The recent ‘no make-up selfie’ trend which has taken social media by storm has raised over £8m ($13m) for Cancer Research UK. The trend involves women taking photos of themselves bare faced, and posting them on social media, at the same time as making a £3 (5$) donation. Initially the craze began in the UK, but within days it had spread to the US. The trend was not initiated by Cancer Research UK, although the charity has widely expressed its gratitude for the donations.
As the money was so unexpected, Cancer Research UK has yet to decide how all of the funds will be used. However, we already know that 10 critical clinical trials will be funded thanks to these donations, some of which the charity was previously unable to fully fund, or couldn’t afford to fund at all.
Nine of the new clinical trials will involve testing treatments for cancer; the tenth involves collecting and analyzing tumor samples. The key to successful treatment of cancer is in its early diagnosis. Some of the cancers with the lowest survival rates such as pancreatic and lung cancer have a poor prognosis because they are typically diagnosed at a late stage in the disease. This is partly due to the late onset and non-specific nature of symptoms, as well as the location of the tumors deep within the body. By the time these cancers are diagnosed, treatment options are often limited to palliative care.
Cancer diagnostics currently rely heavily on invasive biopsies, to confirm tumor type and to determine the treatment plan. Invasive biopsies are not always a practical option due to tumor location and the frailty and age of the patient. Recent research has also shown that tumors are not genetically uniform, meaning that a small area biopsy may not give an accurate view of the tumor as a whole (1).
There are three broad research approaches to improving cancer diagnostics. Firstly, Cancer Research UK aims to improve knowledge of the biology of cancer. The charity funds research to identify biomarkers associated with early stage cancerwith the aim of developing tests to identify these tumor markers in the blood.
Secondly, researchers now know that tumors release DNA into the blood stream of the patient. Work is currently being undertaken to look at this circulating DNA with the hope of identifying signatures for each different type of cancer.
An example of the effective use of ‘liquid biopsies’ was highlighted last year in a paper published by Nature, featuring work undertaken by the Cancer Research UK Cambridge Institute and University of Cambridge (2). In the paper, the authors describe how the use of exome sequencing enabled them to analyze circulating DNA and take a snapshot of the genetic errors in patients with breast cancer. Samples taken before and after treatment were compared, allowing different treatments to be monitored. DNA is a much more reliable biomarker than protein, and researchers can now begin to understand how cancers change during treatment, and how that affects the development of drug resistance.
This research is in its very early stages, however the development of a ‘liquid biopsy’ could enable researchers to understand how a tumor is evolving and responding to treatment. Once the tumor signatures are fully understood, liquid biopsies could be used for very early diagnosis of cancers, which in turn would improve survival rates.
The last area of research involves the use of advanced imaging to give an accurate view of tumors in the body. MRI scans are extremely important in giving information on location, type and characteristics of a tumor. Advanced imaging could, for example, be used to non-invasively look at blood vessels that are feeding a tumor, to determine whether that tumor is growing or dying. This could help physicians to determine whether a particular treatment approach is effective.
Cancer research can also take unusual turns as scientists try to tackle the disease. Many of us will have read stories in the media of dogs pawing at the chests of women who are subsequently diagnosed with breast cancer. Dogs have a very sensitive sense of smell and some studies have suggested they can detect volatile organic molecules, such as those released by tumors. Current research is exploring the possibility of ‘electronic noses’ which would be able to detect certain tumor scents or signatures. This research is also in its infant stages but could one day result in an innovative diagnostic tool.
All diagnostic tests must be highly accurate, specific and safe. A huge amount of research is still to be carried out on the discussed diagnostic methods before they can be utilized in the fight against cancer.
There has been much discussion about the moral, ethics and relevance of the ‘no make-up selfie’ campaign. In the brutal world of cancer, anyone whose life has been touched by the disease will tell you that true bravery does not come from a woman bearing her face devoid of make-up. However, it seems irrelevant to argue over the tenuous link between selfies and cancer, or about whether we have missed the point of the original campaign. The truth is that ‘no make-up selfies’ have raised over £8m to help fund lifesaving research. Does it really matter how?
With thanks to Flora Malein, Press Officer, Cancer Research UK and Dr Emma Smith, Science Communications Team, Cancer Research UK
(1) Intratumor Heterogeneity and Branched Evolution Revealed by Multiregion Sequencing N Engl J Med 2012; DOI: 10.1056/NEJMoa1113205 http://www.nejm.org/doi/full/10.1056/NEJMoa1113205
(2) Cancer Research UK, Blood test tracks breast cancer http://scienceblog.cancerresearchuk.org/2013/03/13/blood-test-tracks-breast-cancer/