Sixty or seventy years ago, one of the public aims of cancer research was to develop a 'cure' for cancer. However, research is increasingly suggesting that far from there being a universal cure for the condition, the experience of it is in fact unique to each individual and effective treatment will have to be tailored to the nature of the disease in the individual sufferer. This insight underlines a new development to fight cancer in the UK.
The 'War against Cancer' was the name of the campaign launched in the United States in the 1950's with the goal of raising funds to research the cause, treatment and prevention of cancer. It helped encourage a public perception that if enough funds and intellectual effort could be devoted to the task, then a cure for cancer could be produced.
Even today, where across the world cardiovascular disease is the cause of death for some two and a half times more people than cancer is, it is still cancer with its measured but-inevitable progression that is seen as a more traumatic way to die - compared to the swift passage of a fatal heart attack or stroke.The research that the 'War' campaign funded made clear to everyone that there is no prospect of a single cure for cancer because there is in fact, no single condition called cancer - indeed there may be as many as a hundred or more diseases that each progress in the same broad way.
The common element is the existence of some aberration in the body's chemistry that stimulates a group of cells in some organ or tissue into a process of growth which gets out of control. When this happens in an organ, such as the liver or the pancreas, this destructive process can be quickly transferred to other organs which is why cancer in these organs is almost always fatal. By contrast, cancer of the prostate is almost universal in elderly men - some 80% of men over 80 in the UK for example will have some evidence of it - but because it is both slow growing and slow to spread, it is less often a fatal condition in itself.
Furthermore, this ongoing refinement of understanding of the disease now suggests that there are at least ten distinct forms of breast cancer - each with a different prognosis and each requiring a different approach and treatment.
The biochemical malfunction that results in a cancerous process can be attributed to three broad causes. As we grow older, a tendency for our basic body chemistry to begin to fail becomes more likely and the incidence of cancer is clearly related to the ageing process. Some cancers are clearly inherited and attributed to the existence of a 'rogue gene' which brings about the biochemical breakdown - this topic has received much comment following the publicity given to the family experience of film actress Angelina Jolie.
The final broad area of cause reflects the extent to which the external environment may play a material part in triggering the problem - the connection between smoking and lung and other cancers in particular is a significant example. Even in those cases where there appears to be a clear link between genetic make up and the probability of contracting cancer, the detailed mechanics are not clear and the precise mechanisms that connects cause and effect are not understood. In many instances, all three of the components highlighted above may be - to a greater or lesser degree - important.
The outcome of this long programme of research however, is turning the long term aim of arriving at a general ' cure for cancer' into a recognition that ultimately every case of cancer is, in a sense, unique to the individual and that this is where effective treatment has to begin.
The latest initiative in the research and treatment of cancer in the UK is the development of a database that will hold and be able to cross check information on each of the new tumours that are identified in the country every year - and that is some 350,000 in total. It will take in well over 10 million historic records and will be added to as each new diagnosis in concluded.
The goal is to develop a comprehensive history of the way in which the growing range of cancers actually respond to treatment and effectively create a template against which the treatment of the condition in its huge variety can be developed. The ultimate goal could be seen as the creation of a personal and bespoke course of treatment that takes account of the individual circumstances which have given rise to it.
A related initiative has seen the UK Heath Department allocate some £100m to records the entire genetic code of a sample of about 100,000 suffers from cancer and other rarer diseases with the same aim of speeding the development of this personalised approach.