Time to Fight Back

		Are we beating cancer? The old joke among cancer researchers is that they’ve cured cancer thousands of times—in mice. But when it comes to ridding humans of the devastating illness, it’s a far different story.  Nearly thirty years after the groundbreaking discovery of the first cancer-causing gene (called an oncogene), researchers have learned only to manage, not cure this leading killer of both women and men. It’s not for lack of trying. Over the past 15 years in Alberta and across the world, there has been an explosion in research activity that has led to an increased understanding of the cellular, molecular, and genetic bases for many types of cancer. Thanks to the identification of oncogenes, which accelerate cancer’s growth, and the more recent discovery of tumour-suppressor genes, which slow it, scientists have gained better insight into how abnormal cells in the body grow uncontrollably and form cancerous tumours. Tumour-suppressor genes control the tendency of cells to die when they are damaged. If the cells survive, they might start to grow again—an abnormal characteristic for mature cells, but a common feature of cancer cells. Another function of tumour-suppressor genes is to repair damaged DNA. When that repair fails, cell mutations increase. This accounts for cancer’s astonishing ability to grow and resist almost anything scientists throw at it, says Dr. Randy Johnston, Director of the Southern Alberta Cancer Research Centre in Calgary. “Murphy’s Law seems to apply in the development of cancer,” he says. “Anything that could go wrong does go wrong.” Catching up with knowledge While the breadth and depth of knowledge about cancer is rapidly increasing, advances in cancer treatments have been fewer and slower, says Dr. Brent Zanke, Director of the Cross Cancer Institute in Edmonton. “A lot of the therapies being offered essentially have not changed over the last two decades. There are some new drugs that have changed the way that we’re treating cancer,” he notes. “New radiation techniques are also being developed, but we haven’t seen a massive overhaul of cancer therapy.” A recently announced $21-million addition to the Cross Cancer Institute will help address this concern, Dr. Zanke says. The addition will house new world class technology that will improve cancer diagnosis and treatment allowing, for example, the delivery of higher doses of tumour-killing radiation than ever before, and with unprecedented accuracy. Surgery is the oldest form of cancer treatment. It ranges from biopsies confirming a cancer diagnosis to tumour removal aimed at preventing the disease from spreading. Other treatment options include radiation therapy, which destroys or damages cancer cells with X-rays or gamma rays; chemotherapy, which kills cancer with strong drugs; hormone therapy, which attacks the cancer with hormones; and immunotherapy, which uses the body’s own immune system to fight the disease. Treatment horizon positive As far as cancer drugs go, Dr. Johnston is encouraged that half of the clinical trials underway around the world represent new approaches to cancer therapy. Two of these innovative trials are based in Alberta. “We’re excited about the advances happening through Biomira Inc., an Edmonton biotechnology company. They’re conducting successful clinical trials on a vaccine for a virulent form of breast cancer,” he says. “In Calgary, we’re equally excited by Dr. Patrick Lee’s reovirus discovery.” Dr. Lee recently gained world attention when he injected live reovirus into cancer tumours, causing the virus to replicate and kill the cancerous cells. The process appears to be highly effective against 80% of cancers. Oncolytics Biotech Inc. of Calgary is currently testing reovirus in clinical trials. Innovation key to advancement University of Calgary cancer researcher Dr. Stephen Robbins says that serendipitous findings like the reovirus will be instrumental in the ultimate eradication of cancer. “It may be too bold to say, but I think classical approaches to cancer are not working that effectively,” he comments. “Surgeons can do as much as they can do. We’re improving our chemotherapy and radiation techniques, but I think we’re at the point now where we have to start with more innovative thinking. At the University of Calgary and other research institutions we’re starting to integrate ideas from other disciplines into a really comprehensive understanding of cancer.” Given the Heritage Foundation’s continued recruitment of top researchers, access to new technologies, and the comprehensive cancer data registries available through the Alberta Cancer Board, Dr. Robbins says the province’s scientists are poised to make enormous progress. His own research on signal transduction (how cells communicate with each other) looks at the intricate biochemical circuitry that connects the outside of the cell to the inside of the cell. “We work on many proteins that are involved in telling the cell to divide, move somewhere, or become a particular kind of cell,” Dr. Robbins explains. “We want to know how a particular cell decodes that signal.” By better understanding how cells communicate with each other, researchers could pinpoint potential targets for cancer drugs to make them more effective against the disease. Dr. Robbins started his career working as a postdoctoral fellow in the lab of Nobel Prize winner Dr. J. Michael Bishop. Dr. Bishop won the prestigious award for his discovery that oncogenes are actually a mutation of normal cell genes. Slicing through genes In collaboration with Heritage researcher Dr. Max Coppes, Dr. Robbins is also studying the molecular genetics of cancer in children. “Children with cancer are treated very differently than adults with the disease,” he explains. “Because these cancers present themselves so early we believe there must be a heavily genetic component to them.” The researchers are working on molecular profiling of pediatric cancers in order to better understand the genes involved in these types of tumours. The new gene chip technology will aid them in this research. Gene chip technology allows a scientist to look at a “snapshot” of DNA that is so precise it can show how active a gene is and any mutations it carries. It’s a revolutionary technique that will speed up the job of analyzing tumours immeasurably. Photonics Research Ontario, a provincial Centre of Excellence funded by the Ministry of Energy, Science and Technology, predicts that within a decade doctors will be using gene chip scanners in their offices to accurately diagnose such common health problems as a cold or the flu. They will be able to identify which gene is causing the problem and whether or not it is resistant to specific antibiotics. The University of Calgary is establishing a state-of-the-art gene chip facility that will become operational this spring. Dr. Robbins predicts this shared provincial asset, in combination with other home-grown resources, will help Alberta researchers make improved cancer diagnoses and treatments. Beyond DNA Another new cancer fighting technology already in use at the Cross Cancer Institute is PDT (photodynamic therapy). PDT uses light to activate photosensitizer drugs that target cancer cells, to identify and then zap tumours. This minimally invasive therapy is proving highly effective against bladder cancer, but its clinical application is currently limited because of side effects. Dr. Ron Moore, a Heritage researcher and noted urological surgeon (oncology and transplantation) based at the University of Alberta, has been working on strategies to overcome these limitations. Dr. Moore is also taking part in a successful collaboration with Dr. Lee to treat bladder cancer with the Calgary researcher’s reovirus. Potentially, 50% to 70% of bladder cancers should respond to reovirus therapy. In animal testing, Dr. Moore’s lab has observed cure levels greater than 70%, with no complications. Clinical studies are now being planned. PDT is also being used clinically to treat lung, brain, and gastrointestinal cancers at other institutions. At present, Dr. Moore and colleague Dr. John Tulip are attempting to improve the accuracy of the treatment for prostate cancer. Discussing the prospect of an imminent cure for cancer, Dr. Moore suggests that researchers are making great strides in understanding what causes the disease. Whether they will ever be able to devise a simple treatment that is affordable and readily available to everyone is still an unanswered question, he says. “The ideal cancer therapy would be selective for the disease, be minimally invasive, and have few side effects.”  Future challenges While much progress is being made, researchers and doctors are facing the immense challenge of translating laboratory wonders into therapies and treatments for patients. “Our population is increasingly aging,” notes Dr. Zanke. “And the overall incidence of cancer is rising.” The World Health Organization (WHO) projects that by 2015, 15 million people will develop cancer annually. Closer to home, Health Canada predicts that by 2010, 105,000 Canadians will die of the disease every year. Estimates are that in 15 years, 70% more Albertans will be living with cancer than today—a staggering thought, although Dr. Zanke can see a positive aspect: “More people are living with cancer because the cancer therapies we’re using are working better.” Nonetheless, if these predictions come true, strong research will be more important than ever. “The strain on the healthcare system is going to be considerable,” says Dr. Zanke. “We have to focus our research efforts on trying to relieve that strain in a cost-effective way. It’s going to be through research that we’ll make true advances.”. Dr. Randall Johnston is the Director of the Southern Alberta Cancer Research Centre, the Associate Director (Research) of the Tom Baker Cancer Centre, and the Terry Fox Professor for Cancer Research. He is also the Associate Vice- President (Research) for the University of Calgary. Dr. Johnston receives support from the National Cancer Institute of Canada and the Alberta Cancer Board. Dr. Ron Moore is a Heritage Scholar and an Associate Professor in the Division of Surgical Oncology in the Faculty of Medicine and Dentistry at the University of Alberta. He receives additional funding from the Alberta Cancer Board and the National Cancer Institute of Canada. Dr. Stephen Robbins is a Heritage Scholar and an Assistant Professor in the Department of Oncology and the Department of Biochemistry and Molecular Biology in the Faculty of Medicine at the University of Calgary. He holds a Canada Research Chair in Cancer Biology. Dr. Robbins receives additional support from the Canadian Institutes of Health Research (CIHR), Cancer Research Society Inc., and the Alberta Cancer Board. Dr. Brent Zanke is the new Director of Edmonton’s Cross Cancer Institute. He receives support for his research from the Leukemia Research Foundation and the Canadian Institutes of Health Research. Check here to read this article at source.