Steve Hewlett, victim of cancer treatment
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One of Britain’s most intelligent and well-loved broadcasters died of cancer last week - the wonderful Steve Hewlett, at the very young age of 58. He had been diagnosed with esophageal cancer only last September. Despite the best chemotherapy that money can buy (which he personally forked out for) and treatment at Britain’s top cancer hospital, he was dead within six months.
As a journalist, he prided himself on having done his homework on the treatments he was offered. But he clearly hadn’t. He should have discovered that the chemotherapy regimes he was offered wouldn’t - indeed, couldn’t - work.
When chemotherapy became the ‘gold-standard’ treatment of choice in the 1970s, it was thought that, because cancer cells grow more rapidly than healthy cells, it made sense to poison the patient in the expectation that cancer cells would come off worse. And indeed, they do – at least initially. However, the problem is that the cancer patient needs to survive the treatment.
Because chemotherapy infusions are so toxic, they can’t be given in one hit, for fear of making the patient very ill indeed. That’s why chemo is usually given in a series of doses in 6 week sessions, with a month’s respite in between, to allow the patient time to recover. The trouble is that this treatment holiday to protect the patient turns out to be godsend to the cancer cells, which take advantage of the interlude to marshal their defences – and indeed, redouble them. [Lancet Oncol. 2000 Oct; 1():86-93].For it’s been discovered that, much as bacteria become resistant to antibiotics, cancer cells can become resistant to chemotherapy. “Resistance to therapy is not only common but expected,” admit cancer experts [Adv Exp Med Biol. 2007;608:1-22]
The mechanisms are very different, of course: whereas bacteria have the one simple “survival of the fittest” technique, cancer cells have as many as four ways of becoming resistant. [Nat Rev Cancer. Aug 2008; 8(8): 592–603]
.
The upshot is that chemotherapy regimes require the use of stronger and stronger toxins to combat the increasingly resistant cancer cells – to the increasing detriment of the patient’s own healthy cells, of course.
But the problem gets worse…. much worse.
It’s recently been discovered that progressively toxic chemotherapy can create “cancer stem cells”. Now, stem cells are very potent, as we know from the fact that they’re currently being touted as miracle ways to regenerate everything from corneas to livers.
Cancer stem cells are equally powerful. That’s good news if you’re a cancer, but very bad news if you’re someone harbouring the cancer. In fact, it’s exceptionally bad news for the cancer patient, because it’s recently been discovered that cancer stem cells are cancer’s very foundation stones: cancers can’t develop without stem cells. Worse still, cancers can’t spread without stem cells – and it’s the spread of cancer (“metastasis”) that is the real killer.
And that’s exactly what dear Steve so rapidly and tragically succumbed to.
As a journalist, he prided himself on having done his homework on the treatments he was offered. But he clearly hadn’t. He should have discovered that the chemotherapy regimes he was offered wouldn’t - indeed, couldn’t - work.
When chemotherapy became the ‘gold-standard’ treatment of choice in the 1970s, it was thought that, because cancer cells grow more rapidly than healthy cells, it made sense to poison the patient in the expectation that cancer cells would come off worse. And indeed, they do – at least initially. However, the problem is that the cancer patient needs to survive the treatment.
Because chemotherapy infusions are so toxic, they can’t be given in one hit, for fear of making the patient very ill indeed. That’s why chemo is usually given in a series of doses in 6 week sessions, with a month’s respite in between, to allow the patient time to recover. The trouble is that this treatment holiday to protect the patient turns out to be godsend to the cancer cells, which take advantage of the interlude to marshal their defences – and indeed, redouble them. [Lancet Oncol. 2000 Oct; 1():86-93].For it’s been discovered that, much as bacteria become resistant to antibiotics, cancer cells can become resistant to chemotherapy. “Resistance to therapy is not only common but expected,” admit cancer experts [Adv Exp Med Biol. 2007;608:1-22]
The mechanisms are very different, of course: whereas bacteria have the one simple “survival of the fittest” technique, cancer cells have as many as four ways of becoming resistant. [Nat Rev Cancer. Aug 2008; 8(8): 592–603]
.
The upshot is that chemotherapy regimes require the use of stronger and stronger toxins to combat the increasingly resistant cancer cells – to the increasing detriment of the patient’s own healthy cells, of course.
But the problem gets worse…. much worse.
It’s recently been discovered that progressively toxic chemotherapy can create “cancer stem cells”. Now, stem cells are very potent, as we know from the fact that they’re currently being touted as miracle ways to regenerate everything from corneas to livers.
Cancer stem cells are equally powerful. That’s good news if you’re a cancer, but very bad news if you’re someone harbouring the cancer. In fact, it’s exceptionally bad news for the cancer patient, because it’s recently been discovered that cancer stem cells are cancer’s very foundation stones: cancers can’t develop without stem cells. Worse still, cancers can’t spread without stem cells – and it’s the spread of cancer (“metastasis”) that is the real killer.
And that’s exactly what dear Steve so rapidly and tragically succumbed to.