Medical Physics and Applied Radiation Sciences Department, McMaster University, Hamilton, ON, Canada.
Breast Cancer (Dove Med Press). 2013 Dec 3;5:111-9. doi: 10.2147/BCTT.S44399. eCollection 2013.
This discussion paper seeks to provoke thoughts about cancer research in general, and why breast cancer in particular is not yet "curable". It asks the question - are we looking at the disease in the right way? Should we regard cancer as a progressive state, which is part of aging? Should we tailor treatment to "reset" the system or slow progression rather than try using toxic and aggressive therapy to kill every cancer cell (and sometimes also the patient)? The thesis is presented that we need to revisit our fundamental beliefs about the disease and then ask why we cling to beliefs that clearly are no longer valid. The paper also questions the role of ethics boards in hampering research and discusses the concept that breast cancer is an industry with vested interests involving profiteering by preventive, diagnostic, and therapeutic players. Finally, the paper suggests some ways forward based on emerging concepts in system biology and epigenetics.
这篇讨论稿旨在引发人们对癌症研究的思考,特别是为什么乳腺癌尚未“可治愈”。它提出了一个问题:我们是否以正确的方式看待这种疾病?我们是否应该将癌症视为衰老的一部分,看作一种渐进的状态?我们是否应该调整治疗方法,以“重置”系统或减缓进展,而不是试图使用有毒和激进的疗法来杀死每一个癌细胞(有时也会杀死患者)?本文提出,我们需要重新审视我们对这种疾病的基本信念,然后问一问,为什么我们固执地坚持那些显然已经不再有效的信念。本文还质疑伦理委员会在阻碍研究方面的作用,并讨论了这样一种概念,即乳腺癌是一个涉及利益相关者的行业,包括预防性、诊断性和治疗性参与者的谋利。最后,本文根据系统生物学和表观遗传学的新兴概念提出了一些前进的方向。