Does cancer have “bad-face”?

Please take a look at the two photos below. Both are tumors of the human colon; one is good and one is bad. Can you tell which is bad tumor (termed as cancer)? Just like cartoon characters, the one with a businessman-look (left) is the good tumor and the another with a gang-look is the cancer. (right). Who decide diagnosis of patient’s tissue in the hospital? These kinds of decision termed as pathological diagnosis of cancer is made by medical doctors as pathologists. We belong to Department of Cancer Pathology, and educate young MDs to become pathologists, and at the same time, research to control over cancer with cutting-edge technologies is ongoing night and day in our lab.
In Japan, cancer became the leading cause of death in the 1980s and has been increasing with time. Approximately 980,000 patients are affected by cancer, and 350,000 dye of cancer in 2015. It accounts for approximately 30% of all deaths in Japan and the development of effective treatment methods is highly anticipated.

Figure 1. Which is cancer, right or left?

 

Cancer is a formidable enemy. To defeat this, it is essential to know it well. Pathology is termed originated from Greek, pathos and logic. The objective of our research is to elucidate the mechanism of the cancer. We aim to achieve a greater "understanding" of the characteristics of cancer, thereby allowing us to "control" it.

In Japan, cancer became the leading cause of death in the 1980s and has been increasing with time. Approximately 980,000 patients are affected by cancer, and 350,000 dye of cancer in 2015. It accounts for approximately 30% of all deaths in Japan and the development of effective treatment methods is highly anticipated.

Cancer is a formidable enemy. To defeat this, it is essential to know it well. Pathology is termed originated from Greek, pathos and logic. The objective of our research is to elucidate the mechanism of the cancer. We aim to achieve a greater "understanding" of the characteristics of cancer, thereby allowing us to "control" it.

Find the boss!

Cancer cells are derived form one’s body and continuous and uncontrollably grow, eventually destructing whole organs, resulting in the death of the patient. To date, wildly acting cancer cells were believed to have been derived from a single cell , and cancer was homogeneous (Figure 2-left).

Figure 2. Conventional cancer theory (left), cancer stem cell theory (left). Cancer stem cell is resistant to therapy

 

Target of chemotherapy or radiotherapy should be these wildly acting cells. It is similar to a police officer venturing into a fight and arresting gangs at the scene. However, it was recently revealed that cancer has a boss (Figure 2-right). The boss does not appear at the scene of the fight, but stays in the office, so police does not arrest. So, the boss is resistant to regular treatments. The boss increases the number of his henchmen (differentiation ability), and chooses a successor (self-renewal). This boss is termed as cancer stem cell. Recently, identifying and defeating this boss has come to be of utmost importance, with a stronger emphasis placed on research focusing on the identification of cancer stem cell markers and the development of treatment methods. 

What is the meaning of "personal cancer character"?

What do you order when you go to McDonalds with your friends? A cheese burger, Big Mac, or something else? You can choose an item from the menu. Such selection has not been conducted in cancer treatment. If you were diagnosed with lung cancer, surgery, treatment with anticancer drugs, or radiotherapy is carried out. However, treatment does not differ in terms of the characteristics of each cancer. Recently, the situation is changing. Patient A can choose drug treatment, while patient B can undergo surgery, even both are the same kinds of cancer. Differential susceptibility of cancer to drugs or radiation among patients can be predicted (Figure 3).

Figure 3. Personalized medicine: Pathologist directs tailor-made medicine for cancer treatment.

Bench to bed: pathology translates basic medical research to clinical medicine

From now on, it is anticipated that treatment methods will be selected according to the individual characteristics of each cancer, termed as personalized medicine. We are using high-spec next generation sequencer (NGS) to show personal whole genome sequences predicting drug sensitivity, in combination with immunostaining in the process of pathological diagnosis (Figure 3) Pathologist play a central role for cancer patient treatment.