学术英语课后答案 unit2(6)

Listening: Lecture 8

1 We diagnose cancer with pattern recognition or identify the form of the cancerous cells without molecule test or gene sequencing, etc.

2 Cancer doctors have strived to understand cancer rather than to control it.

3 It disrupts the complex cancer system and reduces its reoccurrence.

4 If we change the environment or the system of the cancer, we can control cancer.

5 It’s collaboration that physicists, mathematicians are brought in to think about cancer.

Lecture 8 A new strategy in the war on cancer

I’m a cancer doctor, and I walked out of my office and walked by the pharmacy in the hospital

three or four years ago, and this was the cover of Fortune magazine sitting in the window of the pharmacy.

And so, as a cancer doctor, you look at this, and you get a little bit downhearted. But when

you start to read the article by Cliff, who himself is a cancer survivor, who was saved by a clinical trial where his parents drove him from New York City to upstate New York to get an experimental therapy for—at the time—Hodgkin’s disease, which saved his life, he makes remarkable points here. And the point of the article was that we have gotten reductionist in our view of biology, in our view of cancer. For the last 50 years, we have focused on treating the individual gene in understanding cancer, not in controlling cancer.

So, this is an astounding table. And this is something that sobers us in our field every day. In

that, obviously, we’ve made remarkable impacts on cardiovascular disease, but look at cancer. The death rate in cancer in over 50 years hasn’t changed. We’ve made small wins in diseases like chronic myelogenous leukemia, where we have a pill that can put 100 percent of people in remission. But in general, we haven’t made an impact at all in the war on cancer.

So, what I’m going to tell you today is a little bit of why I think that’s the case, and then go out

of my comfort zone and tell you where I think it’s going, where a new approach—that we hope to push forward in terms of treating cancer. Because this is wrong.

So, what is cancer, first of all? Well, if one has a mass or an abnormal blood value, you go to

a doctor, they stick a needle in. The way we make the diagnosis today is by pattern recognition: Does it look normal? Does it look abnormal?

So, that pathologist is just like looking at this plastic bottle. This is a normal cell. This is a

cancer cell. That is the state-of-the-art today in diagnosing cancer. There’s no molecular test, there’s no sequencing of genes that was referred to yesterday, there’s no fancy looking at the chromosomes. This is the state-of-the-art and how we do it.

You know, I know very well, as a cancer doctor, I can’t treat advanced cancer. So, as an aside,

I firmly believe in the field of trying to identify cancer early. It is the only way you can start to fight cancer, is by catching it early. We can prevent most cancers. You know, the previous talk alluded to preventing heart disease. We could do the same in cancer. I co-founded a company called Navigenics, where, if you spit into a tube—and we can look look at 35 or 40 genetic markers for disease, all of which are delayable in many of the cancers—you start to identify what you could get, and then we can start to work to prevent them. ’Cause the problem is, when you

have advanced cancer, we can’t do that much today about it, as the statistics allude to.

So, the thing about cancer is that it’s a disease of the aged. Why is it a disease of the aged?

Because evolution doesn’t care about us after we had our children. See, evolution protected us during our childbearing years and then, after age 35 or 40 or 45, it said “It doesn’t matter anymore, because they’ve had their progeny. “So if you look at cancers, it is very rare—extremely rare—to have cancer in a child, on the order of thousands of cases a year. As one gets older? Very, very common.

Why is it hard to treat? Because it’s heterogeneous, and that’s the perfect

substrate for evolution within the cancer. It starts to select out for those bad, aggressive cells, what we call clonal selection. But, if we start to understand that cancer isn’t just a

molecular defect, it’s something more, then we’ll get to new ways of treating it, as I’ll show you. So, one of the fundamental problems we have in cancer is that, right now, we describe it by a number of adjectives, symptoms: “I’m tired, I’m bloated, I have pain, etc.” You then have some anatomic descriptions, you get that CAT scan: “There’s a three centimeter mass in the liver.” You then have some body part descriptions: “It’s in the liver, in the breast, in the prostate.” And that’s about it. So, our dictionary for describing cancer is very, very poor. It’s basically symptoms. It’s manifestations of a disease.

What’s exciting is that over the last two or three years, the government has spent 400 million

dollars, and they’ve allocated another billion dollars, to we call the Cancer Genome Atlas Project. So, it is the idea of sequencing all of the genes in the cancer, and giving us a new lexicon, a new

dictionary to describe it. You know, in the mid-1850s in France, they started to describe cancer by body part. That hasn’t changed in over 150 years. It is absolutely archaic that we call cancer by

prostate, by breast, by muscle. It makes no sense, if you think about it.

So, obviously, the technology is here today, and, over the next several years, that will change.

You will no longer go to a breast cancer clinic. You will go to a HER2 amplified clinic, or an

EGFR activated clinic, and they will go to some of the pathogenic lesions that were involved in

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