Insights: Cancer care in Florida

Cancer Insight: Staying a Step Ahead

Gatenby and his team use mathematical tools like game theory, which predicts gains and losses in competitive scenarios, to try to figure out ways to outwit cancer. The idea, he says, it not to sit and wait and see how a tumor reacts to a particular treatment, but rather to anticipate what it will do.

One example that has worked with some cancers, Gatenby says, is combining immunotherapy and chemotherapy. In some cases, he says, a drug that boosts the patient's immune system doesn't kill all the cancer cells, but the cells that avoid the body's immune response do so by taking on properties that make them more vulnerable to chemotherapy. In the end, the cancer isn't completely eradicated, Gatenby says, but the approach produces a kind of uneasy stalemate that keeps it in check.

Why Chemo Sometimes Fails

Cancer cells in a tumor aren't all the same, and the different variations compete with for survival even as the overall tumor grows.

Traditional, massive doses of chemotherapy wipe out all the cells that are sensitive to the drugs. Others, however, adapt in some way.

While surviving cells may be weaker than those the chemo killed, they now have no competition, and can grow freely.

The cancer recurs, but now in a form that doesn't respond to drugs at all.

Tags: Cancer Care