On 2015 Nov 17, Miguel Lopez-Lazaro commented:

New ways to prevent cancer

This article provides an excellent assessment of the status of cancer chemoprevention research and gives useful recommendations for moving the field of cancer prevention research toward meaningful practice guidelines. However, there are very recent developments in the field that, in my opinion, will change the way we prevent cancer.

Knowing neither the cellular origin of cancer nor the main biological cause of the disease has been the most important obstacle to cancer prevention. It is actually very difficult to prevent a process without really knowing where it starts and how it develops. Recent evidence strongly suggests that cancer arises from normal stem cell, and that the main reason we have cancer is that our stem cells divide. The division of stem cells is necessary to form, maintain and repair our tissues. But when they divide, their DNA gets damaged and our risk of cancer increases. Recent data have revealed that the more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer is diagnosed even millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age (1, 2).

This fresh knowledge about the etiology of cancer opens new ways to prevent the disease. Controlling the division rates of stem cells will be a key strategy to prevent cancer, like controlling hypercholesterolemia and hypertension is a key strategy to prevent cardiovascular disease. This can be achieved by identifying and controlling environmental factors that promote the division of stem cells, and by identifying and controlling internal signals that regulate their division rates. Importantly, some of these factors and signals are already known and can be controlled (2).

Some stem cells will acquire DNA alterations no matter what we do. Stem cells have to divide, and some errors arising during cell division are unavoidable. Cancer prevention will partially protect stem cells from getting damaged and will lead to a cancer-free life in many cases. In other cases, primary prevention efforts will not stop some stem cells from becoming malignant. But prevention is still possible in these cases (secondary prevention). The accumulation of DNA alterations in stem cells can make them vulnerable to specific pharmacological and non-pharmacological interventions. An important challenge will be to find ways to selectively kill mutated stem cells before they give rise to cancer. Premalignant stem cells might be eliminated, for example, by selective restriction of specific amino acids (2).

(1) Cancer arises from stem cells: opportunities for anticancer drug discovery. Drug Discov Today. 2015 20(11):1285-7. (https://www.researchgate.net/profile/Miguel_Lopez-Lazaro)

(2) Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer. Oncoscience, 2015, 2(10), 849-856. http://www.impactjournals.com/oncoscience/files/papers/1/257/257.pdf

On 2015 Nov 17, Miguel Lopez-Lazaro commented:

New ways to prevent cancer

This article provides an excellent assessment of the status of cancer chemoprevention research and gives useful recommendations for moving the field of cancer prevention research toward meaningful practice guidelines. However, there are very recent developments in the field that, in my opinion, will change the way we prevent cancer.

Knowing neither the cellular origin of cancer nor the main biological cause of the disease has been the most important obstacle to cancer prevention. It is actually very difficult to prevent a process without really knowing where it starts and how it develops. Recent evidence strongly suggests that cancer arises from normal stem cell, and that the main reason we have cancer is that our stem cells divide. The division of stem cells is necessary to form, maintain and repair our tissues. But when they divide, their DNA gets damaged and our risk of cancer increases. Recent data have revealed that the more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer is diagnosed even millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age (1, 2).

This fresh knowledge about the etiology of cancer opens new ways to prevent the disease. Controlling the division rates of stem cells will be a key strategy to prevent cancer, like controlling hypercholesterolemia and hypertension is a key strategy to prevent cardiovascular disease. This can be achieved by identifying and controlling environmental factors that promote the division of stem cells, and by identifying and controlling internal signals that regulate their division rates. Importantly, some of these factors and signals are already known and can be controlled (2).

Some stem cells will acquire DNA alterations no matter what we do. Stem cells have to divide, and some errors arising during cell division are unavoidable. Cancer prevention will partially protect stem cells from getting damaged and will lead to a cancer-free life in many cases. In other cases, primary prevention efforts will not stop some stem cells from becoming malignant. But prevention is still possible in these cases (secondary prevention). The accumulation of DNA alterations in stem cells can make them vulnerable to specific pharmacological and non-pharmacological interventions. An important challenge will be to find ways to selectively kill mutated stem cells before they give rise to cancer. Premalignant stem cells might be eliminated, for example, by selective restriction of specific amino acids (2).

(1) Cancer arises from stem cells: opportunities for anticancer drug discovery. Drug Discov Today. 2015 20(11):1285-7. (https://www.researchgate.net/profile/Miguel_Lopez-Lazaro)

(2) Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer. Oncoscience, 2015, 2(10), 849-856. http://www.impactjournals.com/oncoscience/files/papers/1/257/257.pdf