Fall 2000 Newsletter: Connections with Friends

Guest Columnist: Nicholas J. Vogelzang, M.D., Fred C. Buffett Professor of Medicine and Director, University of Chicago Cancer Research Center

The problem of cancer continues to pervade the consciousness of the people of the United States. The intense public concern about cancer can be attributed in part to the decline in death rates due to stroke and heart attacks in the aging population. At the same time, diseases like Alzheimer's, diabetes, and other degenerative diseases such as cancer continue to threaten the growing elderly population of the United States. Because cancer strikes the greatest fear within most Americans, the public has encouraged and generously supported cancer research since 1971 when the "war on cancer" was officially declared. Yet the Cancer Research Foundation (CRF) founded by Maurice Goldblatt has been fighting the "war on cancer" since 1944 when Maurice's brother Nathan died of the disease. Over the ensuing years the CRF has supported University of Chicago cancer researchers with over fourteen million dollars in funding.

In light of this official 30-year war on cancer (and the CRF's more than 50-year war), the most pressing question for those who have supported cancer research is: How have we, the medical community, made use of your funds and how will we use your funds during the next 30 to 50 years? Such questions are extremely important, would require volumes to answer, and probably could never be answered fully.

Yet one statistic summarizes the answer: we can confidently report that cancer-related deaths have dropped below the 50% mark for the first time. That is, over 50% of all cancer patients are cured of their disease! In contrast, the cancer cure rate in the 1940s was barely 20%! These cures are the result of innovative surgical and radiation techniques, and increasingly sophisticated chemotherapy and immunotherapeutic approaches. Improved diagnostic and molecular markers that predict prognosis have also contributed to the high cure rate. In fact, of the 150+ cancers known to man, virtually all can be cured if detected at an early enough stage. Additionally, with the continual support of countless individuals, scientists, and clinicians, the medical community has seen significant advances in therapies for cancers that are rarely detected at an early stage, such as mesothelioma. I tell my patients that we have cured about 50% of all cancers and I look forward to seeing the remaining 50% cured before I retire!

How will we accomplish this lofty goal? The big answer lies in the in the recent completion of the entire "blueprint of life", the human genome. The wealth of information provided by this exciting scientific accomplishment will enable researchers to determine the precise genetic sequence of each human cancer. Because individual cancers will differ in their specific genetic alterations, the technique of genetically "fingerprinting" or "blueprinting" cancer will become a vital tool in the development of new anticancer therapies. Fingerprinting or "blueprinting" tumors will allow investigators to identify which genes are turned "on" or "off" beyond normal levels. Results of these analyses will identify possible targets for new therapies that attack cancer cells.

The process of genetic fingerprinting, however, requires sophisticated tools and equipment. To illustrate, one DNA sequencing machine alone costs over $150,000. The human genome project used over 400 such machines running day and night. Similar expenses will be required to generate gene expression profiles for every human cancer type. Thus, the next generation of cancer research will rely on an incredible amount of resources and support from the public, government, and the medical community.

The answer does not lie, however, solely in sophisticated equipment. It will rely on dedicated, intelligent, and curious scientists, like the Young Investigators that the CRF supported in 1999 and 2000: Wei Du, Ph.D., Carl Correll, Ph.D., Guido Franzoso, M.D., Ph.D., Lalitha Iyer, Ph.D., Michael Thirman, M.D., Suzanne D. Conzen, M.D., Bruce T. Lahn, Ph.D., Jonathan P. Staley, Ph.D., Joel Shilyansky, M.D., and Wouter Hoff, Ph.D. Whether these investigators use million dollar machines or the back of a scratch pad to make discoveries is not important. What is important is that they are committed to achieving the goal of eradicating cancer in our lifetime and making cancer a thing of the past!

In conclusion, I believe that the focus of cancer research in the 21st century will be for investigators working in supportive environments such as the University of Chicago to identify the unique molecular characteristics of each type of cancer. Once the genetic and biochemical mechanisms that govern cancer development are better understood, a cure for cancer will not be far behind.

(Special thanks to Melissa Karabinis, M.S., Research and Development Director of the UCCRC for assistance with this project.)