It’s 2018. How is Cancer Still a Thing?

Cancer is such a scary word. It comes in many different types, and chances are, it has touched your life in some way, whether through you or a loved one. The lifetime odds that you’ll end up with cancer are about four in ten, and the odds that it takes your life are about one in five. It feels like cancer is everywhere these days, not only in personal stories, but in the fundraisers, celebrity spokespeople, and political speeches on our televisions. In a general sense, this disease can seem daunting to tackle. But on a personal level, one thing is sure – we’ve all seen the toll cancer has on our families and loved ones, and we all aim to prevent it in our own lives.

But figuring out how to keep cancer at bay can seem like a confusing mess. There is a lot of misinformation and partial truths out there. So how do we know who to listen to? How do we evaluate research meaningfully when it’s presented to us in a short news clip on Facebook? How can we suss out people trying to deliberately mislead us from those who are simply uninformed? It can seem frustrating, for instance, when one day, you read that fiber will prevent cancer and the next day you see another study claiming it’ll increase your risk.

So let’s talk about what cancer is and isn’t, what’s holding researchers back from finding a cure , and what you can realistically do to prevent cancer.

What Is Cancer?

First of all, cancer is not a single disease. There is a type of cancer for just about every organ in your body (think heart, lung, colon, brain…) and of those, cancer comes in many subtypes for the different types of cells that make up an organ.

A good example is blood cancer, or leukemia. You have different types of healthy blood cells in your body – the most commonly known are red blood cells (which feed your body with oxygen) and white blood cells (a group of cell types that fight infection). Each of these cells types can become cancerous.

It's 2018. Why is Cancer Still a Thing?
Blood stem cells differentiate into several cell types. From Cancer.gov

 

Cancer is simply what happens when a healthy cell’s functions go haywire – and this can happen in multiple ways. Healthy cells do all the same things cancer cells do, but in a carefully controlled and regulated manner. Usually, cancer results from different genetic mutations that lead the cell to change its behavior in a harmful way: It consumes too much food, it replicates too fast, it changes shape, it doesn’t die when it’s supposed to, or it moves to different parts of the body. A single cancer-causing mutation is often not a problem; that mutation can be stifled by protective processes your body activates when things go wrong. But combine several mutations and let them fester, or damage the genes that protect you, and those cancerous cells can grow and proliferate uncontrollably.

Why Is Finding a Cure So Difficult?

Researchers spend time investigating how mutations arise. People can be born with cancerous mutations, or they can develop during someone’s lifetime from environmental causes such as smoking or sun exposure. However, a cancer researcher’s job is largely to figure out the molecular differences between healthy and cancerous cells, and to find a way to either a) stop cancers from spreading or b) prevent them from causing more harm. There are tens of thousands of researchers out there receiving millions of dollars to study cancer, and it often feels like we’ve barely made progress since the United States Congress started funding the “War on Cancer” in 1971.

Often, labs will study a single gene and its role in a single type of cancer – it can take years to determine exactly how a mutated gene causes cancer and how to go about fixing it. Meanwhile, another lab may find the same gene behaves differently in another type of cancer. This means that even within the research community, it can be difficult to achieve a consensus on what drives cancer. It also means that since so many different factors contribute to cancer growth, and since each person has different genes and is exposed to different environments, there is no single cure for cancer.

Despite this challenge, we have made progress with various cancer types. In fact, we understand much more about how a lot of cancers work. Scientists have developed chemotherapies that target specific cancers in specific patients based on their DNA.  Palliative care has also improved.

Even a modest extension of life can feel like a victory to those who have loved ones with cancer. “Okay fine,” you say, “But I read about amazing new discoveries about cancer in the news every day! Where are those cures I keep hearing about?!” This is fair to ask, but the true answer to that question is complicated. Research progress is slow, and change is often incremental. This is incredibly frustrating when we simply want answers, but it is also the reality of things. Since each cancer is really unique to its host, there is no one-stop-shop for a cure.

If I Can’t Trust Mainstream News, Then How Do I Really Reduce My Risk For Cancer?

The best thing you can do to prevent cancer is to stop reading about “miracle cures” and simply try to live a generally healthy lifestyle. Eat your veggies and skip the extra scoop of ice cream. Try to get up and away from your desk from time to time, build meaningful relationships with the people around you, and don’t stay up all night on the internet. The precise number and type of apples you eat per day aren’t going to keep the oncologist away, but having the fruit instead of a slice of pie just might.

Note: for a wonderful breakdown of cancer research and its impact on scientific progress, public policy, and personal lives, I heartily recommend Siddhartha Mukherjee’s The Emperor of All Maladies: A Biography of Cancer.

Stefanie Kall is a Ph.D. candidate in biochemistry at the University of Illinois, Chicago.