Word: cancers
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Dates: during 1990-1999
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This welcome boom in cancer drugs owes its beginnings to one of this century's greatest scientific insights: that cancer is caused not by depression or miasmas or sexual repression, as people at various times have believed, but by faulty genes. Every tumor begins with just one errant cell that has been unlucky enough to suffer at least two, but sometimes several, genetic mutations. Those mutations prod the cell into replicating wildly, allowing it to escape the control that genes normally maintain over the growth of new tissue...
This realization has transformed cancer, in little more than a decade, from an utterly mysterious disease into a disorder whose molecular machinery is largely understood. Now cancer biologists are in the midst of their second epiphany: the recognition that tumors evolve, in Darwinian fashion, as each succeeding generation of cancer cells accumulates genetic mutations. "Survival of the fittest applies to cancer cells," says Richard Schilsky, associate dean for clinical research at the University of Chicago. "We now think of cancer not as a disease but as a genetic process...
...killing large numbers of people. "We are going to see a real shift from diagnosis and treatment to prediction and prevention," declares California surgeon Susan Love, author of Dr. Susan Love's Breast Book. Indeed, if all goes well with current clinical trials, women at high risk for breast cancer will soon be able to be screened with a device that removes a sample of breast cells through the nipple. If any cells show signs of the early mutations that lead to cancer, doctors can suggest the drug tamoxifen, which is believed to reduce the risk of breast cancer...
Within five years, early detection will be available for many other types of cancer as well. A stool sample will be all that is needed to search for colon-cancer cells on their way to becoming tumors, and drugs like the new COX-2 inhibitors, which are improved versions of pain killers, can prevent those precancerous cells from progressing. By the end of the next decade, a simple blood test could alert doctors to a wide variety of cancer precursors...
That's because a tumor is made up of a hodgepodge of cells containing different genetic mutations, each of which allows it to wreak a different brand of havoc. Some mutations spur rapid growth; others prod nearby blood vessels into sprouting new capillaries; still others send cancer cells out into the bloodstream, where they can seed new tumors. Within 10 years, predicts Robert Weinberg, a cancer biologist at the Whitehead Institute in Cambridge, Mass., "we will analyze the mutant genes and then tailor-make a treatment [for] that particular tumor...