Q&A With Samuel Waxman
Samuel Waxman, M.D., is the Founder and Scientific Director of the Samuel Waxman Cancer Research Foundation.
What is cancer?
Each cell is programmed to carry out a specific job in the body and then die. This process is called cell differentiation. But in cancer, the genetic program in a cell goes haywire and the cell no longer obeys the rules of growth, differentiation and natural death. Cancer cells have blocked differentiation and refuse to die. Instead, they multiply and invade normal tissue.
What do we know about why cancer develops?
Cancer cells develop when the normal control of growth, differentiation (function) and survival breakdown. The breakdown can result from DNA mutations in the gene, but is more commonly due to the epigenetic or non-DNA components that regulate the gene function.
Breakdown in epigenetic components worsen with age and may explain why cancer is increasing in our aging population. Drugs are now in use to correct abnormal epigenetic components in cancer cells. These epigenetic therapies restore function (differentiation therapy) and selectively program cancer cell death (apoptosis) with minimal toxicity to normal cells.
What kind of research does the Samuel Waxman Cancer Research Foundation support?
The Foundation funds research that spans the spectrum of cancer—from children to adults; from men to women; and from those who are newly diagnosed to those with more advanced disease.
In addition to funding programs in tumor dormancy, cancer stem cells and epigenetics, the Waxman Foundation funds specific research in cancers such as brain, breast, colon, lung and pediatric cancers.
What is the scientific approach of the Foundation?
The scientific mission of the Samuel Waxman Cancer Research Foundation is to reprogram cancer cells to behave in a normal manner through differentiation therapy. We believe that by studying the biology of cancer's growth and development, the more it is likely that scientists can discover common denominators that many types of cancers share to find effective cures across various disease types.
What is differentiation therapy?
Cell differentiation defines how each individual cell behaves and carries out its function. Often after cell differentiation, there is a limited life span followed by a cell death program called apoptosis - the natural death of each cell. When a cancer cell malfunctions, it often survives past its natural death. Cell differentiation therapy involves reprogramming these cells to let them know, "It's time to die."
By understanding how the cell works and how cancer cells develop, we can then seek ways to correct the "broken switches" that are signaling cells to malfunction.
Has cell differentiation proven to be successful?
Scientists have reprogrammed cancer cells to behave normally in a rare leukemia with retinoic acid, a derivative of Vitamin A and arsenic trioxide. So far, this treatment has resulted in a 95 percent survival rate in patients with acute promyelocytic leukemia. The FDA approved drug is now used worldwide. Cell differentiation therapies are currently being tested in other cancers, including breast cancer.
How can reprogramming cancer cells improve treatment options for cancer patients?
The model of 20th century cancer care was to find the cancer and kill it, killing healthy cells along with it. Whether through surgical removal, chemotherapy or radiation, this approach has harmful side effects and, at times, fails to succeed in killing the cancer cells.
By reprogramming cancer cells, researchers have corrected abnormal cancer cell behavior and showed that treatment response to chemotherapy can be improved when followed by cell differentiation agents. A combination treatment sometimes dramatically reduces some of the toxicity of chemotherapy alone, greatly improving a patient's quality of life.