Cancer: Are we closer to the “Golden Bullet?”

A stained T-Cell. Cells like these are modified by the vaccine and used to combat cancerous cells Image: National Institutes of Health (US)

Cancer is the biggest cause of premature death in the UK, accounting for 42% of deaths from the top five “common killers”. Developments in healthcare and public health awareness means that as a race, we are able to live longer lives, but these are not guaranteed to be healthy ones. In fact, the peak rate of cancer diagnoses between 2013 and 2015 was in individuals aged between 85 and 89. Cancer Research UK estimates that a new diagnosis is made approximately every two minutes in the UK, the majority of which are made at the “late” stage, for those not au fait with medical terminology, late-stage cancer is the term given to that which has spread from its primary site to other parts of the body. It is the stage at which radical – that is curative treatment – is not an easy task.

Cancer itself is defined as the uncontrolled division of cells within the body. Cell division is a necessary and normal part of daily existence, it allows new tissues to grow and our bodies to heal. However, on occasion a mutation in our DNA either through natural error, or exposure to chemicals or radiation, can cause a change which leads to this cell division being uncontrolled, leading to the development of a tumour. The most common areas for cancers to develop are within the prostate, breast, lung and bowel. Prostate cancer itself has recently overtaken breast cancer in incidence rates in the UK for the first time. Known as a cancer which predominantly affects the ageing male population, the longevity of our species is leading to more and more diagnoses.

Due to the prevalence of cancer, we are all likely to be affected either directly or indirectly in one way or another, either as a patient with the disease or from a holistic point of view as part of a familial community who support those in their fight. They say the rates of cancer are 50% in terms of diagnosis, however, overcoming the challenge to gain control of such a wide-ranging disease is one which will benefit us all.

One of the main difficulties in finding the “Cure” for cancer is that it is an umbrella term for a disease which can have a wide variance in physiological manifestations. Although billions of pounds have been funnelled into cancer research and public awareness to date, it is an illness which continues to plague us with no one size fits all cure in sight. In fact, those treatments which are currently utilised, often come with debilitating side effects in themselves.

Previously, approaches to the treatment of cancer formation have been a well-publicised mixture of Chemotherapy, Surgery and Radiotherapy. Although effective in a lot of instances, these can have side effects which may affect the long-term quality of life of an individual, for example, hair loss or cognitive dysfunction following chemotherapy increased risk of secondary cancer, fatigue or skin problems following radiotherapy and scarring or potential nerve damage following surgery.

One of the newest approaches to cancer treatment is called Immunotherapy. This is a treatment which uses the individual’s own immune system to attack cancerous cells. If immunotherapy is not employed in a treatment, cancer cells are able to evade the immune system’s natural defence mechanism through changes in DNA meaning cancer cells are not identified as a threat.

T cells in the blood are key players in the immunological fight of infection and viruses. Recent scientific advancements have utilised these T cells to attack tumours within a host, as has been widely reported on recently, this has been touted as a “Vaccine for cancer”. A claim which obviously could be potentially groundbreaking in how we view one of the biggest killers in the developed world.

A recent publication in Science and Translational Medicine has gained a lot of traction within the media recently as it reportedly has seen a significant effect relating to tumour reduction following an approach utilising immunotherapy.

This study looked at 90 mice, which were injected directly at the tumour site with a mixture of a TLR9 ligand, and an OX40 antibody. This then leads to an immune response which identifies tumour cells of that type throughout the body and attacks them. Whilst human trials are yet to be completed, the theory behind using this type of approach is considered safe as, within the test subjects, only low doses of the immunostimulator were required to elicit a tumour specific immune response.

The mice tested had tumours representative of colon cancer, melanoma, breast cancer or lymphoma. Using this approach they found that all 90 mice showed complete regression of tumours following vaccination, with the primary tumour site regressing first followed by distant metastases. Of these 90 mice, 3 developed recurrence, however, the recurring tumours were also shown to be susceptible to the vaccination protocol.

This approach is certainly promising from the trial which has recently been published, the authors recognise that there are similarities in the properties of the cancers tested in the mice and those which affect the human population so they suggest logical reasoning as to its effectiveness in human trials. However more research is needed to identify whether or not this approach will work in practice, it is unknown territory on the frontier for fighting one of the biggest killers of the modern world, but it certainly looks like progress is being made.

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