Will there ever be one cure for cancer?

TL;DR – probably not.

Cancer is a disease which will have an impact on most people throughout their lifetimes, and there are few things that can bring people to agreement more than wanting a cure for this disease. But despite countless years of financial investments and researchers who dedicate their careers to cancer, we still don’t have a “cure”, and it can be difficult for non-scientists to fathom why.

One key concept to understand here is that cancer is not a single disease, does not have a single cause, and therefore cannot have a single cure. The differences between neuroblastoma and breast cancer are vast. And similarly, between patients with the same cancer type (e.g. two patients with breast cancer), the differences can be equally as big. Let’s for a minute, take an analogy of a large business company. (Disclaimer, I have never studied business in my life, so please humour me). The company is run by a CEO and board of directors and has many different departments with managers and teams of workers with specific roles. Suddenly, business is declining, and the company is not sure why. For one business, maybe this is down to someone in the Communications team spreading misinformation. For another, maybe a mistake has been made in the Finance team, which has had a knock-on effect on the other departments. Maybe Human Resources have not been properly reprimanding staff who have broken protocol. With hundreds of staff working in the company, it can be hard to pinpoint exactly where the problem has arisen, which has negatively impacted the company as a whole.

Standard business hierarchy, created with BioRender.com

Human cells aren’t so different to a company. They have a central “nucleus” tasked with controlling the functioning of the cell as a whole (Board of Directors/Management). They have proteins which relay messages inside the cell, as well as outside with other surrounding cells (Communications). They have proteins which are responsible for detecting when something goes wrong, to correct or destroy whatever is acting out of place (Human Resources). Issues within any of the “departments” in a human cell can potentially lead to cancer, and just like our business model, it can be hard to trace where the problem arose, and it is often different between two cancers.

Cell signalling networks, or the “business departments” within a cell, from Reactome.org

For decades cancer was treated with chemotherapy, famous for attacking the good healthy cells as well as the bad. The research focus has now shifted towards more targeted therapies. An example of this is Herceptin therapy for breast cancer. This therapy targets a specific protein called HER2. HER2 is a team within the Communications department in breast cells. It receives communications from outside the cell, which tells the cell it’s time to grow, and relays this message to the Nucleus, which instructs proteins involved in cell growth to start this process. However, in some breast cancers, there are too many members in the HER2 team, all relaying this message to the Nucleus, resulting in too much cell growth. Herceptin is a drug which specifically targets HER2 and prevents it from relaying this message, effectively preventing the cancer cells from growing. While this can be very efficient at preventing tumour growth in HER2+ breast cancer, HER2 is not the culprit in all breast cancers. It is estimated that only 1 in 5 breast cancers have too many members in the HER2 team (Irish Cancer Society), and so targeting this will be inefficient in treating 4 out of 5 breast cancers. Meanwhile, cells of other cancers, such as liver or thyroid cancer, may not even have a HER2 team.

Hopefully, it is becoming clear why one “cure” will likely never be a reality. All cancers are different, all have different causes, and different employees breaking protocol. So, a one-size-fits-all approach simply can’t work. Instead, we need to focus on finding common company malpractices for each cancer, such as HER2 in breast cancer, generate a repertoire of different targeted treatment options depending on the various causes of cancer, and treat each patient as an individual investigation to determine what employee/protein is acting out of line to cause their cancer, so we can specifically reprimand them.

Written by Catherine Murphy

How I became interested in science?

I’ve just submitted my PhD thesis following 4 years of cancer research, which came after a 4-year undergrad in Biomolecular Sciences. But how did I get here? What prompts an interest in science? Or in my case specifically, in biology. When I was younger, I had bad asthma – estimated to affect 1 in 5 children in Ireland at some point (Asthma Society of Ireland). I remember spending many a morning in the asthma clinic in Tallaght Hospital when I was in primary school, entertaining myself in the play area while patiently waiting my turn to see the doctor. Admittedly, I didn’t really know what asthma was back then – I just knew that it was the reason I often got out of breath while playing sports and had to carry my clunky inhaler with me everywhere I went from school to sleepovers.

Asthma Society of Ireland Statistics

This changed in Secondary School in one of my 1st year Biology classes. We were learning about organ systems, and I vividly remember reading a small paragraph in the respiratory system section describing an asthma attack as a tightening of the muscles around the airways leading to constriction. It was by no means a detailed description, but for the first time, it made me think about what was actually going on in my body when I got out of breath. This awakened an interest in me as to how the body works. I continued to enjoy science classes throughout school and picked both Biology and Chemistry as Leaving Cert subjects. This enjoyment even led my friends to buy me some test-tube shot glasses as part of my 18th birthday present – a gift that I still have 8 years later! I was delighted to get into a Biomolecular Sciences degree after the Leaving Cert, and it was during this degree that my interests focused on cancer biology and immunology, the key research areas of my PhD, which looked at immune cell interactions in childhood cancer neuroblastoma. As this project comes to a close, I can’t help but wonder what my next scientific endeavour will be – will I stay in cancer research or unlock a new area of interest? Only time will tell!

My scientist origins 2015 – messing with St Paul’s most popular skeleton Mr. Bones in a Leaving Cert. chemistry class, the test-tube shot glasses my friends bought me for my 18th birthday, and the lab coat I bought for my undergrad degree (quite clearly not designed for short people)

When you’ve been in science for so long, it can be easy to forget how it all began, so I challenge any scientists reading this to reflect on what sparked their interest and led them to where they are today and how we can support the interests of the up-and-coming scientists of the future!

So, did I manage to keep sane?

Absolutely not.

If you read my last blog post in May, you’ll know that I made a list of my five top tips for keeping sane while thesis writing (read here). Well, today, I’m here to tell you that despite my best efforts, the “so close to the end” pressure and lunacy did eventually get me.

As I’ve said before, writing a thesis is hard. Not knowing when you’ll be done is hard. Setting deadlines to work towards, which subsequently fall through, is hard. And I actually now think it’s unreasonable to believe that there’s a 5-step formula to prevent this from taking a toll on your mental state.

I submitted my PhD thesis on the 15th of June – I won’t tell you how many months later than my original goal this is. But I submitted it nonetheless. The weeks leading up to this submission were tough as I started to feel the burn-out and longed to be done. I think the tips I shared before can help during this time, but I won’t tell you that they made my stress and desire to be finished disappear.

These feelings lifted the day before my submission, my last day of minor edits and final checks when I got up to watch the sunrise. I sat watching the sun rising over the sea and tried to embrace where I was in the present rather than thinking about where I could have been had I submitted sooner or where I’ll be in a few months when I close my PhD chapter. I started to feel some relief as I could see the light at the end of the tunnel just as clearly as I could see the sun rising. I listened to Billy Joel Vienna on the way home – “Slow down, you’re doing fine” – reinforcing all these feelings.

My “light at the end of the tunnel” – the sun rising over the sea in Dun Laoghaire

That day I wrote my thesis acknowledgements, where I thanked everyone who helped me through my PhD. I focused particularly on those who helped me in my not-so-sane moments over the thesis-writing period, my family and close colleagues/friends.

I still believe that the tips from my last post – maintaining social contacts, exercising, getting outdoors, having some fun and planning ahead – can help you navigate the thesis process. But I take back what I said about them keeping you sane. Because sometimes, the task at hand is just too big for one person to tackle without going off the rails a bit. It’s a balance between self-care, asking for help when needed, and simply riding out the waves.

For anyone who’s writing up and is feeling a lack of sanity, I hope you can find your own ways to ride out the waves, and I hope your light at the end of the tunnel becomes visible soon. I can assure you the post-submission honeymoon period is definitely something to look forward to!

Thesis submission celebrations at the Swan Bar – an RCSI tradition

Written by Catherine Murphy

A February Full of Conferences

For a short month, we really made the most of February in the Cancer Bioengineering Group. We attended not one, but two conferences both outside of Dublin, with presentations from every member of the group and more great memories made.

At the end of 2022, I was lucky enough to be sent on a 3-month research secondment to the Institute for Bioengineering of Catalonia (IBEC) in Barcelona, so I was delighted to return in February for the Transdisciplinary Approaches in Neuroblastoma Therapy symposium. I got to present my work from my secondment in “Flash-poster” style, alongside other group members Ciara, Lin & Alysia. Ellen and Ronja also did a great job presenting a more extended cut of their research, and we got to see team lead Olga give a round-up of our group’s work as a whole.

Barcelona, Spain, February 2023

Outside of the conference schedule, I was tasked with the role of Tour Guide because of my familiarity with the beautiful city of Barcelona. I led a group of 20+ researchers to a small bar in the Gothic Quarter for some well-deserved refreshments after a day of conferencing, brought my team to my favourite tapas restaurant for lunch (I still dream of the croquetas) and went on a lovely walk up Montjuic Hill to take in the views of Barcelona and reminisce on the 3 months I had spent there.

It felt as though the Ryanair flight had just touched down in Dublin when we started preparing for another conference – the Irish Association for Cancer Research (IACR) meeting, taking place in Athlone. With great memories from IACR 2022 in Cork, I prepared for the conference with great excitement – looking forward to both interesting science talks, and good craic with the gang of RCSI researchers attending the conference. I had a poster presentation for this, again focussing on the work I carried out on secondment in IBEC as well as some work at home in RCSI. I enjoyed my chats with the poster judges who gave some good insights on the work. Ellen and Lin had oral presentations at the conference so again I got to resume my role as the group Twitter mom, taking pictures and drafting tweets while the girls showcased their great research.

IACR Meeting 2023, Athlone, Ireland

Each day when the conference was drawn to a close we set our sights on having a bit of fun with the other attendees. We enjoyed a pint of Guinness and some Trad music in the oldest bar in Ireland – Sean’s bar (they had the certificate to prove this). We made friends from outside RCSI including researchers from Queens University Belfast and Sales Representatives from various lab supply companies, had a good dance in the residents’ bar of our hotel and took over the dancefloor of a small local club.  The gala dinner was lovely as always, and I’ll forever have fond memories of my lab group playing “Heads Up” to entertain ourselves in between courses. Finally, a highlight for me was being given a Highly Commended Poster Award at the dinner, such a nice acknowledgement to receive for my work and a lovely way to wrap up the last conference of my PhD.

Written by Catherine Murphy