The past few decades have seen many claims that we are on track for a cure for cancer – and each time, those claims have only left us disappointed. The initial bold optimism surrounding the fight against cancer – inaugurated by Nixon’s War on Cancer in the 1970s – gave way to more moderate claims as we realised that cancer was more easily halted temporarily than cured entirely. The truth is that cancer encompasses a wide range of related diseases, which are unlikely to be beaten by a single cure. And the high rate of mutation in tumours has meant that even our best methods, like chemotherapy or radiotherapy, can’t always decisively eliminate a cancer – tumours often mutate enough to gain immunity to all the methods we have at our disposal.
Given these two fundamental obstacles to a finding a single cure for cancer – the diversity of cancer and its resistance to a permanent cure – is it sensible to talk about the possibility of curing cancer at all? The medical community prefers to talk about solutions to particular cancers, some of which may cure the disease (in the sense that patients have no traces of cancer left in their bodies), some of which will cause partial remission. It is considered more accurate to think about curing cancer in these more limited terms, than to be seeking out a silver bullet.
But the lessons of the business world tell us that thinking big is essential to finding success – just look at the high goals and strong vision of high net worth individuals like Elon Musk or our own founder Tej Kohli, which have brought them success in business and philanthropy. Without forgetting the problems with the concept of a single cure for cancer, having that big picture in mind can help us to better direct our efforts, keeping us optimistic that cancer can and will be beaten. And recent developments in the field of immunotherapy give us cause to believe that something like a cure for cancer may well be on the horizon.
Immunotherapy works by using the body’s natural immune system to fight off cancer, rather than attacking the tumour directly with, say, radiotherapy. The immune system doesn’t always stop cancer on its own because cancer can “disguise itself” from a core part of the immune response, T-cells. T-cells are a special kind of white blood cells which target infected cells and destroy them – and usually they would be able to destroy cancerous cells as well. But cancer is sometimes able to block the T-cell’s ability to detect it, allowing the cancer to grow freely without any attack from the immune system.
Immunotherapy has two main branches in fighting cancer. First, it changes the T-cells so that they can better detect the cancer – the cancer’s “disguise” works by exploiting certain aspects of the T-cell’s design, and those potential exploits are removed by the immunotherapy. And secondly, immunotherapy boosts the production of T-cells, allowing for a more powerful response to deal with the tumour.
Why does immunotherapy hold such promise as a cure for cancer? One key feature is its ability to deal with the second problem with finding a cure: tumours mutate too quickly, so a single cure may not always work for the same patient, meaning it’s hard to permanently get rid of a cancer. But developments in immunotherapy have shown that it’s possible to target the same tumour, however much it mutates: certain genes remain constant in the tumour after any number of mutations, allowing the T-cells to always target cells with that particular gene. While we have yet to see whether the technique does successfully eliminate cancer entirely, without the tumour gaining resistance, in principle it should be possible.
Immunotherapy seems to have found a solution to one half of the obstacles to curing cancer. The first obstacle remains in place – we haven’t yet found a single cure for such a diverse range of diseases. But the lesson of immunotherapy gives us reason to feel optimistic – we may finally be within sight of a real cure for cancer.