In the recent scifi Elysium there are wonder-chambers that scan the human body and remove all the cancer cells and diseases and thus keep a person immortal. Is it possible to create such a machine?
I’m often asked about cancer, what the current drugs are, when we will cure it, though I’m not a clinical oncologist but a molecular biologist. Many people don’t understand that cancer is a term for many different types of malignant tumours. Sure they’ve heard of melanoma, carcinoma, blood cancer (for instance, lymphoma). Yet, for some reason, despite the awareness of the different tissues these tumours occur in, there’s often an assumption there is one underlying cause to cancer, which can be found and eliminated for good.
To clarify, I’ll first explain what cancer is. Every cell in our body that is able to divide into more cells does it in a controllable manner. Imagine if cells in our body divided at their whim – would we have our highly structured organs, blood vessels, brain, face or just a chaotic mess of cells?
The body develops from a zygote, a fertilised egg, and from the start of our life embryonic cells divide and migrate in a highly controlled manner. Our cells have complex molecular systems in place in order to be instructed when to divide, when to stop, and when to die. This control is the basis of life, at least for a multi-cellular organism.
So when mutations in our genes happen that affect these molecular systems this can make our cells divide limitlessly. From a single mutated cell like this, a tumour can develop, give metastases, and when the tumour growth interferes too much with physiological processes the body gets sick and eventually dies.
Many cells are mutated in our body every day, but our body eradicates the vast majority of them using the immune system. Immune cells are capable of recognising misbehaving cells and killing them. But that poses a different problem. By eliminating relatively weak tumour cells, our body selects for the most aggressive malignancies that can easily evade our immune system and, horror horror, are more resilient to chemotherapy or other medical intervention.Now why is there no one common way of treating cancer? That’s because cancer can arise from many cells types and it be caused by different mutations. There are hundreds of genes that when mutated can contribute to tumorigenesis either by being inactivated (tumour suppressor genes like p53) or by becoming hyperactive or overabundant or both (oncogenes like Ras). Then again these mutations can happen in skin cells or liver cells or stem cells in certain tissues. (There’s even a popular theory that all tumours come from stem cells that are mostly differentiated and thus disguised as common somatic tissue cells). So depending on their tissue origin and the identity of mutations tumours differ in their biology, the way they grow, react to the immune system, have their metabolism and as a consequence – respond to therapy.
That’s why, it is therefore currently impossible to create one drug for all of them, an individual approach is needed.
Just half a century ago only about 30% of all tumours were medically curable, now it’s 70-80%. The underlying scoence and the clinical tools are constantly evolving and who knows maybe one day we will come up with the machine like the one in Elysium.
What is stopping us to create it now?
To cure cancer we need to know more about its biology. Most of the biomedical research focused on behaviour of one or several genes and their relationship per study, it is a very reductionist approach. And it’s difficult enough to do even that already. Currently biomedical research moves into systems biology. A modern study attempts to monitor behaviour of thousands of genes/proteins in a given process, cell or tissue. The goal is to to understand how our body works at the whole system level.
Imagine monitoring tumour growth and looking at work of not just one or two genes or cell types but at the whole picture? We are still short of research techniques that would enable us to follow processes with such high resolution and capacity in a living organism. But theoretically it’s possible, so the science will keep making progress.
Aside from treating cancer, bolder question arise – is it possible to keep our body in shape endlessly, to withstand mutations, to keep it structured and healthy indefinitely? Is it possible to overwrite our ageing program in order to stay young?
Should we stay forever young or ageing is a blessing in disguise? Such questions are not simply biological anymore, so maybe we shouldn’t seek just a biological answer. And perhaps, everyone should decide for themselves. What’s your answer?