In its December 20, 2013 issue, the journal Science identified cancer immunotherapy as the science breakthrough of the year. An editorial by the journal’s Editor-in-Chief Marcia McNutt explains the basis for the selection.
She notes that the war on cancer started 40 years ago and has had great success in treating some cancers, while others remain difficult to effectively combat. She also explains that as the baby boomer generation ages, cancer incidence, morbidity, and mortality will almost assuredly increase – hence the need for new tools.
The war on cancer has been fought primarily with three tools – chemotherapy, surgery, and radiation. Each comes at a cost to the human organism and the health care system, and most effective interventions for aggressive cancers almost always include at least two of these strategies. While most interventions slow the progression and spread of the disease, cancer is a stubborn disease with a tendency to manifest in new places and ways. Current therapies often drive tumors or blood cancers into remission, but far too many find a way to come back, and often more aggressively than before. Scientists wonder why, and recognize than new therapeutic interventions will arise as answers emerge to this key question.
“Cancer immunotherapy aims to harness the body’s own immune system to fight cancer,” according to Marcia McNutt. In a news story on the selection, Science states that “Immunotherapy marks an entirely different way of treating cancer –by targeting the immune system, not the tumor itself.” The basic idea is to disrupt protein receptors on T cells that launch focused attacks on the immune system. When a person’s immune response is depressed, the door is opened for opportunistic cell proliferation, which can lead to the early stages of cancer or promote the growth of any existing cancerous cell masses.
At its core, cancer immunotherapy is a preventive intervention that strives to harness the body’s natural defense mechanisms. It is fundamentally different than today’s three big guns of cancer treatment. It is easy to imagine in the future complex combinations of cancer immunotherapy and surgery, radiation, and chemotherapy.
In the 1970s, cancer treatment and agriculture began decades of rapid change grounded in the belief that incrementally more aggressive treatments could spare people, crop fields, and livestock from serious pest or health threats. In the world of oncology, progress in the war on cancer was achieved despite multiple social, demographic, and life-style factors that opened the door for the disease, or set the stage for rapid promotion of tumor growth. Successes in treating certain cancers reinforced the notion that all cancers might someday be prevented or managed using basically the same approach.
On the farm and across the agricultural sciences, the same dynamic unfolded over the last half-century, as a series of remarkable technological innovations made it possible for conventional farmers to combat pests and animal diseases in wholly new ways, mostly through inputs brought onto the farm, and made possible through the wonders of chemistry. Despite steady increases in pest and animal disease pressure as a result of the intensification of farming systems coupled with loss of biodiversity on the farm, agricultural scientists and private industry teamed up to discover and commercialize a steady stream of treatment-oriented interventions that worked very well much of the time, and well enough most of the rest of the time.
But just as the case with human cancer treatment options, evidence is mounting that some pest and disease-related threats to crop and livestock production are not responding as well as they once did to now-routine, treatment oriented interventions. Plus, the collateral damage of the interventions needed on the farm are taking a rising toll, just as the combination of the big guns in the war on cancer are taking a bigger toll on patients fighting for their lives in the face of aggressive cancer.
It is encouraging that cancer immunotherapy has triggered such great interest and new hope in the search for better ways to combat certain cancers. Likewise, it is encouraging that there is growing recognition that a healthy life style, including sound nutritional choices over many years, is the best way to tip the odds in favor of healthy aging and cancer prevention.
Perhaps one day Science will select as the breakthrough of the year a new farming system innovation that prevents a serious threat to food security or food safety through management of natural biological processes and ecological interactions. If and when that happens, the roots of such a breakthrough will likely be traced back to attempts by organic farmers to avoid or prevent a problem by unleashing or augmenting natural cycles and interactions that are inherently preventive in nature.