Treating, preventing cancer beyond genetics: University of Alberta researcher

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Environmental and metabolic factors — not just genetics — are growing considerations in the fight against cancer, concludes a research review by a leading expert at the University of Alberta.

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Cancer as a genetic disease, focusing on the set of genetic instructions every person is born with; it is also an environmental disease, focusing on the exposure, which includes everything a person’s body has been exposed to; and cancer is a metabolic disease, focusing on the metabolome, or all the chemical byproducts of the process of metabolism, explains David Wishart, professor in the departments of biological sciences and computing science, in a Thursday news release.

But that metabolic perspective hasn’t had much research until now, as more scientists begin to understand the metabolome’s role in cancer.

Heritable cancers account for just five to 10 per cent of all cancers, Wishart said, with the other 90 to 95 per cent initiated by factors in the exposome, which in turn trigger genetic mutations.

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“That’s an important thing to consider, because it says that cancer isn’t inevitable.”

As cancer develops and spreads in the body, it creates its own environment and introduces certain metabolites, becoming “a self-fueled disease. And that’s where cancer as a metabolic disorder becomes really important.”

Considering the genome, exposome and metabolome together when thinking about cancer shows more promise for finding treatments.

Researchers who focus only on the genetic perspective are looking to address particular mutations — but there are around 1,000 genes that can become cancerous when mutated, and it typically takes two different mutations within these cells for cancer to grow, notes Wishart, meaning there are a million potential mutation pairs. Then it can become “hopeless” to narrow down possibilities when seeking new treatments.

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But considering cancer from the metabolic perspective, there are just four major metabolic types, said Wishart, so determining the patient’s cancer type can immediately guide doctors on the best treatment for their specific cancer.

“It really doesn’t make a difference where the cancer is — it’s something you’ve got to get rid of. It’s how it thrives or grows that matters,” said Wishart. “It becomes a question of, ‘What’s the fuel that powers this engine?’”

Wishart cautions that health-care providers still need a mix of therapeutics for cancer, and a deeper understanding of the metabolome and its role in the cancer feedback loop is also critical to preventing cancer.

“If we understand the causes of cancer, then we can start highlighting the known causes, the lifestyle issues that introduce or increase our risk,” he said.

“From the prevention side, changing our metabolism through lifestyle adjustments will make a huge difference in the incidence of cancer.”

The research review was funded by Genome Canadathe Canadian Institutes of Health Research and the Canada Foundation for Innovation.