science | cancer

there is hope that the 20% of grants su2c

is setting aside for outside-the-box research A Foe Solid Cancers
With
will yield something semimiraculous.
The strategy is often compared to that
skin prostate breast

Many
of the Manhattan Project, which produced
the first atom bomb, or the Apollo program,
which put astronauts on the moon. Some
worry that it oversimplifies things. “This
isn’t an engineering problem,” says the
Faces
nih’s Harris. “It’s a problem in which we Cancer is not
know only parts of the solution.”
But more communication among scien-
one disease
tists is always better than less, and besides, but dozens, all
there may be more engineering to beating
cancer than people realize. mit, which with different
knows a thing or two about designing therapies and Diagnosis Diagnosis Diagnosis
things, is building a $100 million research
center that will put together biologists and prognoses. The old-fashioned
way is best for de-
A blood test for the
prostate-specific
Physical ­exams and,
past age 40, annual
chemists with engineers skilled in such Still, scientists tecting melanoma,
the most serious skin
antigen (PSA) is the
most common
mammograms can
detect up to 90% of
arts as nanofabrication. “We are going to
breed a group of people who are totally are finding cancer—by looking screen. A physical cases in women.
aware of the cancer problem and totally common for and keeping track
of irregular moles.
exam can also pick
up changes in the
184,450 new cases
aware of the modern tools and computa- in the U.S. expected
tional powers of engineers,” says Sharp. roots that may 62,480 new mela-
gland’s size or shape.
in 2008; 27% (if
mit plans to make dream-team pro- link them all, noma cases in the
U.S. expected in
186,320 new cases
in the U.S. expected
spread) to 95% (if
localized) five-year
posals, which Sharp views as a chance to
loose the forces of science on the particu- which could 2008; 91% five-year
survival rate
in 2008; 99% five-
year survival rate
survival rate
larly diabolical forms of cancer. One of
mit’s strategies is to build nanomolecules
lead to more
that, when injected into the body, can hunt powerful Treatment Treatment Treatment
for cancer cells, bind to them and deliver
therapies directly to the bad cells; or to
treatments Surgery can ­often Doctors can cut Well-funded re-
build nanomolecules that could locate ab- By alice park remove early out contained search efforts have
normal genes and silence them. “It’s mit,” ­tumors, but if the growths, while brought breast-
says Sharp. “We shake and bake.” melanoma has radioactive seeds ­cancer therapies
penetrated more implanted in the closest to person-
None of this absolves the rest of us
deeply and widely tumor can destroy alized medicine.
from our own behavior. Think of all those into the body, from within. Newer The first targeted
fools standing in front of office buildings doctors may also beam devices can cancer drug,
and restaurants grabbing a cigarette. choose to take out focus radiation on Herceptin, was
Think of our national epidemic of obe- some lymph nodes the prostate from designed to seek
sity, which researchers believe has many and add radiation outside the body. and destroy breast
links to cancer. or chemotherapy. Hormone therapies cancers contain-
Cancer has become a little too familiar to Efforts to create a can also shrink ing the HER2neu
us, too much a part of our social fabric. We vaccine to corral growths and stall protein. The latest
cancer cells are the cancer. test, Oncotype Dx,
embrace it with runs and walks and swims
under way. a 21-gene screen,
and bike rides that bring people together to can predict the
raise funds and hopes and share their grief. likelihood that a
“It’s tough. We are a very ­optimistic orga- woman’s cancer
nization, and all of our materials are about will recur and
living every day to the fullest and living even whether she
strong and fighting ­cancer. But at the end will respond to
of the day, if you look at what’s happened, chemotherapy.
some would ­ argue that we haven’t been
that successful,” says laf’s Ulman.
At a Livestrong ride, run and walk in Outlook Outlook Outlook
the Philadelphia area, some 5,000 people About 80% of mela- It’s one of the more No other cancer
took part on a beautiful summer day to nomas are detected ­curable cancers, as comes with so many
raise $3 million for the laf. “These aren’t early, before they long as it is detected treatment options,
fun runs,” says Armstrong. “They are very have spread, and can early. Cases still which means more
emotional, tearful times.” Some partici- be cured. Screen- remain high among women than ever
pants had cancer; some were survivors. ing programs and African-American before can—and will
self-exams are key men. ­continue to—survive
And most of those who rode by bore on to keeping down the the disease.
their backs the names of dead relatives, cancer’s rates.
a rolling graveyard passing through the
placid Pennsylvania countryside.  n

A l l p h o t o s f r o m p h o t o r e s e a r c h e r s , f r o m l e f t: S t e v e g s c h m e i s s n e r ; S t e m J e m s ; S c i e n c e s o u r c e ; c n r i ; s t e v e g s c h m e i s s n e r ; s p l ; d r . a n d r e j s l i e p i n s ; d r . e . w a l k e r ; ja m e s c ava l l i n i
 Liquid Cancers
brain pancreatic lung leukemia lymphoma
Non- Hodgkin’s Hodgkin’s

000,000
new cases per year

Diagnosis Diagnosis Diagnosis Diagnosis Diagnosis Diagnosis

There is no screening No screening exists, Doctors are investi- Routine blood tests Swollen lymph nodes Swollen nodes in the
test for brain cancer, so only 7% of cases gating whether X-rays can reveal the may be the first sign neck or chest are a
and symptoms such are detected early. or spiral CT scans are hallmark of the dis- of this most common first sign. It may be
as headache, blurred The rest are spotted better at finding lung ease—an abnormal variety of lymphoma, ­revealed during X-rays
vision and seizure when pain or other cancers early. number of white which can occur in for flulike symptoms.
are often the first symptoms occur. blood cells. 30 different forms.
215,020 new cases 8,220 new cases
signs.
37,680 new cases in in the U.S. expected 44,270 new U.S. 66,120 new cases in ­diagnosed in the U.S.
21,810 new cases in the U.S. expected in in 2008; 15% (if ­cases ­expected in the U.S. expected annually; 85% five-
the U.S. expected in 2008; 5% (if spread) spread) to 49% (if 2008; 21%-75% five- in 2008; 63% five- year survival rate
2008; 32% five-year to 20% (if localized) localized) five-year year ­sur­vival rate, year survival rate
survival rate five-year survival rate survival rate depending on type

Treatment Treatment Treatment Treatment Treatment Treatment

Surgery, radiation Surgery can remove Until targeted drug In 2001, Gleevec, Chemotherapy is Alternating rounds
and chemotherapy some of the ­cancer, therapies emerged the most powerful an old reliable, but of radiation and
are the ­standard but because it is in the past decade, new anticancer highly specialized chemotherapy
anticancer often found late, traditional cancer treatment to come antibodies that are the most
­measures. But chemotherapy and therapy could do along in decades, target proteins ­effective treatment
because growths radiation are rarely little for lung- was introduced. Its coating the cancer ­option. During the
in the brain are dif- enough. ­Doctors ­cancer patients. first target—chronic cell’s surface are disease’s early
ficult to reach with have a poor under- But certain forms myeloid leukemia, proving effective stages, radiation
these methods, standing of what of the disease a difficult-to-treat killers as well. focused on the
­researchers are drives ­pancreatic depend on blood- blood cancer. By While leukemias ­affected lymph
testing a ­number cancer, which vessel and growth- ­disabling a signaling are destroyed from nodes may prevent
of potentially more means that even factor agents, all pathway inside the the inside out, the lymphoma from
effective ones, the latest targeted of which can now cancer cell, Gleevec lymphomas appear spreading.
­including harness- drugs are ineffec- be inhibited with does what chemo to be vulnerable
ing immune cells tive. Most research anticancer drugs. and radiation can’t: to the traditional
via vaccination, efforts are focused Other compounds ­attack the tumor ­attack on the outer
heating up the on finding better that block insulin from the inside out. flanks—provided
­tumors and cutting ways to detect the growth factor are That proved ­effective that the antibodies
off the cancer’s disease sooner so being studied. for other leukemias are designed to
blood supply ­­using the tumor can be as well; some child- find the right lym-
targeted drug removed before it hood versions now phoma targets.
therapies. spreads. have an 81% five-
year survival rate.

Outlook Outlook Outlook Outlook Outlook Outlook

New treatment It may be one of the Survival rates remain Next-generation New treatments Once nearly always
options have only toughest cancers to stubbornly low, but targeted drugs will ­provide hope that fatal, this lymphoma
recently started to treat today, but that smarter treatments continue to assault non-Hodgkin’s cases is now predominantly
emerge, but a better might change as a combined with ­better leukemia cells’ can be controlled, but treatable, owing to
understanding of deeper understand- screening tests may inner ­workings, the incidence of the early detection and
the molecular ing of what causes soon raise those making them disease has climbed judiciously applied
mechanisms behind pancreatic cancer is percentages. The more ­vulnerable to since the 1970s for therapies.
brain cancer could reached. best way to avoid the ­destruction and the ­reasons that puzzle
push survival from disease altogether? effects of chemo and researchers.
months to years. Don’t smoke. radiation.

time September 15, 2008 43