January 7th, 2011
11:29 AM ET
Dr. Siddhartha Mukherjee, oncologist and cancer researcher at Columbia University Medical Center in New York, and author of the New York Times best-selling book, "The Emperor of All Maladies: A Biography of Cancer," recently sat down with CNN and answered questions from iReporters about cancer. See the iReports and his responses, below.
"Every year, I ride, along with over 7,000 cyclists, in the Philadelphia American Cancer Society Bikeathon. We typically raise over $1,000,000 for the American Cancer Society. My question is: What does the American Cancer Society do with the money?"
Mukherjee: I am not the spokesperson for the American Cancer Society, so I cannot tell you exactly how they allocate the money. But I do know that much of this money will be used to perform important research on cancer biology, prevention and treatment. In fact, I know several promising young scientists whose work is being funded by the society, and I think this is a truly promising sign of using money wisely.
Michelle Yamada wrote: "My father died of lung cancer. I watched my father deteriorate every day through chemo, then laser therapy. He said chemo did the most damage to his body. We are so intelligent, why haven't we come up with [better methods of] spread prevention in cancer? [Also,] What is the battle against cancer looking like in the future in treating stage 4 -5 cancers?"
Mukherjee: The capacity of cancers to spread – called “metastasis” – is still one of the most poorly understood processes in biological terms. In fact, this is one of the most active areas of research in cancer biology. Amazingly, each cancer appears to spread to only distinct organs – for instance, lung cancer tends to spread to the bone, to the adrenal glands and to the liver and brain, but not commonly elsewhere. This idea is called the “seed and soil” theory – that cancers need particular “soils” to grow. We are just beginning to find out what constitutes this “soil” for particular cancers, and this will help us understand and treat metastasis. Indeed, some drugs that modify the “soil” are just emerging, and this will revolutionize the treatment of metastatic cancers.
Marilynn Shcolnik from Seattle, Washington asked: "What do you feel are the most successful treatments for cancer pain? Both pain from the cancer and pain from the treatment?"
Mukherjee: Pain from cancer is treated using a variety of different methods – from medicines, counseling, holistic therapies to meditation. Just as there is no archetypal cancer patient, there is no archetypal treatment for pain. But all these methods work in different populations of patients. Opiates, such as morphine, are effective in certain cases. In other cases, a psychiatric drug can help, such as an antidepressant. In other cases, more holistic approaches are helpful. Usually, the best place to begin is with the question: What is the cause of the pain? Or where, exactly, does it hurt? Is the pain psychic? Is it emotional?
Lorena Isla from Mexico City, Mexico wrote: "My grandmother died of colon cancer. What are the chances for my family to have colon cancer too? Also, may I know if cancer can develop from being sad or depressed? Can emotional issues develop into cancer?"
Mukherjee: Some forms of colon cancer are inherited, while others do not have a known inheritance pattern, and may occur in patients without any family history. I would talk to your doctor about your family history and see whether you should see a genetic counselor.
Tamara Doane of Chilhowie, Virginia wrote: "My husband was diagnosed with colon cancer in January 2010. He had no signs or symptoms, just went for a routine colonoscopy. The doctor found a tumor and surgery was done that same day. The tumor came back as stage 3 and he had 10 chemo treatments. He became allergic to the chemo treatments and they were stopped. He had a C T scan in Nov. of 2010 and was normal. He had a colonoscopy in Dec. of 2010 and 7 polyps were removed and the doctor said they were not cancerous. My question: [Are] there certain foods he can eat to prevent colon cancer and polyps from occurring?"
Mukherjee: Diets high in red meat and low in fiber have been linked to colon cancer, but there are no data concerning recurrence in this setting. Thus, I would advise a diet low in red meat, and containing plenty of fiber. A nutritionist can help determine the optimal solution.
Priya Jacob of Prosper, Texas wrote: "My question to Dr. Mukherjee is whether there is any hope for potential cancer patients in treatments at the molecular level. I must admit that I have difficulty in accepting that the present cut, burn, poison method is the way to go. As with any other disease, shouldn't we be looking at cancer, at the cellular level and taking steps to prevent [it] rather than wait for it to claim more lives?"
Mukherjee: This is precisely what is being done right now. For some cancers this has been extremely successful. For chronic myelogenous leukemia, for instance, scientists found the molecular aberration, then found a drug that would target this aberration, and it is incredibly effective. A similar approach is being tried for many forms of cancer.
"What is the truth of placebo as a cure for cancer?"
Mukherjee: Placebos can have powerful effects, particular powerful psychological effects, but it’s unlikely that a placebo can directly affect a cancer cell. That said, there are new studies, in mice, that hormones secreted by the brain, can affect cancers, and this needs to be tested in humans.
"Even though cancer has been here for more than 4,000 years and we live in a scientific and technological modern world, and though intensive research has been done on this disease, why has there not been a cure and remedy found for cancer?"
Mukherjee: That’s because there is no single “cancer” – but many diseases that are very diverse and complex. Our molecular understanding of these diseases was very crude until recently, and thus we were unable to find the most effective treatment and prevention mechanisms. Scientists now have a much deeper understanding of the diversity of cancer, and this will surely allow us to make inroads into treatment and prevention.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.