According to the National Cancer Institute (the U.S. government’s agency for cancer research of the National Institutes of Health) roughly 2 million people will be diagnosed with some form of cancer in the United States in the year 2023. It is also estimated that over 300,000 people (the vast majority of which being women) will be diagnosed specifically with breast cancer, and prostate cancer diagnoses are expected to climb to over 288,000 cases this year. In addition to this, it is estimated that nearly 610,000 people will succumb to this disease this year alone.
With these statistics, it should come as no surprise that cancer research is of the utmost importance. Thanks to advances in the medical sciences and dedicated research efforts we have already witnessed significant progress in the field; despite this, we still have far to go. Research and development is imperative to furthering the improvement of prevention, detection and treatment of this life-threatening disease.
Over the past several decades, researchers, and scientists have worked hard to understand how different types of cancers can change and evolve. It goes without saying that cancer, in its many iterations, is a vastly complex, adaptive disease.
With each individual case of cancer, comes its own differentiation. The body is made up of trillions of different cells, all growing, dividing, and dying each day. The body works diligently to keep those cells under control, but unfortunately, some cells will deviate from their original path; when this happens, they become malignant.
Where some cancers manifest themselves in the form of a solid mass (often referred to as a tumor), others may present in the blood or show up in the form of skin changes (such as discoloration, sores, changes in moles, etc).
What’s more, cells within an individual tumor can vary from other tumors of the same cancer type. It’s also important to recognize that cancer is not stagnant; it moves and grows over time. This can happen incredibly quickly, even during the course of treatment. This complexity means that cancer can be very difficult to treat, making cancer research all the more critical.
What Does Cancer Research Consist Of?
Simply put, cancer research is the study and testing of cancer, how it evolves, how we can treat it and ultimately how we can cure it. Research progress in any field is often cyclical and ongoing, this is especially true of cancer research. The more we understand about cancer, the more progress we’ll make towards eradicating it completely.
A few key components of cancer research are:
- Clinical Research
- Laboratory Cancer Research
- Prevention and Early Detection
- Precision Medicine and Personalized Treatments
- Population Research
- Targeted Therapies and Immunotherapies
Let’s take a closer look at these areas of research and how they are critical parts in eradicating cancer.
Laboratory Cancer Research
Laboratory research (sometimes referred to as “basic cancer research”) focuses on the understanding of how healthy cells function and how cancer grows and changes. Researchers can accomplish this by studying the cellular, molecular, genetic, biochemical, and immunological mechanisms that affect the progression of cancer.
In most cases, laboratory cancer research will start with the study of cells or tissues (rather than whole organism) before a promising idea is found, and testing ultimately moves on to animal models. Successful tools and treatments move slowly and carefully from animal trials into human trials. This type of research is an essential starting point that helps to inform the development of new treatments and diagnostic tools, especially personalized/precision medicine.
Clinical Cancer Research
Clinical trials have been a massive contributor in the fight against cancer. Clinical cancer research is the comprehensive study of cancer treatments and tools in patients to ensure their safety and effectiveness. Utilizing clinical trials, doctors and researchers are able to fine tune treatments helping to improve the quality of life and care of patients. Often associated with the testing of new medications, clinical research can be used to test any prevention, detection, treatment and management method.
One of the key challenges in modern cancer clinical research is to ensure inclusion and diversity in these trials. Historically, trials tended to focus primarily on adult male Caucasian patients. It’s clear that clinical trials must incorporate more women, patients of color, representatives of the LGBTQ+ community, and other under-represented groups.
There are 4 phases of clinical trials. These phases are designed to ensure that new treatment methods and tools are safe for use, as well as to see how it may compare to the current standard of care.
There are four phases of clinical trials, Phase 1 through 4. In Phase 1 trials, initial impressions of the safety and potential activity of the experimental treatment are obtained; this can be studied in normal volunteers or advanced cancer patients that have very limited options available to them. Multiple dose levels are interrogated. In Phase 2 trials, a few dose levels are tested in larger numbers of patients, and efficacy endpoints are included; this may involve initial estimates of progression-free survival (PFS) or surrogates of efficacy, such as biomarkers, genetic changes, blood tests, etc. In the evaluation of some cancers, larger (or extended) Phase 2 trials may be sufficient for accelerated approval, subject to further confirmation after approval. Phase 3 trials are designed to test the efficacy of new treatments. In most Phase 3 clinical trials (and some Phase 2 trials), participants are assigned to either a “control group” (where a placebo or standard of care is given) or an “experimental group” (where the treatment is given). During these randomized clinical trials, participants are not allowed to know which group they’ve been placed in. However, they are informed that being given a placebo is a possibility. Phase 4 trials are generally post-approval and are used to expand our knowledge of real-world data on the treatment in larger numbers of patients – aimed at better defining the uses and limitations of new treatments.
Because testing is designed to answer specific questions (about the treatment, disease, tool, etc), participants must meet certain entry requirements. For example, volunteers may be required to be at a certain stage in the progress of their disease while also at a certain age in their lives. This can lead trial populations to become limited compared to that of the world. To combat this, some institutions have begun designing testing specifically for underserved populations and communities. In addition to helping close the gap in medical research for minority groups, this also helps create more reliable options for the general population.
Prevention and Early Detection Cancer Research
Prevention and early detection cancer research is about understanding the causes of cancer, finding cancer (as well as precancerous changes) in the body, and mitigating against its risks. Learning how to spot the disease when it’s still treatable, and learning to stop it before it ever starts is a critical piece of eradicating cancer. New cancer blood tests based on genomic and proteomic information (genes and proteins) are becoming extremely valuable and are likely to dramatically impact the early diagnosis of cancer.
Unfortunately, there are millions of people across the world who currently are and will be suffering with preventable cancer diagnoses simply due to economic challenges within underserved communities. Because of this, it is imperative that we continue to support and fund this type of research; so that answers, treatment methods and accessibility will continue to spread and expand.
Precision Medicine and Personalized Cancer Treatments
When it comes to medicine, it’s almost never a “one-size-fits-all”situation. This is especially true of cancer treatment. Precision medicine and personalized treatments are medical care options designed to optimize the efficiency and benefits for individual patients, that take into consideration that person’s individual genes, life-style and environment.
As previously mentioned, no two cancers are identical. Depending on the person, cancer develops and evolves in unique ways. This type of medicine often uses a person’s specific genetic information to help prevent, diagnose and treat cancer. Developing personalized treatments, prediction, and detection methods leads to fewer side effects, less internal cell damage and more efficient options overall.
The more information we have about how genetic changes correlate to cancer, the better we will be at preventing and curing the disease. Although the term may be relatively new, the concept of personalized medicine has been around for many years. For example, if a person needed to receive a blood transfusion, the donor’s blood would need to be matched to the receiver’s blood type in order to reduce the risk of complications. Utilizing this concept, doctors and researchers can look for specific patterns in a person’s gene markers, habits, and locations and more to create personalized care options.
Targeted Cancer Therapies and Immunotherapies
Targeted cancer therapy “targets” specific proteins within the cells that help regulate the growth and development of cancer. This type of cancer treatment is often referred to as the foundation of precision medicine. Most often administered in the form of a pill (small-molecule medications) or through a shot (monoclonal antibody treatments) targeted cancer therapy works by:
- Delivering compounds that kill cancer-cells specifically
- Helping the immune system fight and destroy cancer cells
- Starving cancer of the hormones it needs to develop
- Modifying the patient’s immune response to cancer to augment the body’s ability to fight the cancer
Population Cancer Research
Population research refers to the study of how specific groups of people are more susceptible to certain diseases and illnesses. It also focuses on studying the overall long-term health of special populations. Characteristics and lifestyle factors that can influence health outcomes include (but are not limited to):
- Access to healthcare
- Geographic location
- Health conditions
- Lifestyle choices (such as diet, activity level, social habits, etc…)
Studies generally include large numbers of people over significant amounts of time in order to learn about health or disease in a certain population. These observations allow researchers to improve cancer screening, prevention techniques and treatments.
Supporting Cancer Research
With each passing day, we climb closer and closer to curing cancer. Progress in cancer research is made possible by dedicated doctors and researchers around the world, as well as the support of generous donors. If you are looking to support cancer research, consider donating to one of the nation’s leading cancer research centers, the Dana-Farber Cancer Institute. Learn more about donating here.
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Disclosure: I am currently a Governing Trustee of the Dana-Farber Cancer Institute, a member of the Board’s Executive Committee and Chair of the Board’s Science Committee. I am not a paid employee or consultant of the DFCI. I previously was the Founder, Chairman and CEO of ARIAD Pharmaceuticals, Inc.,a cancer therapeutics company focused on targeted cancer therapies for patients with difficult-to-treat cancers, such as non-small lung cancer and Ph+ leukemias. ARIAD now is a subsidiary of Takeda Oncology, Cambridge, MA.