Previous Next Cancers that are detected early — when they are small and less likely to have metastasized spread away from the primary tumor — are more likely to be treatable with local therapy, whereas successful treatment is ultimately unlikely once metastatic tumors develop. And improved therapies mean that warts on hands virus can be treated with drugs that work better and that patients are more likely to receive the full dose needed.
But our dramatic progress in detecting and treating cancer has also led to growing awareness of the problem of tumor dormancy: a patient appears to be cured, only to have the same cancer return years or even decades later.
In breast cancer or melanoma, for example, recurrences 25 years after initial treatment have been reported.
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With a growing number of cancer survivors, we need to understand better the twin processes of tumor dormancy and metastatic cancer recurrence. While remarkable progress has been made in understanding the biology of cancer — leading in part to the development of new, less toxic drugs — our understanding of the biology of tumor metastasis, and especially the development of metastases after a long period of tumor dormancy, has lagged. We do know that metastasis is a very inefficient process, with most cancer cells that escape into the blood stream failing to form metastatic tumors in distant organs.
Recent studies — from both the laboratory and the clinic — suggest that many cancer cells that leave the primary tumor may lodge themselves in new organs and go into a dormant state. We also have evidence that says that these dormant cells may resist most current treatments.
This means that adjuvant cancer therapy, designed to kill presumed micrometastatic disease, may be missing an important fraction of disseminated cancer cells, some of which may eventually wake up. Subscribe to Project Syndicate Subscribe to Project Syndicate Enjoy unlimited access to the ideas and opinions of the world's leading thinkers, including weekly long reads, book reviews, topical collections, and interviews; The Year Ahead annual print magazine; the complete PS archive; and more.
Subscribe Now Moreover, we are beginning to identify molecular mechanisms that regulate the entry of cancer cells into a dormant state, as well as their re-awakening at later times.
Our knowledge of the regulation of tumor dormancy is really in its infancy. But, given the growing numbers of cancer survivors, the need for this knowledge is becoming more pressing.
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Indeed, there is evidence suggesting that tumor dormancy is a valid target for therapy. For example, in some types of breast cancer, patients may be treated for more than a decade with anti-hormone therapies, and these long-term treatments are working — they are successful at preventing some of the cancer recurrences that occur with shorter treatment.
But, while these long-term therapies are relatively safe, they do have side-effects, and the number of cancer recurrences that they prevent is small. The challenge today is thus to understand the processes of tumor dormancy and metastasis better, in order to determine more accurately which patients will benefit from long-term therapy.
Cu toate acestea, până în prezent nu s-au efectuat studii clinice cu graviola pe oameni pentru a-i studia potențialul anti-cancer, deși unele studii experimentale au indicat că graviola poate avea proprietăți anticancerigene. Alimente de mâncat după diagnosticarea cancerului! Nu există două tipuri de cancer la fel. Treceți dincolo de orientările nutriționale comune pentru toată lumea și luați decizii personalizate cu privire la alimente și suplimente cu încredere. Cu toate acestea, nu se fac studii clinice pentru a explora siguranța acestuia și, de asemenea, pentru a confirma dacă graviola sau guanaciul poate vindeca cancerul.
Would intermittent therapy be as useful as long-term treatment? Are there features of the primary cancer, or of individual patients, that can help us predict who will develop late recurrences and metastatic disease?
What if late recurrences simply cannot be predicted at diagnosis? Are there modifiable factors — for example, lifestyle, immune-system status, or environmental conditions — that influence whether or not patients develop late recurrences?
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The answers to these questions will require research, and research into metastasis and tumor dormancy is difficult. It requires patience, development of models, and willingness to undertake long-term studies.
We also need to understand better the prevalence of long-term dormant disease in patients. How common is the phenomenon we are examining?
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It may be that many cancer patients harbor disseminated tumor cells, and not all of these cells are destined to re-awaken. This focus ultimately may be shortsighted, as the increasing number of cancer survivors leads to an increase in late recurrences.
Metastases, not the primary metastatic cancer can be cured, are metastatic cancer can be cured for most cancer deaths. If we are to continue to improve on cancer survival statistics, we need to learn how to prevent, delay, or thwart the processes that give rise to metastatic disease.
Support High-Quality Commentary For more hpv cancer head and neck 25 years, Project Syndicate has been guided by a simple credo: All people deserve access to a broad range of views by the world's foremost leaders and thinkers on the issues, events, and forces shaping their lives. At a time of unprecedented uncertainty, that mission is more important than ever — and we remain committed to fulfilling it.
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