Cancer is not a single disease
To understand why cancer is so hard to cure, the most important thing to know is that cancer is not one disease. Instead, it’s an umbrella term for more than 200 distinct diseases.
Each broad cancer type has many sub-types, and they all look and behave differently because they are different on a genetic and molecular level. This is because cancer arises from our own cells, so each cancer can be as different and diverse as people are.
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Myriads of mutations exist
Cancer is caused by the appearance of faults in our DNA, the genetic material in our cells which carries all the information they need to function. These faults, called mutations, cause cells to grow uncontrollably. Underlying the 200+ different cancers are a myriad of different genetic mutations. Every cancer is caused by a build-up of mutations and, as the cancer progresses, more and more different mutations accumulate.
This means that two people with the same broad type of cancer, such as bowel cancer, can carry individual sets of mutations. There are some more common types of mutation that can be tested to show if certain treatments are likely to be suitable. However, because of the variety of mutations, a drug that works for one cancer patient might have absolutely no effect for another.
That’s why we fund researchers like Dr Diego Pasini in Italy, whose research project aims to understand why a particular mutation makes some cancers more likely to develop.
Cancer cells within a single tumour are not identical
Different cancer cells in the same tumour can have different mutations. Although an original set of mutations caused the cancer to appear, over time new mutations can appear and cause the cells to change.
That means that treatments may kill all of one type of cell in a tumour, while others that are resistant survive the treatment and grow in number again. This is also how, if not spotted early, cancer spreads to other places in the body – a new mutation gives a new line of cancer cells the ability to survive in the bloodstream and move elsewhere.
Treatments can eventually stop working
The genetic mutations that cancer cells acquire over time mean that the cells change the way they behave. This can be an incredibly difficult problem during treatment because the mutations can lead to cancer cells developing resistance to a treatment over time - a patient may have success with a treatment for some time, then find that it stops working.
If that happens, the patient will then have to be put on to a different treatment – but again, the cancer could develop resistance to the new drug. There also may not be any alternative options if that treatment fails. This is why we fund researchers like Dr Maite Huarte in Spain, who is trying to figure out how to overcome this resistance in bowel cancer.
Cancer cells are really good at staying alive
Normal cells have 'safety’ mechanisms in place that stop them from growing or dividing too much, and every day our immune system kills off cells that could have become a problem. Cancer cells have lost these mechanisms and can hide from the immune system, so they survive and continue to grow out of control. Cancer cells can develop an arsenal of tricks to avoid being killed.
That’s why we fund researchers like Dr Vincenzo Giambra in Italy, who aims to understand how cancer cells become such survival experts.
Will there ever be a cure for cancer?
There won’t be one single cure for cancer because it is not a single disease and doesn’t have a single cause. However, new breakthroughs in our understanding of cancer will help us find new cures for the 200+ different types of cancer that exist. Discovery research that you support is vital to turn the best ideas today into the best future cures for all cancer types.
We aim to end the suffering caused by cancer and improve the quality of life for people affected by cancer. This will happen through discovering new ways to prevent, diagnose and treat all types of cancer.
What types of cancer can be cured?
Thanks to research, cancer survival rates in the UK have doubled since the 1970s. One in two people diagnosed with cancer can now expect to survive for 10 years or more after their diagnosis.
However, there has been more progress made in some cancers than others. Breast cancer survival rates have improved dramatically and today around 85% of people in the UK will survive 5 years after their diagnosis.
We have also made great progress at tackling cervical cancer. The incidence rate in Scotland has plummeted by nearly 15% since 1993 and researchers hope that the disease could be completely wiped out thanks to screening and the HPV vaccine.
For some cancers, there has been less progress. Despite research efforts, pancreatic cancer survival rates have remained stubbornly low - fewer than 8% of people in the UK survive for 5 years after their diagnosis. That’s why we fund researchers such as Dr Edna Cukierman in America, who is exploring how proteins found in nerve cells influence the growth of pancreatic cancer.
