Why Is It So Hard to Find a Cure for Cancer?

Finding the cure for cancer is about as sought after as any elusive treasure. But there’s a reason nobody’s found it yet: Cancer isn’t actually a singular disease, but a broader genre of affliction, like viral infections. As much variation as there is between humans in their normal DNA, there’s evengenetic variation between any two types of cancer. That doesn’t mean researchers aren’t hard at work to figure out the best therapeutics possible and yes, even cures, for cancers.

The path from genetic mutation to tumor is fairly well understood. For instance, lung cancers are some of the best understood. They’re often caused by different mutations depending on whether the patient is a smoker or non-smoker. “There are now drugs that target some of the specific mutations brilliantly — in particular for non-smoking individuals, as it happens,” explains Todd Golub,in Cambridge. Cancer drugs like these target the specific protein that’s been coded for by the mutated gene.

“If the goal is to eliminate 100 percent of the tumor cells, you can do that with chemotherapy. I can guarantee it. The only problem is, you’d kill so many normal cells that the patient wouldn’t survive. And that’s the challenge with chemotherapy. It’s all about this balance of tumor cells being slightly more sensitive to the drug than normal cells,” says Golub. “We try to thread that needle.”Any time you don’t kill every last bad cell, the survivors can cause serious problems.

The solution to this, Golub says, is combination therapies. “If you take drugs that work via different mechanisms, the ability of any one cancer cell to evolve in such a way that it becomes resistant to [all of them] is very low,” he says. It’s the same idea as when HIV patients take a “cocktail” of antiretrovirals — taking only one at a time would allow too many viruses to escape and replicate into a viral population resistant to the drug.

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