Dr. RAJENDRA ACHYUT BADWE


Chemistry

4919 Views Cancer:Need for Cross-Talk

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Cancer remains an enigma with rising numbers and relatively static cure rates for many decades and complete failure to cure those with recurrent disease. We have tried to understand cancer with a reductionist paradigm with modest benefits but failures loom large. It is time to re-look through a unifying lens. Prevention and screening are the most appealing approaches. Tobacco,infections and obesity put together accounts for almost 67% of cancers in India. Reducing tobacco and infections are low hanging fruits yet difficult to pluck due to mercantile reasons or non-saleable ideas like swatcchha bharat. Obesity can be tackled effectively by compulsory exercising at work place as well as in modes of travel. Screening is another arena where bio-medical engineering could give great inputs. Early detection improves survival and as a corollary screening should save lives. Unfortunately such logic has failed in human biology where huge amount of overdiagnosis does not go hand in hand with saving of lives e.g. prostate,lung and breast cancer (< 50yrs). We need biomarkers that would pick up killer tumours before they disseminate. We have liquid biopsy that is sold for screening as well as for early detection of recurrence. We need robust evidence for their efficacy. Majority of these interventions are ineffective and hugely expensive. A fall out of these studies is effect of act of observation on observed. This has opened some new avenues for existing medicines to be tested in a novel setting. Properties that bestow the ability to metastasize on the primary tumour during act of observation could be modulated using new drugs. Thus the focus could change from treating metastases to preventing metastases. Biologist should defines the properties of cancer for chemist to formulate molecules of precision or physicist to devise novel modes of detection and therapy so that we can conquer this dreaded scourge.

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