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Cancer Message: Have Hope
GRAND RAPIDS — Brian J. Druker, M.D., a scientific investigator with the Howard Hughes Medical Institute, brought a message of hope to Grand Rapids Wednesday: The scientific community is at a “very remarkable place” in regard to cancer research.
Van Andel Institute’s Board of Scientific Advisors honored Druker as the recipient of the 2005 Daniel Nathans Memorial Award for his groundbreaking work on Gleevec, a drug that effectively targets the gene that causes chronic myelogenous leukemia (CML). CML is a cancer of the white blood cells that afflicts some 4,600 Americans each year.
Druker chronicled the strides medical science has made in the past 100 years and the scientific breakthroughs that advanced the nation over the 21st century.
He talked about the poor quality of life in New York City at the turn of the century — massive overcrowding, poverty, lack of running water and no sewage treatment. Life expectancy was 47 years, and a child had a one in 10 chance of dying before age 6, he said.
“Infectious diseases were the leading cause of death in this country in 1900; tuberculosis, diarrhea diseases and pneumonia made up one-third of all deaths in this country,” Druker said. “If you got the diagnosis of infection in 1900, it was essentially a death sentence.”
Despite the bleak outlook, scientists of the era were “wildly optimistic” about the potential to cure diseases. Why? Because in the latter part of the 1800s a new theory called the “germ theory” emerged and scientists were beginning to identify the germs that caused infectious diseases.
“If a cause has been discovered, there is hope for a cure,” he said.
Health advances over the 20th century included the chlorination of water, the pasteurization of milk, refrigeration, vaccinations and antibiotics. Penicillin became the magic bullet for infectious disease in the 1940s, Druker said.
“These infectious diseases that they thought could never be treated were disappearing in front of their eyes. Infectious diseases became preventable, treatable, curable.”
Today cancer is the No. 2 killer in America and will likely become No. 1. Twenty-five percent of all deaths in this country are attributable to cancer, Druker said.
So why are scientists “wildly optimistic” about finding a cure for cancer? Because scientists over the last 20 to 30 years have come up with a new theory of cancer: the gene theory.
Druker used the analogy of a thermostat regulating temperature to explain the gene theory. He said the human body has a “thermostat” and every day a certain number of cells have to replaced in the body. If a body needs more cells the thermostat turns on, replaces the right number of cells and shuts off.
But if the thermostat breaks and gets stuck “on,” the temperature will start to rise and keep going and never shut off. That’s exactly what happens with a cancer, Druker said. Cells that normally are regulated begin to grow and keep growing.
“How do we fix the problem? We can bang the thermostat with a hammer — sort of like chemotherapy,” Druker said. “It works sometimes but leaves patients battered and broken. We could replace the thermostat — that would sort of be like a bone marrow transplant.
“But imagine now that you could take that thermostat apart piece by piece, figure out what part was broken and just replace the broken part. We have to start with the basic understanding of what part is broken and then we can come up with a treatment.”
Druker said that’s exactly what his team did with chronic myelogenous leukemia. Decades of research had identified the “broken part” that drove the growth of leukemia. The team identified a drug (Gleevec) that specifically shut down what was causing the growth of the cancer cells.
Gleevec doesn’t work for every cancer because there are hundreds of parts that can break, he said, and one replacement part isn’t going to fix every broken thermostat. But there are many, many examples of these new types of targeted therapy.
“Clearly what we need to do is we need to have significantly more basic research, much like what’s going on in the Van Andel Institute, to identify the causes and identify the right target.”
Druker is convinced that curing cancer will become commonplace someday. He said seeing his CML patients restored to health during the Gleevec clinical trials made him realize that the greatest gift he had to give his patients was the gift of hope for their future.
“If you understand the cause, there is hope for an effective treatment,” he said.