About our Research
Most cancer related deaths are due to secondary cancer, potent cells that have penetrated into the circulatory system and established colonies in other parts of the body. A group of over 100 diseases, cancer is characterised by abnormal uncontrolled cell growth. In a healthy body, cells grow, die and are replaced in a very controlled way. However, damage or change in the genetic material of cells by environmental and internal factors can result in cells that do not die and continue to multiply until a mass of cancer cells or a tumour develops.
It is the spread of tumours to distant locations that is of greatest importance in cancer. About 90% of the deaths due to cancer involve tumours that have spread around the body. The movement of tumour cells to other parts of the body is known as metastases or secondary spread. This is a complex process during which cancer cells break off the original or primary tumour and survive passage through the circulation to form tumours at new locations. Once cancer cells enter the bloodstream they can travel to any place in the body. Metastatic cancer cells can lie dormant for days, weeks, months and even years and then become reactivated. Micro-metastatic cells can go undetected by CT imaging, MRI and PET scans.
At Cork Cancer Research Centre, we have previously reported bone marrow micro-metastases to be detectable in the rib bone marrow in up to 90% of patients who have oesophageal cancer and are referred for curative surgery. These micro-metastases occur at a frequency of between 20 and 5,000 cancer cells per 100,000 marrow cells irrespective of the histological type or of the lymph node status of the tumour. These cells are present in most patients resistant to current chemotherapy regimens and indicate a poor prognosis. We have also shown that apparent responses of micro-metastases to conventional chemotherapy may be illusory as we have, after chemotherapy, been able to grow, from the marrow, metastatic cancer cells which were not detectable initially by conventional staining. These patients eventually died of metastatic disease which suggests that after chemotherapy metastatic cells, resistant to chemotherapy, remain dispersed and are as yet undetectable by conventional methods.
Surgery, chemotherapy and radiation can only do so much when tumour cells hide in plain sight and even a single overlooked cell can seed disease. Currently there are no chemotherapeutic agents specifically designed to combat micro-metastases. However, certain immune cells (natural killer cells and natural T Cells) are the body’s own innate defense against micro-metastases. More treatment options are certainly needed. Professor Gerry O’Sullivan, Centre Director at Cork Cancer Research Centre says that “part of our mission is to find a systemic treatment that controls the spread of secondary disease”. At Cork Cancer Research Centre multiple research themes are all directed to this key component of the disease:
The Cell Death and Cell Survival Group is focused on overcoming the ability of cancer cells to resist chemotherapy and lie dormant until a future date.
The Gene Therapy Group is looking at ways to develop immune control of the disease.
The Gene and Drug Delivery Group is providing technologies to get therapeutic genes and drugs directly into the tumour site.
Cancer is still a leading cause of death. The National Cancer Registry of Ireland predicts that the number of cancer cases in Ireland will double by 2020 and one in three people will be diagnosed with cancer in their lifetime. In this battle, we do not have a second to lose.