A Metabolic View of Cancer

Theories about cancer have been changing in recent years. The conventional collective wisdom points to the “somatic mutation theory,” suggesting that cancer results from DNA damage. A series of mutations leads to oncogenes, which is genetic material that is capable of inducing cancer. Then the cancer follows a typical path to development. This theory has been accepted in established circles for many years.

In 2006, the U.S. launched The Cancer Genome Atlas (TCGA) as part of the sixteen-nation International Cancer Genome Consortium. The objective was to map out all the genes in thousands of cancer cells to pinpoint which mutations were associated with cancers. Then the endeavor was to develop therapies that targeted specific mutations.

While there was considerable excitement at first, years later the results are creating confusion. As summarized in 2015 in the journal Nature, “most mutations formed a bewildering hodgepodge of genetic oddities, with little commonality between tumours.” The reporter further observed, “cancers are often quick to become resistant, typically by activating different genes to bypass whatever cellular process is blocked by the treatment.”

In other words, the group found no consistent mutations that connected to various types of cancers. And when specific targets were identified and therapies developed to block them, the cancer cells bypassed the process. The result has been multiple failures of very costly biologic and targeted therapies.

Thus, the genome project has added skepticism over the conventional somatic mutation theory. Some researchers have concluded that cancer is too complex to understand. Others are working on developing other theories of cancer leading to effective therapeutic alternatives.