A Multifaceted Battle Against Cancer

Cancer is the second leading cause of death in the United States [1]. As of early 2014, there were approximately 14.5 million Americans living with a history of cancer. There are also 1.6 million new cases of cancer estimated to arise in 2015 [2]. While cancer is often generalized by the definition of abnormal cell growth and invasion, it is, in fact, a group of highly heterogeneous diseases. We commonly categorize cancer by the affected organ, such as the breast, lung, and prostate. At the molecular level, these cancers can be even further divided into sub-groups based on protein expression profile, which is critical for clinical diagnosis, treatment decision, and prognosis prediction. Different types of cancer vary significantly from each other in aspects such as epidemiology, pathogenic mechanism, clinical manifestation, and management. The result is an overwhelmingly complex group of diseases that have taken a huge toll on our society. Because of this, cancer has been a constant focus for disease research and therapeutic development for decades. More recently, there has also been an explosion of cancer research that focuses on areas such as cancer prevention, early detection, and clinical management. Nevertheless, we are still facing many hurdles in the fight against this group of devastating diseases. In this issue of the Yale Journal of Biology and Medicine, we selected several articles that focus on a wide range of interesting topics related to cancer. Jansen et al. review different risk factors and prevention strategies for pancreatic cancer (PC†). Because PC has a high mortality rate, personal risk assessment and prevention are critical strategies for combating the disease. The authors discuss potential risk factors for PC, such as smoking and obesity, and emphasize that a healthy lifestyle can reduce a person’s risk of developing the disease. In addition, Jansen et al. assess three genome-wide association studies that identified sets of single nucleotide polymorphisms (SNPs) associated with PC. Also within the topic of cancer prevention, DiMaio focuses on cervical cancer, one of the leading causes of death among women. Since the majority of the cervical cancer cases are caused by human papillomavirus (HPV) infection, the author discusses how HPV vaccines have the potential to prevent almost all future cases of the disease. Furthermore, we present an article by Tiwari and Bhargava, who provide a detailed review of the Fourier transform infrared (FTIR) spectroscopic imaging technique. Before a treatment plan is put in place for a cancer patient, biopsies are generally performed to evaluate the type and severity of the disease. FTIR is one of the emerging methods to analyze cells from a biopsy. FTIR requires very minimal sample preparation, does not require contrast agents, and is amenable to computational analysis, unlike conventional staining methods. The authors introduce the potential of using FTIR in digital diagnosis to assist pathologists in increasing accuracy of diagnosis. They also discuss practical considerations that ahould be made when implementing a modified FTIR protocol. New types of cancer therapies are constantly being investigated and implemented. One actively developing cancer therapy exploits synthetic lethality. Cancerous cells often contain specific mutations resulting in activated proto-oncogenes and/or inactivated tumor suppressors. These mutations create new synthetic lethal partners that are not present in normal cells. Thompson et al. provide a thorough review on studies that identify synthetic lethal partners for common cancerous mutations using chemical, siRNA, shRNA, and CRISPR library screens, as well as the DAISY approach. In a clinical review focusing on brain metastases by Colaco et al., the authors begin by introducing a medical case of a female non-small cell lung cancer patient who eventually developed brain metastases. The article follows the clinical progression of her disease and provides