02 DECEMBER 2021

The Role Of Genomics In Cancer Management

Contributed by: Dr Foo Kian Fong

For decades, we have known that genetic alterations are the root cause of cancer. This is where cancer genomics comes in, transforming the way we treat cancer by beginning with these genetic differences.

Cancer is a group of diseases, caused by changes in genes or a combination of genetic alterations that alter cell behaviour, causing uncontrollable growth of malignant cells in the body.

Genetic alterations can be inherited, caused by environmental factors, or occur during natural processes such as cell division. Generally, the genes that are linked to cancer include mutated tumor suppressor genes, oncogenes and DNA repair genes.

Mutations in the BRCA1 and BRCA2 genes, for example, have been linked to a much higher risk of breast, ovarian, pancreas and prostate cancer. An understanding of these genetic alterations can thus be useful in understanding how cancers develop and are treated.

What is cancer genomics

Cancer genomics is a relatively new field of research that studies human DNA sequence and gene expression between tumour cells and normal cells.

Such research offers us a better understanding of genetic changes behind cancer, and their roles in tumour development, metastasis and resistance to drugs on a molecular level. This information can provide key underpinning strategies to find potential target mutations that influence cancer and develop new drugs for various cancers.

How cancer genomics is transforming cancer treatment

With a better understanding of cancer on the genetic level, better diagnoses and treatment strategies can be developed to treat cancer using an approach called precision medicine.

From inhibiting enzymes to blocking signaling pathways that encourage the growth of cancer cells, precision medicine aims to target specific characteristics of cancer cells or genetic mutation without exposing healthy cells and surrounding critical structures to toxic chemicals or radiation.

In addition, cancer genomics also provide a more precise diagnosis of some cancers by defining cancer types into further subtypes based on genetics. For example, breast cancer can be classified further based on genetic characteristics into distinct subgroups such as HER2 type breast cancer or triple-negative breast cancer, which vary in aggressiveness and response to different types of treatment. Patients with certain cancers may thus benefit from this more precise diagnosis as it offers a more personalised treatment strategy, guided by knowledge of the cancer’s molecular subtype.

Is cancer genomics enough?

While research on cancer genomics has led to new advances in medicine and technologies to treat cancer, it should be noted that genetic mutations do not play a central role in all cancer diagnoses.

However, their presence or absence do impact how the cancer will be diagnosed and treated.

While there is no question that these new developments brought about by cancer genomics lead to better outcomes and survival for those with certain cancers, it is not the only answer to the fight against cancer. Other new technologies such as immunotherapy, for instance, leapfrog cancer genomics altogether and treat patients by harnessing the body’s own immune system to fight against the cancer.

Furthermore, we must not forget that traditional methods of treatment such as surgery and chemotherapy remain the standard of treatment for many cancers, with reliable, long-term data to support its effectiveness in patients in the long run.

Ultimately, integrating all types and levels of information across multiple disciplines offer the best approach in determining the patient’s cancer and a personalised treatment plan that will deliver optimal outcomes and response for the patient.

POSTED IN Cancer Treatments
TAGS breast cancer, cancer latest breakthrough, cancer treatment abroad, chemotherapy, immunotherapy, pancreatic cancer, vaginal cancer, women (gynaecological) cancer
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