There have been breakthroughs in treating cancer, but what about preventing it in the first place?
In 1970, the nation launched a “War on Cancer.” The goal was to cure it in 25 years, but back then, researchers didn’t know what we know now. That cancer is a disease of our genes… “a distorted version of our normal selves” as Nobel Prize winner Dr. Harold Varmus said.
In the final part of our week-long series, I visited some researchers at the University of Michigan's Comprehensive Cancer Center who are looking deep into our cells for answers.
When I visited Dr. Madhuri Kakarala, she had me peek through a microscope in her lab.
“Just describe for me what you see here, and I’ll tell you what it is,” said Kakarala.
The last time I peered through a microscope was in a high school biology class. Those images were typically a hazy outline of something… maybe green… and with a hair in it.
But what I was seeing here was crystal clear. Tiny white spots on a gray background, and several spots had clumped together in the center.
“That looks kind of like a circular ball, right? A three dimensional sphere. That is a mammosphere,” said Kakarala.
I’m looking at stem cells from human breast tissue donated by women who have undergone some type of breast surgery.
They’re analyzing these cells to see how they react to a chemical many of us are exposed to – bisphenol A, or BPA.
BPA is used in plastic food containers, water bottles, and the linings of metal food cans. It’s even on money and some paper receipts.
Scientists at the National Toxicology Program at the Department of Health and Human Services say this about BPA:
In the case of BPA, the NTP and our expert panel expressed “some concern” for potential exposures to the fetus, infants and children. There are insufficient data from studies in humans to reach a conclusion on reproductive or developmental hazards presented by current exposures to bisphenol A, but there is limited evidence of developmental changes occurring in some animal studies at doses that are experienced by humans. It is uncertain if similar changes would occur in humans, but the possibility of adverse health effects cannot be dismissed.
It’s “uncertain,” so the researchers in this lab are gathering more data.
They want to know how this estrogenic compound affects breast cells. Kakarala says BPA can promote progenitor cell growth, and they want to know if it promotes the growth of some kinds of breast cancers.
This is just one experiment in this lab. It’s one puzzle they’re working on.
They’re also looking at how some spices, like turmeric and pepper, might keep cells from turning cancerous – how some foods and anti-inflammatory drugs might also help.
“What we are trying to do is look at those individuals that we know have an increased risk of developing cancer, and intervene with those people before they already have cancer,” said Kakarala.
Much of the research they do here falls under the umbrella term of cancer prevention research.
Cancer prevention can be cell biology research like this, or developing vaccines, or it can mean educating the public about the things that can reduce cancer risk – things like maintaining a healthy weight, reducing emotional stress, eating the right foods, and exercising (the Mayo Clinic lists 7 tips for reducing your cancer risk).
Some cancer rates are rising, but if you look at all cancers combined the overall rates have been ticking downward since 2001.
More people have quit smoking, and that’s led to a drop in lung cancer rates.
More people are getting screened, and that’s led to a drop in colon cancer rates.
Dr. Dean Brenner heads up the lab where Dr. Kakarala works. He said the lesson is that cancer prevention works.
“That’s why it’s so important to think of dealing with cancer as a process that starts long before one sees the bad endpoint, which is the disease that everybody calls cancer and treats with chemotherapy, but rather that the whole process that we intervene early than that because we already know that when you intervene early, we see a reduction in mortality,” said Brenner.
The complex puzzle remains. Can researchers find the things that increase our cancer risk?
There are around 80,000 chemicals in our lives today. Only a fraction of them have been well studied.
But all this research takes money, and today more money is spent on treating the disease than preventing it.
The National Cancer Institute is the biggest funder of research in the U.S. The government agency has an annual budget of more than $5 billion.
When we looked at the programs aimed at prevention, around 13 percent of their 2011 budget went toward this kind of research.
In an e-mail, an NCI official told us they spent closer to 27 percent of the 2011 budget on prevention. And they said much of the research they fund focuses on basic cell biology, which can lead to breakthroughs in treatment and prevention.
Dr. Kakarala said no matter what her funding situation, she’ll keep looking for answers.
In her first year of medical school she was diagnosed with an advanced thyroid cancer.
She said living through that experience has helped her. And it helps today when she’s in the lab or with her patients.
“It makes me really understand the suffering that they’re going through, because I’ve been in that bed. And in the lab, it’s a huge motivator. You may or may not get your next grant, but I’m not giving up on this, because this is a mission. It’s not just a career.”
Dr. Kakarala said she feels like her experience drives her to solve these complex genetic puzzles – to learn ways to keep our cells from mutating out of control.