THE key point that determines how bowel cancer will grow has been discovered by scientists in what has been labelled the “Big Bang” moment.
The new finding could lead to stronger success of treatments, they say.
Beating bowel cancer means understanding what happens in the earliest stages of the disease, say expertsCredit: Getty
Like the astronomical explosion that kickstarted the universe, has a similar “Big Bang” moment, according to new research from .
Researchers found the moment is created by cancer cells successfully hiding themselves from the immune system – a process called immune escape.
During this process, bowel cancer cells disrupt genes which allow the cancer to be detected by the immune system.
After immune escape happens, scientists observed very limited changes occurred in how the cancer presented itself to the immune system.
The new finding provides a potential way doctors could identify people with bowel cancer who are more likely to respond to immunotherapy, including vaccines for bowel cancer, which are designed to help the immune system recognise and destroy cancer cells.
Professor Trevor Graham, Director of the Centre for Evolution and Cancer at The Institute of Cancer Research, , said: “Some bowel cancers are ‘born to be bad’. How they interact with the immune system is set early on.
“Immunotherapy and bowel cancer vaccines hold enormous promise for treating the disease. Our research suggests that a bowel cancer’s relationship with the immune system doesn’t change very much as it grows.
“If we can target that relationship early on, treatment should have a stronger change of success.
“As bowel cancer treatment becomes increasingly personalised, understanding how tumours evolve and change matters even more than it did before.
“Like the explosion which set the course of the universe, bowel cancer’s Big Bang gives us the biggest clues of what its future holds and how we might change that future.”
Bowel cancer is the fourth most common cancer in the UK with around 44,100 new cases in the UK every year, roughly 120 every day.
Around 15 per cent of bowel cancers are known to respond well to immunotherapy, with the remainder less likely to respond to this type of treatment.
Several therapeutic bowel cancer vaccines are currently in clinical trials.
Designed to train the immune system to prevent bowel cancer from coming back after initial treatment, they recognise and destroy newly emerging bowel cancer cells.
Dr Catherine Elliot, Director of Research at Cancer Research UK, said to beat bowel cancer for everyone, we need to understand what happens at the very earliest stages of the disease.
She continued: “No matter how different bowel cancer tumours can look, one defining moment at the start makes a big different to how the cancer grows.
“Bowel cancer has an insidious ability to resist treatment. Immunotherapy is starting to work well for patients but it doesn’t work for everyone.
“This research helps us understand why, as well as giving us new insights to make immunotherapy work better for bowel cancer.”
Scientists analysed the organisation of immune and cancer cells in bowel cancers from 29 people as part of the study.
The paper ‘Epigenetically driven and early immune evasion is key in colorectal cancer evolution’ has been published in Nature Genetics.
The signs of bowel cancer you need to know - remember BOWEL
- B:Bleeding
There are several possible causes of bleeding from your bottom, of blood in your poo.
Bright red blood could come from swollen blood vessels, haemorrhoids or piles, in your back passage.
Dark red or black blood could come from your bowel or stomach.
Blood in your stools is one of the key signs of bowel cancer, so it’s important to mention it to your doctor so they can investigate.
2. O: Obvious change in loo habits
It’s important to tell your GP if you have noticed any changes in your bowel habits, that lasts three weeks or longer.
It’s especially important if you have also noticed signs of blood in your poo.
You might notice you need to go to the loo more often, you might have looser stools or feel like you’re not going enough or fully emptying your bowels.
Don’t be embarrassed, your GP will have heard a lot worse! Speak up and get it checked.
3. W: Weight loss
This is less common than the other symptoms, but an important one to be aware of. If you’ve lost weight and don’t really know why, it’s worth mentioning to your GP.
You may not feel like eating, feel sick, bloated and not hungry.
4. E: Extreme tiredness
Bowel cancer that causes bleeding can cause a lack of iron in the body – anaemia. If you develop anaemia you’re likely to feel tired and your skin might look pale.
5. L: Lump or pain
As with lots of other forms of cancer, a lump or pain can be a sign of bowel cancer.
It’s most likely you’ll notice a pain or lump in your stomach or back passage.
See your GP if it doesn’t go away, or if it affects how you eat or sleep
Eze Chidiebere Paul
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