Surgery will be determined by genes before tumours appear

Prevention Cancer treatment of the future may involve treating patients before tumours even develop, according to Prof John …

PreventionCancer treatment of the future may involve treating patients before tumours even develop, according to Prof John Reynolds, cancer surgeon at St James's Hospital, Dublin.

"Cancer surgeons of the future will have to be involved in treating patients where their genetics has indicated they will get a cancer in the future," he says.

"We know that breast cancer gene, the colon cancer gene and the stomach cancer gene all run in families and the gene for cancer of the thyroid gland can be picked up in the first few years of life.

"In the US, children under five are having their thyroid removed because they are genetically determined to get thyroid cancer later on," he explains.

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Studies of breast cancer and ovarian cancer have found that the genetic determinant results in the patient developing cancer in 90 per cent of cases.

"The paradigm for how we manage cancer is changing all the time and the knowledge of the molecular signature [for example, gene profile\] for each patient will have to be brought to bear in the future," he says.

"As surgeons, we will have to deal with patients without cancer and there will be a need for surgeons to work with scientists who study these genes."

Prof Mark Lawler, associate professor of experimental haematology at St James's Hospital, adds, "Gene profiling is increasingly becoming an important part of our understanding of how cancer develops and becomes more aggressive within the body.

"Knowledge of the molecular profile of the patient will help to identify new therapeutic targets for which we can tailor specific therapies," he says. "Increasingly, it will become possible to use this information to treat cancer at an earlier stage. This will be the goal of scientists and clinicians working in partnership in the future."