Cancer research encompasses a variety of types and interdisciplinary areas of research. Scientists involved in cancer research may be trained in areas such as
chemistry,
biochemistry,
molecular biology,
physiology,
medical physics,
epidemiology, and
biomedical engineering. Research performed on a foundational level is referred to as
basic research and is intended to clarify scientific principles and mechanisms.
Translational research aims to elucidate mechanisms of cancer development and progression and transform basic scientific findings into concepts that can be applicable to the treatment and prevention of cancer.
Clinical research is devoted to the development of pharmaceuticals, surgical procedures, and medical technologies for the eventual treatment of patients.
Prevention and epidemiology Epidemiologic analysis indicates that at least 35% of all cancer deaths in the world could now be avoided by primary prevention. According to a newer
GBD systematic analysis, in 2019, ~44% of all cancer deaths — or ~4.5 million deaths or ~105 million lost
disability-adjusted life years — were
due to known clearly preventable risk factors, led by smoking,
alcohol use and
high BMI. However, one 2015 study suggested that between ~70% and ~90% of cancers are due to environmental factors and therefore potentially preventable. Furthermore, it is estimated that with further research cancer death rates could be reduced by 70% around the world even without the development of any new therapies.
Detection Prompt detection of cancer is important, since it is usually more difficult to treat in later stages. Accurate detection of cancer is also important because false positives can cause harm from unnecessary medical procedures. Some screening protocols are currently not accurate (such as
prostate-specific antigen testing). Others such as a
colonoscopy or
mammogram are unpleasant and as a result some patients may opt out. Active research is underway to address all these problems, to develop novel ways of cancer screening and to increase detection rates. For example: •
Multimodal learning AI systems are being developed to help detect many cancer types via
integrating different types of data. • Scientists work on identifying and measurability of novel
biomarkers or sets of such to detect cancer early, such as tumor-associated
mycobiomes and
bacterial microbiomes • Researchers investigate whether
ants could be used as
biosensors to detect cancer via urine
Treatment Emerging topics of cancer treatment research include: •
Anti-cancer vaccines •
Oncophage •
Sipuleucel-T (Provenge) is a prostate cancer vaccine • Inactivated tumor cells are investigated as potential bifunctional cancer vaccines • Newer forms of
chemotherapy •
Gene therapy •
Photodynamic therapy •
Radiation therapy •
Reoviridae (Reolysin drug therapy) •
Targeted therapy •
Medical microbots (including bacterial),
nanobots and
bacterial 'cyborg cells' •
Virotherapy •
Antibodies •
Photoimmunotherapy (for
brain cancer) •
Natural killer cells can induce
immunological memory. • How treatments can best be combined (in
combination therapies)
Cause and development of cancer pathways are disrupted in the development of cancer. Research into the cause of cancer involves many different disciplines including genetics, diet, environmental factors (i.e. chemical
carcinogens). In regard to investigation of causes and potential targets for therapy, the route used starts with data obtained from clinical observations, enters basic research, and, once convincing and independently confirmed results are obtained, proceeds with clinical research, involving appropriately designed trials on consenting human subjects, with the aim to test safety and efficiency of the therapeutic intervention method. An important part of basic research is characterization of the potential mechanisms of carcinogenesis, in regard to the types of genetic and epigenetic changes that are associated with cancer development. The mouse is often used as a mammalian model for manipulation of the function of genes that play a role in tumor formation, while basic aspects of tumor initiation, such as mutagenesis, are assayed on cultures of bacteria and mammalian cells.
Genes involved in cancer The goal of
oncogenomics is to identify new
oncogenes or
tumor suppressor genes that may provide new insights into cancer diagnosis, predicting clinical outcome of cancers, and new targets for cancer therapies. As the
Cancer Genome Project stated in a 2004 review article, "a central aim of cancer research has been to identify the mutated genes that are causally implicated in oncogenesis (
cancer genes)."
The Cancer Genome Atlas project is a related effort investigating the genomic changes associated with cancer, while the
COSMIC cancer database documents acquired genetic
mutations from hundreds of thousands of human cancer samples. These large scale projects, involving about 350 different types of cancer, have identified ~130,000
mutations in ~3000
genes that have been mutated in the tumors. The majority occurred in 319 genes, of which 286 were tumor suppressor genes and 33 oncogenes. Several hereditary factors can increase the chance of cancer-causing mutations, including the activation of oncogenes or the inhibition of tumor suppressor genes. The functions of various onco- and tumor suppressor genes can be disrupted at different stages of tumor progression. Mutations in such genes can be used to classify the malignancy of a tumor. In later stages, tumors can develop a resistance to cancer treatment. The identification of oncogenes and tumor suppressor genes is important to understand tumor progression and treatment success. The role of a given gene in cancer progression may vary tremendously, depending on the stage and type of cancer involved.
Cancer epigenetics == Diet and cancer ==