11
Dec
09

Overcoming big hurdles in cancer research and treatment

I’ve posted a couple of times [here and here] about the complexity of living systems and the challenges that reality presents for medicine. That’s certainly true for cancer.

But the march toward greater information goes on. A Princeton U press release titled “Scientists find way to catalog all that goes wrong in a cancer cell” on Physorg.com describes an advance in algorithms that make defining the pathways of complex genetic interactions. Researchers “were able to systematically categorize and pinpoint the alterations in cancer pathways and to reveal the underlying regulatory code in DNA.”

Researchers Saeed Tavazoie, Hani Goodarzi, and Olivier Elemento say:

“We are discovering that there are many components inside the cell that can get mutated and give rise to cancer…Future cancer therapies have to take into account these specific pathways that have been mutated in individual cancers and treat patients specifically for that.”

The researchers developed an algorithm, a problem-solving computer program that sorts through the behavior of each of 20,000 genes operating in a tumor cell. When genes are turned “on,” they activate or “express” proteins that serve as signals, creating different pathways of action. Cancer cells often act in aberrant ways, and the algorithm can detect these subtle changes and track all of them. […] The algorithm devised by the group scans the DNA sequence of a given cell — its genome — and deciphers which sequences are controlling what pathways and whether any are acting differently from the norm. By deciphering the patterns, the scientists can conjure up the genetic regulatory code that is underlying a particular cancer.

The goal: developing much more specific therapies targeted to these variation.

That’s cool. It’s great to keep digging for the information to understand and treat cancers. But I have to add — having spent many years in the sometimes idealistic realm of cancer control — there’s another giant issue that has reared it’s ugly head in recent years: cost. When I started my career three decades ago nobody was talking about the economic barriers of cancer therapy development and widespread adoption being such a problem. But the ongoing farcical struggle over reasonably equitable health care access for all Americans (much less the rest of the world) demonstrates that how much cancer treatment costs and who pays for it is a formidable problem in “curing cancer” in its own right. Teasing out the information this research suggests is needed and then delivering treatments from it in practical terms to a big population is going to be a long process.

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