By Kevin Meyer
Yesterdays Wall Street Journal had an intriguing article on cancer research and how it could lead to radically new treatment regimens. While the information was interesting in its own right, the concept behind the research drew a fascinating analogy.
After years focused on cancer cells, researchers have realized they need to broaden their horizons. Cells outside the tumors play a key role in the development of malignant cancers, helping them to grow and spurring them to attack, scientists are discovering.
Robert Weinberg, a leading cancer researcher, described cancer cells as, in effect, the body's gang leaders. The cancer cells need to recruit members—other cells—to their gangs before wreaking havoc on the body. To form the gangs, the cancer cells send signals through the blood, to as far away as the bone marrow.
Ok that's just to set the fundamental picture. Here's where things start to get interesting. First we have a bunch of evil cancer cells that need to grow, so they outsource core functions.
If one looks carefully at the tumor, one sees, actually, often the majority of the cells in the tumor are not cancer cells, but normal cells recruited from adjacent host tissues from the circulation that represent an aggregate—what is called the tumor stroma. It's formed from a variety of different connective tissue types, and these various other kind of cells are clearly providing critical biological support to the cancer cells.
But soon even that proselytizing isn't enough, and they need to expand outside of the local population and go global.
It's now becoming increasingly clear that tumors actually send signals to the bone marrow, urging the bone marrow to ramp up the production of cells that are then spilled into the circulation, then become available for recruitment by the tumor cells, being used by the tumor cells to construct the tumor-associated stroma.
And so it's not simply the tumors are passive recipients of these cells. The tumors actually go out and perturb the bone marrow, inducing the bone marrow to provide some of the cells that the tumors need.
Intelligent evil buggers, aren't they? Outsourcing to innocent cells, offshoring to different organs, creating long inventory-laden supply chains. It gets worse - the lemming mentality kicks in where the innocent cells begin to assume evil must be good.
So not only does the microenvironment provide various kinds of supportive signals for the cancer cells, but interestingly, it also sends out signals that encourage the cancer cells to acquire more aggressive traits that ultimately empower them to invade and metastasize.
What can be done?
So one potential cancer treatment would aim to disrupt this long-distance supply line. It offers a rational and coherent route by which one can one day imagine therapeutic intervention simply by interrupting the signaling mechanisms that travel from the primary tumor to the bone marrow—which I believe should be interruptible by relatively straightforward means.
Yes, long supply chains have serious vulnerabilities. Such as the blocking of a port, the sinking of a ship, or helping the converted cells wake up to the true overall cost.
I probably shouldn't draw too many parallels, but from this perspective those big name consultants and ivory tower academes who preach that outsourcing and offshoring are the path to cost reduction nirvana are... well... not our favorite cells. And it has taken a global financial crisis for the innocent to begin waking up to the reality of that religion.