The cancer clock: Early alarms reduce fatalities and novel cures give us time

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The true enemy in the war on cancer is not the disease – it’s time. Around the world, some of the brightest minds in science and medicine are, step-by-step, building a better understanding of the disease and the courses needed to stop it. 

Those steps are small and incremental; they must be – science works that way, especially when tackling one of nature’s most complex manifestations. Rushing into battle invites all manner of mistakes.

On the other hand, time waits for no one and, for those with cancer, this is especially true. Over the last few decades, cancer has come to be understood as a disease of unwanted genetic mutations that lead to malfunctioning cells that amass into tumours driven to overwhelm the body. 

Mutations take time and some cancers require few mutations, such as leukaemia and brain cancers, and so our children are affected by these. Others, such as colorectal cancers, require many mutations and so the longer we live, the more likely it is that these cancers will develop. 

To make matters worse, the food we eat, the air we breathe and the pressured lifestyles we live affect the chances of developing cancer even more significantly than the genes we inherited from our parents. One frightening statistic is that colorectal cancers are now found in a greater number of adults younger than 50.

Fortunately, new tools and techniques being developed at the University of Cape Town are being added to the arsenal to help the avalanche of cancer sufferers that the World Health Organisation predicts for the decades ahead. Rapid advances are possible, as is the hope of quicker, easier and more affordable diagnoses.

Molecular oncology the next frontier

For the most part, clinical research in cancer focuses on tumours and the organs and tissues on which they develop. Colloquially, we refer to a diagnosis by its organ of origin, such as breast cancer while, when reading a pathologist’s report, we will come across the tissue type naming such as carcinoma. 

Cancer can develop just about anywhere in the body and limiting the diagnosis by organ tissue or hormonal expression constrains our understanding and ability to accurately diagnose and treat the disease. This is one of the reasons why a growing area within oncology is digging deeper into the complex carbohydrate molecules of cancer cells.

Called glycans, these molecules are one of the four primary components of any cell – the others are lipids, proteins and cellular DNA. Glycans form links (conjugations) with lipids and proteins forming the glycoconjugates that regulate the myriad molecular and cellular processes necessary for life, including those that threaten it. 

And, if there is a key to unlocking our understanding of how normal cells transform into tumour cells, it’s hidden within alterations undergone by their cellular glycans.

However, although the importance of glycans is known, the exact nature and mechanisms of the processes they regulate are still largely a mystery. Glycans are complex biological molecules which do not lend themselves easily to the experimental and computational techniques that have revealed the secrets of proteins and DNA and so they have been referred to as the “dark matter” of human biology and glycobiology, the branch of science studying them, the “next frontier” of cancer research. 

New perspectives can lead to the breakthroughs we need

Have you ever been struggling with a puzzle and have someone walk into the room and place a key piece that leads to the solution? Or have you grappled with a problem and then, while doing something else entirely, a different solution dawns on you? 

These external perspectives can help to break the hypnotic hold of locking onto problems and being limited by solving them using only known approaches. In the scientific process, something similar happens when you bring multiple disciplines to bear on intractable challenges, such as cancer.

For example, combining expertise in chemistry and biology with novel computational tools is showing huge promise in finding some missing puzzle pieces, specifically of the mechanisms that explain how cancer evades our immune systems, growing silently. 

Genomic data from cancer patients can be computationally probed with novel machine-learning software, discovering patterns of glycan genes that point towards cellular glycans changes as accurate biomarkers for cancer types. The gene patterns are not only useful for diagnosis but hold clues to drug targets where the models are made for new drugs using advanced software.

Examining the structures within cancer cells at any moment gives a snapshot of disease development. But trawling through the differences between genes from normal cells and those from tumour cells can only be done with sophisticated machine-learning software and high-performance computing. In other words, we need advanced-learning algorithms to discover gene patterns that can be used as cancer markers.

This could lead to our ability to detect the disease before tumours spread uncontrollably. At the same time, if the tumours are too small to be surgically removed, discovering early cures is a necessary corollary to early diagnosis. Linking early diagnosis to treatment is the best way to stem the tide of the growing wave of sufferers and to slow down the cancer clock.

Speed must come with affordability

If cancer research has therapies as its ultimate objective, it doesn’t help if those therapies are so costly they are the preserve of the few who can afford them. People in developing countries often don’t have access to good healthcare, and are disproportionately affected by the disease, which means we need to find ways to ensure that healthcare providers across Africa are equipped with cutting-edge technologies that enable equitable and accessible care.

As things stand, investment in basic scientific research into cancer that will bring affordable solutions is close to zero in South Africa. Yet we have the wherewithal to lead the way, not just on this continent, but globally. 

In the case of computational and modelling research technology, the ability to process research data quicker to look into the multiple possible permutations in the genes that drive tumour-cell development, and to test therapeutic approaches was, until relatively recently, the realm of science fiction. 

Now our research is demonstrating that focused computational modelling and analytics built on the entire inventory of molecular knowledge from the quantum to genomics could be the key to slowing down the cancer clock giving sufferers a chance at a healthy life.

This is a chance that is surely worth investing in.

Professor Kevin Naidoo is director of the Scientific Computing Research Unit (SCRU) at the University of Cape Town and South African research chair in scientific computing. The SCRU is a multi-disciplinary unit based in the university’s chemistry department that develops the algorithms, modules and packages needed for life science modelling, specifically focusing on cancer.

The views expressed are those of the author and do not reflect the official policy or position of the Mail & Guardian.