Cancer through a historical lens

Cancer. The word itself, perhaps, is one of the most feared in the English language. And the statistic presented in the description of the First-Year Seminar (FYS) that Assistant Professor of Biology Jennifer Lanni is teaching this fall is shocking: “Forty percent of us will be diagnosed with cancer at some point during our lifetime.” One of the biggest questions is: Are we getting anywhere in dealing with the disease? In the FYS “Cancer: Exploring the Enemy Within,” the professor and her students are delving into this question and others during the fall semester. We recently talked with her about the subject that touches too many lives.

First, what is the primary focus of your scholarship?

I am interested in how vertebrates grow. For instance, why do our arms grow to a certain length and then stop? I study this question using zebrafish, a tiny two-inch-long fish that shares over 60 percent of our genes. By comparing long-finned fish to normal fish, I hope to identify the genetic and biochemical signals that control size and proportion.

What led you to create this FYS?

Cancer is personal for me, as it is for almost all of us. I have family members who have survived cancer and family members who have died from it. When I was 29, I was able to donate bone marrow to a lymphoma patient who today is a healthy mother of four. Before that point, I had spent years researching chemotherapy drugs in a mouse genetics lab, which was fascinating, technical and abstract. Looking directly into the gauze-masked, IV-tubed cancer world was a more intimate encounter. This dichotomy of technical science and visceral experience is captured perfectly in Siddhartha Mukherjee’s book The Emperor of All Maladies, which we will be using as a text for the course.

What will you be exploring?

We will be learning about the history of cancer and cancer treatment. For decades, cancer was thought to be one disease, so the focus was to identify one external cause. We will learn how the search for cancer’s origin ultimately led us to our own cells, sparking a new understanding of the disease and inspiring innovative treatments. The acquisition of our cancer knowledge reflects years of work by individual scientists and physicians, and illustrates both the strengths and weaknesses of scientific research.

Tell us about the hands-on work students will be doing.

In the lab, we will study cells and DNA through microscopy, karyotyping, nucleic acid purification, and DNA sequencing. I want students to become comfortable with the physical reality of cells and DNA in the laboratory—how they look, feel and behave.

Talk about the history of the fight against cancer and its treatment.

For many years, the quest was for a single effective treatment for all cancers. The treatment of choice depended on the era: In the 1800s, surgery was common; in the early 1900s, radiation therapy took hold. Cancer treatment was transformed in the 1940s when Sidney Farber tested the first successful chemotherapy drug in children with leukemia, triggering the search for more powerful and effective chemotherapeutic drugs. All three of these treatments— surgery, radiation, chemotherapy—have been refined and improved over the decades and are still in use today. Amazingly, they were all developed without any knowledge of the molecular changes that cause cancer. In the 1970s and 1980s, we learned more about the causes of cancer at the cellular level. These breakthroughs led to novel treatments like immunotherapy, targeted therapy and hormone therapy, and have dramatically increased survival rates.

How has our understanding of cancer changed over the years?

When I began my scientific career, a handful of genes causing different cancers were laboriously being identified. Now, we have a far richer picture of the cancer landscape, and can even identify all the mutations in a patient’s tumor to indicate the most effective treatments. Cancer has gone from an impossibly complex and mysterious disease to a definable problem.

Does a choice need to be made in how much effort is placed on research versus treatment?

Funding agencies are regularly faced with these difficult questions. When a good treatment is developed, of course patients need full access to it. However, if you spend your entire budget on making and distributing this treatment, there’s not much left for research into something else that could save even more lives in the future. Who do you fund, the doctor or the scientist? Can we fund both?

What do you hope students get out of this FYS?

I hope students are fascinated by the topic. There are so many facets: the science and biology of cancer itself, the history of this disease in our country, the politics of health resources and funding, even the human drama of each individual story. I hope something we discuss or do catches the imagination of each class member, and years from now, whether they’re looking into a microscope, casting a vote, writing a novel, or waiting in a doctor’s office, they’ll have a flash of memory about this course and be glad that they took it.

Are there larger lessons to be learned for the general public?

I think one larger lesson for those diagnosed with cancer is to have hope. With each passing year, more effective cancer treatments are becoming available, due to our increased understanding of the disease. A second lesson for all of us is in regard to cancer prevention. While cancer may not always be preventable, we can and should take common-sense steps to decrease our own cancer risk—healthy eating, exercise, and not smoking. These simple habits decrease our risk for cancer as well as for many other deadly diseases. See, this is how scientists are annoying. I’d like to end on an uplifting message of hope for the future, but I also have to nag you to wear your sunscreen. Sorry.

Keith Nordstrom photo