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This is an exciting time for cancer research. Advances in technology have brought us closer to fully understanding what causes cancer, how it develops, how to prevent it, how best to treat it and how to improve the quality of life of people living with cancer.
Cancer research in Canada and around the world continues to move us closer to the day when most cancers will be curable and others will be managed as chronic diseases like diabetes and asthma. Today, more than 60% of Canadians diagnosed with cancer will survive at least 5 years after their diagnosis. This is a great improvement over the 1940s when the 5-year survival was about 25%. As our knowledge grows, we will make even greater progress against cancer.
Cancer research is a step-by-step process. It involves collecting and thoroughly analyzing information. This information may come from lab research and studying people with cancer. New discoveries often build on previous research studies.
Cancer research covers a wide range of activities and aspects of scientific study. The following are some of the types of cancer research that are improving our understanding of the disease.
Basic cancer research
Basic cancer research takes place in the lab. Through experiments, researchers look at how cancer cells behave and try to understand cancer at its deepest levels. In some of these experiments, cells taken from tumours of people with cancer are studied either in a test tube (or similar lab equipment) or injected into an animal such as a mouse so the animal develops cancer. Understanding the basic processes of these cells can help researchers understand how normal cells become cancerous. In other experiments new cancers may be created in animals in order to test for substances that cause cancer or to study how well a possible new treatment works and the side effects of a new treatment.
Researchers are doing a variety of basic cancer research studies to:
- understand what controls cell division and cell death
- find out how normal cells become cancer cells to try and block this process
- find out what makes cancer cells spread, or metastasize, to other parts of the body
- look for certain substances, called tumour markers, that may be found in people with certain types of cancer
- identify unique characteristics of cancer cells to help design new treatments with fewer side effects
- find out why certain cancer cells and tumours become resistant to treatment
- understand the genetic basis of different cancers to find out what might make someone more vulnerable to cancer or find the most effective treatments for a certain type of cancer
A major focus of research today is to take knowledge gained from lab research studies and use it to develop better methods to prevent, find or treat cancer. Researchers are also trying to use knowledge that doctors gain from looking after people with cancer to come up with ideas to study in the lab. Gathering information from the lab bench and taking that information to study at the bedside, and back again to the lab, is called translational research.
Cancer treatment is based on scientific evidence, which means that it has been well tested first in the lab on cells and animals before it is tested in groups of people with cancer. Clinical research is one of the most important ways we can improve how we treat and manage cancer as well as understand what raises or lowers a person’s risk of developing cancer.
A major type of clinical research is clinical trials. Clinical trials are research studies that test new ways to prevent, find or treat cancer. Canada is an international leader in conducting clinical trials. Current clinical trials are looking at:
- ways to reduce your risk of developing cancer
- better ways to find cancer at an early and more curable stage
- new anticancer drugs
- better ways of performing surgery or giving radiation therapy
- more effective ways to combine treatments
- which complementary and alternative therapies might help people with cancer
- ways to improve the lives of people with cancer
Anticancer drugs often show promising results in lab tests. But researchers have to show that these drugs are safe and work well in people before Health Canada will approve them to be given by doctors to people with cancer.
An essential feature of clinical trials is that patients must give ‘informed consent’ before enrolling in a trial. This means that they are given a detailed verbal and written explanation of the potential benefits and risks (including the possibility of unknown risks) of participating in the study. A written consent form must be signed by both the patient and the researcher.
For research in childhood cancers, the Children’s Oncology Group (COG) works with cancer researchers from around the world to understand the causes of childhood cancer and find better treatments. COG is the largest multi-centre trial group in the world and conducts clinical trials in pediatric cancer centres in Canada and elsewhere.
Database and chart review studies
Database and chart review studies look at information from people with cancer in hospital records or a database of information like a cancer registry. Cancer databases store information about particular groups of people with cancer, such as those with a certain type of cancer, so that research can be done in the future. Such studies can help to find out which people in a particular group benefit most or least from a currently available test or treatment.
Population-based research is often done using enormous databases that keep track of information about people (such as all people in a province who develop cancer over a certain period of time) to try to find the causes of cancer. Researchers compare risks of specific cancers in different populations of people with cancer according to factors such as age, sex, race or ethnicity, family history of cancer or place of birth. This helps researchers to get clues about genetic, environmental or other factors that may be important causes of a particular type of cancer. Researchers also look for changes in cancer risk over time that might give additional clues.
Population-based research also looks at the quality of cancer care and access to it in different communities across the country so that any differences can be corrected.
Behavioural research looks at how our lifestyle, including diet, physical activity, type of work and whether you smoke or drink, affects our risk of getting cancer or can affect whether a previously treated cancer recurs (comes back). This type of research also looks at what motivates us to have healthy behaviours and why we don’t always choose them. Behavioural research can help develop strategies to encourage people to adopt healthy behaviours such as not smoking, using sun protection, being physically active and not drinking excessive amounts of alcohol. For many people a healthy lifestyle will prevent cancer or improve cure rates and promote overall better health. Behavioural research may be retrospective and look at a person’s behaviour up to now or be prospective and study behaviour in a clinical trial.
Psychosocial research looks at the emotional, or psychological, and social impact that the disease has on people with cancer, their families and their caregivers and studies the most effective ways to help support these people. Psychosocial researchers also study a variety of issues related to quality of life in people with cancer, survivors and their families.
Survivorship research looks at how cancer affects people throughout their lives. For example, one area of survivorship research studies the late side effects and complications of treatment. Such research looks at the best way to treat or prevent late side effects and may also compare the long-term side effects of new treatments with past treatments. New treatments may cause different long-term problems. Improving the long-term health of survivors is now an important part of overall childhood cancer care.
Many people have a higher risk of developing certain kinds of cancer because they inherit an abnormal gene from one of their parents. Individuals suspected of having an inherited abnormal gene may have a test to look for an abnormal gene if they have a strong family history of cancer or have developed a certain type of cancer (often at a young age) or both. Looking for new cancer genes is a very active area of research. In families who have a cancer gene, individuals who have never had cancer can be tested to find out if they also carry the cancer gene. Those who haven’t inherited the cancer gene can be reassured that their risk of developing a cancer associated with the abnormal gene is no higher than a person who has an average risk. Family members who have inherited the abnormal gene can be advised to take special actions to prevent cancer or detect cancer early.
Funding cancer research in Canada
The research process is expensive. Each year, hundreds of Canadian researchers working in hospitals, research centres and academic institutions, such as universities, need funding to support their work. Their projects range from basic lab research to population health and to clinical trials that look at preventing cancer, treating cancer and improving the quality of life for people living with cancer.
The federal government is the largest funder of cancer research in Canada. The Canadian Cancer Society is the largest national charitable funder of cancer research in the country, and funds research through the Canadian Cancer Society Research Institute (CCSRI). CCSRI follows a strict review process to make sure that only excellent research receives funding.
Find out more about how the Canadian Cancer Society funds research.