13 Things Genius Scientists Wish You Knew About Cancer

Who Knew

Illustration by Serge Bloch
New treatments are saving lives.
The cancer death rate has declined 23 percent since its peak in 1991. Right now, America’s biopharmaceutical companies are working on more than 800 cancer medicines. “If you walk the corridors of any hospital studying cancer today, the excitement is palpable,” says Daniel Haber, MD, PhD, the director of Massachusetts General Hospital Cancer Center and a professor of oncology at Harvard Medical School in Boston.
Please ask for genetic screening.
“One of my early ovarian cancer patients told me her mom and grandma had both died of ovarian cancer, yet her doctor had never said, ‘Have you considered genetic testing?’” recalls Elizabeth Swisher, MD, a gynecologic oncologist at the University of Washington. “By the time she came to me, it was too late. But before she died, I tested her to identify the mutation that had caused her cancer. Afterward, I helped her daughter get that same test and removed her ovaries as a preventive measure. She’ll likely be the first person who doesn’t die of cancer in four generations of women in her family.”
Therapies targeting a cancer’s individual profile are working.
By decoding the thousands of genes in someone’s cancer cells, scientists can find out which mutations they carry and then match the important mutations to the right drugs. Dr. Haber began investigating this method a decade ago, when he read the story of a nurse who’d never smoked but had metastatic lung cancer: “She got into a clinical trial for a new targeted therapy (called Iressa). It was failing, but for 10 percent of participants, it worked magically. She happened to be in that magical 10 percent. We found a gene called EGFR in her tumor and in the other patients who had responded well.” Today, targeted drug therapy is routinely used for many types of cancer, including lung, breast, colon, and melanoma.
Every patient should get his or her tumor profile.
“We had an 11-year-old girl with a rare form of leukemia go through chemotherapy four times—yet her cancer kept coming back,” says Arul Chinnaiyan, MD, PhD, a pathologist at the University of Michigan. “Finally, we sequenced her tumor cells, and we found a genetic mutation that we knew was sensitive to a particular compound. We gave that drug to her, and she went into remission for more than 18 months. As we develop more and more targeted therapies, there will be hundreds of stories like that.”
Forget needle biopsies. We’ve got a “liquid biopsy.”
In a development that may revolutionize cancer screening, scientists have developed a blood test that can identify biomarkers for a variety of stage I cancers in the bloodstream. “The same technology that can find your DNA at a crime scene can find a cancer’s DNA in your body,” says William G. Nelson, MD, PhD, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, Maryland. Cancer centers are already exploring the use of the tests, but the hope is that one day, a simple blood draw at your annual physical would detect cancer before you show any symptoms.
We can help your immune system kill your tumor.
Cancer cells use a type of “brake” to turn off your immune system’s natural response. Immunotherapy drugs release that brake, enabling the immune system’s T cells to attack. The results have been staggering. In clinical trials, for example, almost 5,000 stage IV melanoma patients who weren’t expected to live more than a year or two were given three immunotherapy drugs. Three years later, 20 percent were still alive. “Many patients from that trial have now lived more than a decade with no sign of disease,” says Tak Wah Mak, PhD, an immunologist and molecular biologist at the Princess Margaret Cancer Centre in Toronto, Ontario. “It’s a miraculous thing.” The FDA has since approved more than a dozen different immunotherapy agents for a range of cancers.
Drug combinations may be a patient’s best bet.
“If we come in with just one drug, the cancer can mutate around it or become resistant,” Dr. Chinnaiyan says. “But we’re finding that using a cocktail of drugs—similar to the treatment HIV-infected patients receive—can be more effective.”
Viruses are among our most secret weapons.
“When we put a virus into a tumor, it makes cancer cells think they’re infected, so they commit suicide or display new antigens that signal your immune system to come in for the kill,” says Peter Jones, PhD, chief scientific officer of Van Andel Research Institute in Grand Rapids, Michigan. The FDA recently approved a genetically engineered form of the herpes virus to treat melanoma. And at Duke University in Durham, North Carolina, scientists are fighting brain cancer by injecting tumors with a genetically modified polio virus. Now Jones and his colleagues are working on a solution for tumors that can’t easily be injected: epigenetics, a process that wakes up ancient viruses that are embedded in our human DNA. “We are making tumors visible [to your immune system] by turning on the viruses that are already there,” Jones says. Early research indicates that combining epigenetics with immunotherapy drugs may be particularly effective.
Coming soon (we hope): a Pap smear that can detect ovarian cancer.
“We have developed a test that can find genetic markers of ovarian and endometrial cancers in the cervical fluid collected during a routine Pap test,” says Dr. Nelson. The research is in its early stages, but it’s an exciting development because ovarian cancer kills more than 14,000 women a year, often because it’s diagnosed too late.
We’ve built a chip that can find runaway tumor cells.
Cancer experts have known for 100 years that malignant cancers send free-floating cells into the bloodstream, creating new tumors in other parts of your body. But because there is about one circulatory cancer cell for every one billion blood cells, we haven’t been able to capture the rogue cells—until now. “We have a device that can pull out those cells so pathologists can study them,” Dr. Haber says. “That’s important because the reason most people die of cancer is that it spreads to other places.”
Diagnosed? Make sure you see a medical oncologist as well as a surgeon.
“Surgeons have a financial incentive to recommend surgery,” Dr. Swisher says. “Many of us believe that’s part of the reason for the huge increase in double mastectomies in the United States.” (The rate has tripled over the past decade; more moderate treatments like lumpectomy that preserve the breast can be equally effective.) A medical oncologist can talk to you about the pros and cons of surgery and can share other alternatives such as treatment with just drugs and radiation, chemotherapy, and more frequent screening.
Please make this simple change to your diet.
If you’re overweight or diabetic, you’re much more likely to get dangerous cancers. Many researchers believe that eating too much sugar and rapid-release carbohydrates is particularly dangerous. “Sugar makes your insulin levels spike, and insulin activates P13K, an enzyme that we have learned is a major player in many human cancers,” says Lewis Cantley, PhD, director of Weill Cornell’s Meyer Cancer Center in New York, New York. “The evidence is strong enough that I try to avoid processed foods, especially those with added sugars.”
For many of us, this is personal.
“I decided to become a medical oncologist when I was 16 years old, after I’d lost both my parents to cancer,” says Patricia LoRusso, DO, associate director for innovative medicine at Yale Cancer Center in New Haven, Connecticut. “I wanted to go after the thing that had destroyed my childhood.” Adds Jones, “I think about my research when I’m in the shower, while I eat lunch, and before I go to bed at night. I dream of actually making an impact on the survival rate of the disease.”


Featuring performances from top recording artists and celebrities from film, television, and sports, Stand Up to Cancer will appeal to the public for donations to fund cutting-edge cancer research. The star-studded live event, executive-produced by Bradley Cooper, will deliver an unforgettable evening by engaging viewers with powerful patient stories and a moving call to action. The program will include celebrity phone and multimedia banks that will allow viewers to interact with participating talent. Viewers will also be able to donate at standup2cancer.org. One hundred percent of donations received from the general public will support Stand Up to Cancer’s collaborative cancer-research programs.

Scientists quoted here are all associated with research teams funded by Stand Up to Cancer. Stand Up to Cancer airs Friday, September 9 (8 p.m. to 9 p.m. ET live/ PT tape-delayed) on over 40 networks, broadcasters, and cable providers in the United States and Canada.