Basis of cancer development
Cancer is based on DNA damage caused by environmental pollutants, smoking, and others. The DNA is the carrier molecule for genetic information and, thus, regulates the production of all proteins which determine cell function, cell behaviour and cell-cell interaction. Numerous DNA errors have been identified that cause a dysregulation of proteins and subsequently may cause cancer growth which is characterized by uncontrolled cell proliferation, development of a tumor that destroys surrounding tissues and creates metastasis. One estimates that more than 1,000 different errors in the DNA can cause cancer. Each error in the genetic information can affect the production and regulation of several proteins. Having this in mind it becomes clear that cancer is a very heterogeneous disease on the molecular level and that every tumor is unique concerning its molecular origins and differs like a thumbprint from patient to patient. Therefore, cancer researchers focus on understanding the molecular differences among patients as the most important first step to guide molecular therapy more effectively to individual patients.
Concept for individualizing medicine
With new technologies available and together with modern IT-capacities it has become possible to analyze patient’s tumors on their molecular level and to define differences. Molecular data, together with individual clinical data and effective computer technology should allow better understanding of the complex interaction of molecules involved in cell dysfunction for each patient. In long term, the identification of molecular patterns should allow to develop and apply new treatment therapies effective to specific patients.
A major challenge for achieving this goal is production of reliable molecular data and to combine them with patients’ individual clinical background. Cancer tissues which provide the basis for molecular analysis are highly sensitive to external factors such as drugs (which are routinely given during surgery) or the collection procedures of tissues after surgical tumor removal. Studies have shown that quantity and relation of 30% of all molecules in a tumor change when tissue is not instantly fixed but remains for 30 minutes unfixed. Within minutes tissue reacts to the loss of blood supply by surgical removal and, subsequently, the molecular data become within a short period of time highly variable and unreliable. Unfortunately, uncontrolled tissue collection is the current standard in surgery and pathology departments. In addition, documentation of comprehensive clinical information is not done in a standardized and comprehensive manner. Subsequently, a tumor tissue bank and a comprehensive database is missing that provides a solid basis for individualizing cancer therapy.
For more information we recommend the following websites:
Germany:
Deutsche Krebshilfe (German Cancer Aid Foundation)
http://www.krebshilfe.de
Deutsches Krebsforschungszentrum (German Cancer Research Center)
http://www.krebsinformationsdienst.de
USA:
National Cancer Institute
http://www.cancer.gov
Lombardi Cancer Center at Georgetown University
http://lombardi.georgetown.edu
