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Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. – Epictetus

One of humanity’s perpetual problems has been the rise of a number of diseases, and while a number of medical procedures have significantly improved such as accurate blood monitoring and early detection tests – the crux is on how they are becoming more difficult to cure. Or in some cases, a proper cure does not exist. Cancer is one of those problems. It is the scourge of people since it was first identified; not only those plagued by it, but also the people around them (mostly emotionally). People have wondered if cancer can be cured at all, or it is simply a problem which cannot be solved. To truly understand the predicament we are in, one must first understand what cancer is.

Firstly, the definition. While many people think cancer is a disease in itself, it is an umbrella term – referring to the abnormal growth of cells in a specific part of the body (which could later spread to other parts). That is why there are many ‘types’ of cancer – lung cancer, blood cancer, and skin cancer to name a few.

During a lifetime, cells in the body break down and entirely new ones are created; in some cases, cells undergo cell division. All this is controlled by myriad genes in the body. However, these genes themselves undergo several mutations. Therein lies the root cause of cancer – mutations in genes could increase the cells’ production levels beyond normal. The challenge in finding a cure for cancer lies in identifying which mutation is responsible for a particular cancer (many mutations do not contribute to the growth of cancer). Several medical conditions, such as obesity, and diabetes, are known to increase the risk of cancer.

Studies have found cancer to be one of the leading causes of death globally, with close to 9 million cancer-related deaths in 2015. This computes to nearly 1 in 6 deaths. The most common causes of cancer-related deaths are:

  • Lung (1.69 million deaths)
  • Liver (788 000 deaths)
  • Colorectal (774 000 deaths)
  • Stomach (754 000 deaths)
  • Breast (571 000 deaths)

Another study found the total economic cost of cancer in 2010 alone was estimated to be approximately US$ 1.16 trillion. These figures shed light on why cancer is one the world’s deadliest diseases, and the subsequent interest in finding a cure for it.

Where things stand

As such there is no treatment to prevent the onset of cancer; essentially, most existing cancer treatments target rapidly created (cancerous) cells. There are several treatment procedures which are often used; most common ones include:

Chemotherapy – Here, drugs containing special chemicals are administered to the patients to kill the cancer cells, or inhibit their growth.

Hormone therapy – Several types of cancer (such as prostate and breast) also use hormones to grow; this therapy targets such types of hormone-dependent cancer cells.

Immunotherapy – As mentioned earlier, the immune system often does not detect cancer cells, hence it cannot deal with them. This therapy boosts the immune system’s functioning and ability to deal with cancer.

Radiation therapy – This uses high doses of radiation to kill the cancer cells. For some people, only radiation is enough to kill the cells, while for others, other treatments (such as chemotherapy) are required as well.

Surgery – This is often used to remove the cancerous cells from the body entirely.

Targeted therapy – This primarily targets the changes in cancer cells (such as mutations in genes), which helps them grow and spread, and diminishes the effect of those changes.

However, there are several slow-growing cells (which are not targeted by the treatments), which in the long run can cause cancer to resurface. Moreover, as mentioned earlier, cells in the body are constantly destroyed and new ones are created. Therefore, as long as cells continue to be produced in the body, there is always a risk of developing cancer – especially if there is a genetic mutation. So, while procedures do treat cancer, there is always a chance it will never be completely treated.

Another reason why cancer treatments are not always effective is due to the nature of the cancer cells; firstly the heterogeneity – differences in cells even within the same tumor. This means that one type of treatment may not entirely eliminate all the cancer cells itself. Even the immune system is ineffective in fighting cancer cells – these cells evade detection by the immune system, hence the immune system cannot launch a natural response to the rapid proliferation of cells.

Then, comes the production and growth of the cancer cells themselves. Fast-growing cells (cancerous cells) experience faster genetic changes, which means that the nature of the new cells is entirely different – as mentioned. Therefore, the cancer cells identified initially may be different later on. As a result, a treatment which may have been effective for the previous cells, may not be so effective now. Also, changes in genetics often lead to an even more rapid creation of cells, which means the cancer will grow faster over time. This will mean even more treatment will be required than before.

Several forms of cancer are extremely hard to treat completely. For example, less just five percent of lung cancer patients remain alive 10 years after diagnosis. This is quite a disheartening outlook for patients with lung cancer or mesothelioma (a rare type of cancer affecting the membrane of the lungs and chest cavity).

The complex nature of the science of genes (genomics) means that scientists have only begun to understand its role in cancer. Genomics allows scientists to better tailor treatments to various different cancer types. As our understanding of cancer and the effectiveness of the treatments improves, better treatments can be designed. Consequently, surviving mesothelioma and other serious forms of cancer shall become much easier.

In the context of cancer, Epictetus (the philosopher quoted above) is right. There are some things beyond our control, such as how our body functions, cells reproduce and the rate at which they reproduce and grow. Excessive levels of cell production leads to cancer. As our understanding of genes is just beginning, we have not fully comprehended how cancer cells work, let alone how to prevent them. Some existing treatments only treat the cancerous cells. However, with the increasing understanding of genomics, better treatments are being designed. And this is something that can be controlled. With this realization, perhaps we can get an iota of happiness and freedom from the worry of will cancer ever be cured.

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