused by the disease spreading around the body. So understanding how cancer cells break free from the confines of the primary tumour and move around the body is a crucial question for scientists.
And the more we learn, the more we realise that developing the ability to spread is no easy feat for tumours – they wouldn’t get anywhere without a helping hand. So here, we’ll learn about how their healthy neighbours send them on their way.
Inflammation is crucial for cancer development
Regular readers will know that the infrastructure supporting a tumour – its ‘microenvironment’ – is a hot topic in cancer research at the moment. In our previous post in this series, we looked at how otherwise healthy cells collude to form the blood vessels nourishing the tumour. Today, we’ll tell a story that began in 1863, when a German pathologist called Rudolf Virchow peered down his microscope.
Our body’s immune system forms a defensive shield that any fighting force would be proud of. One of its most powerful weapons is inflammation, a carefully orchestrated manoeuvre designed to eliminate enemies such as bacteria, injured cells and chemical irritants. Without it, we probably wouldn’t survive beyond infancy.
But inflammation has a split personality – one that can wreak havoc for those unfortunate enough to experience it. And we now know that inflammation’s dark side is a powerful force in cancer development, where it aids and abets tumour growth and spread around the body.
Researchers are homing in on the ‘stem cells’ that seem to drive some forms of cancer (Image courtesy of Science/AAAS)
Biology has its share of contentious issues, and the existence of cancer ‘stem cells’ – treatment-resistant cells at the heart of a tumour – is certainly controversial.
We’ve written before about these enigmatic cells, but they’ve made the headlines again this week, so we wanted to re-visit the issue.
The headlines appeared thanks to the publication of three exciting research papers in top international journals, Science and Nature, which showed, in beautiful, fluorescent detail, the development of tumours from what look to be some form of ‘stem-like’ cell.
Let’s have a look at what the researchers did, and what it means.
Professor Phil Ingham, whose Cancer Research UK-funded work in the 1990s has led to a new skin cancer drug
The course of drug development never did run smooth. Drug development pipelines – like the X-Factor – are littered with thousands of ‘hopefuls’ who fail to make the cut.
Very few drugs survive the arduous journey from bench to bedside, and those that do often emerge ten to twenty years later, bearing little resemblance to their former selves.
In fact, only about one in ten drugs initially tested in patients make it through to routine use. So it’s always good news when an experimental drug makes it all the way through the difficult journey of tests and clinical trials.
As we reported this morning, vismodegib – a skin cancer drug that our work helped shape – is described as “the greatest advance in therapy yet seen for this disease” in the prestigious New England Journal of Medicine – extremelyexciting news.
So in the latest of our ‘High-Impact Science’ blog posts, we’d like to tell the story of Professor Phil Ingham, and how his fundamental research in fruit flies and fish evolved into a drug that could revolutionise treatment for patients with advanced basal cell carcinoma – a type of skin cancer.
Dr Gareth Veal wants to find the best way to give chemotherapy to children with cancer.
When it came to avoiding extremes, Goldilocks knew what she was doing as she plumped for the perfect porridge. In fact, her skill in finding the happy medium was immortalised in what we now call the Goldilocks Principle – the suggestion that “just right” usually lies somewhere between two ends of the spectrum.
Doctors use the Goldilocks Principle when deciding how much chemotherapy to give a patient. Too little and the drug won’t hit the cancer hard enough to have an impact, but giving too much of the drug can cause unacceptable side- effects. So how do they figure out which dose is “just right”?
Clinicians usually consider a patient’s size or weight when prescribing chemotherapy, and although this approach is usually effective, it doesn’t always work for everyone. Children can be especially vulnerable to cancer drugs because their bodies are still growing. This means that they can suffer long-term side effects, or their cancer simply doesn’t respond to treatment at all.
Dr Gareth Veal wants to change this situation, by understanding more about the fate of cancer drugs once they’re inside the body. His mission is to improve the way we treat children with cancer so that every child receives a dose of chemotherapy that is “just right”. We recently caught up with Dr Veal at the Northern Institute for Cancer Research in Newcastle, where he told us more about his work.
Being told your child has cancer is every parent’s worst nightmare. But every year, around 1500 families are given this devastating news. And while survival rates for childhood cancers have improved significantly, around 300 children still lose their lives to cancer each year.
That’s 300 too many and we’re determined to bring that number down to zero. To do that, we need to have the brightest and most committed minds on board. So, in April this year, we were pleased to support an application for funding from Professor Josef Vormoor and Dr Olaf Heidenreich, both at the Northern Institute for Cancer Research in Newcastle.
Professor Josef Vormoor is an expert on childhood acute lymphoblast leukaemia.
Professor Vormoor is a children’s cancer doctor at the Great North Children’s Hospital specialising in childhood acute lymphoblastic leukaemia (ALL) and in our latest Expert Opinion interview, he and Dr Heidenreich talk about their plans to transform treatment for children with ALL. Continue reading
Professor Fran Balkwill
No man is an island – we exist together with other people in families, communities and societies. The same is true of cancer cells – they need a host of non-cancerous cells, collectively known as the tumour microenvironment, to help them grow and develop.
In the latest of our Expert Opinion interviews we talk with Professor Fran Balkwill, who argues that treating the tumour and its microenvironment together represents an exciting frontier for cancer treatment.