I define “curing cancer” as reducing American cancer deaths to 100,000 per year. Further
major reductions are unlikely, because some patients will be ineligible for curative treatment
due to coexisting medical conditions, some patients will refuse treatment and all of us will
eventually die of something.
What changes are needed to reduce cancer deaths to this level?
The first step in curative therapy is halting cancer cell growth, which involves several distinct
approaches.
1. Institute more effective treatment for the primary tumor.
1a. Develop more effective treatments to kill the cancer cells that damage
critical tissues and organs. Some patients need immediate treatment because their
cancer is life threatening due to its advanced and aggressive nature. This includes childhood
leukemia patients and some adult patients, such as actor Dustin Diamond, who died of
disseminated small cell lung cancer shortly after diagnosis. We should shift our focus from
targeting driver mutations (i.e. specific mutations common in a particular tumor) towards
targeting dysfunctional cellular networks which include the driver mutations. This is
admittedly more difficult, due to possible alterations in many genes in the network plus all of
the components with which the genes and their products interact (Barabási 2011).
1b. Curative treatment must attack different aspects of the cancer, requiring
combinations of combinations of treatment. Disabling any single cancer attribute,
such as rapid cell growth, will likely require combinations of 3-5 drugs or other treatments
(radiation therapy, hyperthermia) because each attribute develops through activation of a
web of biologic pathways that readily bypasses a single treatment block (Curing Cancer
Blog-Part 4).