Categories: Oncology

Can we Cure Cancer – The story of the ‘SMART’ versus the ‘SHREWD’

When we talk of blood cancer to our patients, we call them the ‘bad cells’. The story of cancer is thus often reflected as a struggle between the bad cells and the good ones. Yet, the perennial question lingers as to why the cells turn ‘bad’ or cancerous. Bad habits like smoking and excess alcohol have been blamed for certain types of cancer, but what is the trigger for the rest remains largely unknown. The study of blood cells and its inner complexities over the last 30 years have helped us somewhat understand the journey of a cell from the ‘good’ to ‘bad’ and to ‘ugly’.

Each cell in our body is destined to behave in a particular way, depending on its surroundings, its function, and its potential. This is a complex network governed by the expression of the genes within the cells or the lack of it. Every cell possesses the entire set of genes it inherits, yet different genes are expressed and silenced in the liver, heart and the brain as their functions are very different. An aberrance in this function can lead to the death of these cells or uncontrolled proliferation- the latter being called cancer. Not just smoking, but there are innumerable stimuli in our daily environment for each and every cell in our body to turn ‘rogue’. Yet, most of us never develop cancer in our lifetime and some unsuspectingly fall victim to these ‘bad’ cells.

The dichotomy lies in the cat and mouse game that goes on between the ‘smart and alert’ among the good cells (the immune cells) and the ‘shrewd and deceptive’ among the bad cells (the cancer cells). The former is like the BSF patrolling the LOC and the latter are the terrorist infiltrators trying to cross the border through many means of deception. Once they cross the border of control, they establish themselves in the organ of their origin and often infiltrate distant parts of the body. If detected at early stages, they can be eradicated, but when they mingle with the normal cells and go far and wide-they become invincible. This is the normal story of any cancer originating from any of the solid organs of the body. But this is not true for blood cancers.

Cancers of the blood cells (called leukemia, lymphoma or myeloma), travel far and wide from the moment they have evaded the immune barrier-yet they remain the most curable of all the cancers. Immune cells are the ‘smart’ cells in the blood which have been studied for the last three decades, with new and exciting discoveries about them helping us believe that we can outsmart the bad cells in their own game. The treatment of cancer has moved from the age-old concept of poisoning all the cells with toxic chemotherapeutic drugs, hoping that the good ones survive through all the trauma-to one where we can cleverly manipulate the smart cells of the immune system to kill the cancer cells. This is called ‘immunotherapy’-when drugs or agents are used to manipulate the immune system to specifically target the cancer cells or ‘cellular therapy’-when cells from the patients own body or from another person is used to directly attack cancer. These discoveries have reshaped the treatment of blood cancers to make us imagine a cure for them when all hope was lost. Many use ‘T cells’ to orchestrate the attack against cancer. Our team has developed the use of ‘Natural Killer (NK) cells’ for this purpose. We hope that the successes in the field of blood cancers will instigate a paradigm shift in the treatment of solid tumours as well. The story of the ‘smart’ versus the ‘shrewd’ will unfold further over the next decade or so and we shall know if we have been smart enough to win over this deadly disease.

Dr. Suparno Chakrabarti & Dr. Sarita Jaiswal, Head of the Department – BMT & Haematology, Dharamshila Narayana Superspeciality Hospital, Delhi

Narayana Health

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