I keep reading memes and other nonsense that if scientists are so smart why can’t we have a cancer vaccine as fast as we did for COVID-19? It’s not a serious question, it’s actually pejorative – it’s meant to imply that we’ve been looking for years for a cancer vaccine without success, yet we were able to get a COVID-19 vaccine within a few months, so obviously it was rushed.
Fortunately for us on the side of science, this is one of the silliest and most desperate myths being pushed by our favorite anti-vaxxers.
Busting cancer myths is one of my favorite activities – my non-statistical analysis of medical pseudoscience puts cancer slightly above vaccines on the stupidity of the tropes. Combining vaccine nonsense with cancer is right up my bailiwick. Let’s have some tearing apart this trope.
Was the COVID-19 vaccine rushed?
Before we get to this mythical cancer vaccine, let’s crush the trope that the COVID-19 vaccines were rushed.
Moderna, which has been researching and developing mRNA vaccines for a variety of diseases, already had the science to allow it to pivot quickly to developing a vaccine for COVID-19. BioNTech, which helped develop the Pfizer vaccine, had a similar experience in mRNA vaccines.
Moderna has seven mRNA vaccines for a variety of diseases under development for over 10 years. Many of these vaccines are in late phase 1 or phase 2, so Moderna itself has extensive experience with the mRNA vaccine that gave them an advantage in development.
However, the research on mRNA vaccine technology goes back to 1990, when scientists determined that they could use mRNA messages to induce mouse cells to produce various proteins. The mRNA vaccine technology has been developing extremely rapidly over the past 20 years. And there is a large body of preclinical data that has accumulated over the past several years, and multiple human clinical trials have been initiated.
It is simply one of the many myths about the mRNA vaccines that want you to believe that they were rapidly developed in a matter of a few months. This vaccine technology has been around for a long time.
Because of our ability to sequence the DNA of the SARS-CoV-2 virus, we were able to determine which sequences produced the S-protein and quickly get the mRNA sequence. This is what sped up the development of the vaccine, not cutting corners. The technology was there and the vaccine was almost “easy” to produce.
Although it will take time to understand the effectiveness of mRNA vaccines, the safety of these vaccines has not been circumvented by the speed of getting the mRNA vaccines to us.
The other vaccines that may soon become available in the USA, Europe, and other developed countries include ones from JNJ Janssen, AstraZeneca, and Novavax also use well-understood technology.
JNJ and AstraZeneca have developed viral vector vaccines that use an unrelated virus, that does not cause disease, to transport some of the SARS-CoV-2 genes into the body in order to stimulate an immune response. The hepatitis B vaccine employs this particular technology to prevent the cancer-causing virus.
Novavax actually isolated the S-protein and utilizes that as the antigen to induce an immune response, another typical vaccine technology.
These technologies for the new COVID-19 vaccines were anything but rushed. It was fast because we needed to save lives, but it wasn’t rushed.
What is cancer?
Simply, cancer is a group of diseases characterized by abnormal cell growth which can invade or metastasize to other tissues and organs. Although people use tumors and cancer interchangeably, not all tumors are cancers. There are benign tumors that do not metastasize and are not cancers.
Cancer usually requires numerous, possibly up to 10, independent genetic mutations in a population of cells before it can become a growing, metastatic cancer. Each mutation is selected, as in natural selection, because it provides some benefit to the cancer cell, such as causing blood vessels to supply the cells for nutrition and oxygen, or the ability to divide rapidly, whatever the feature is.
These mutations can have a lot of different causes. The environment (like smoking or UV radiation), viruses (hepatitis B and human papillomavirus are the most common), genes, and just random chance can contribute to an increased risk of cancer.
By the way, around 66% of cancers do not have any cause
There are a few things you can do to prevent cancer, such as quitting smoking, staying out of the sun, getting your hepatitis B and HPV vaccinations, not drinking alcohol, keeping a low body weight, and eating a balanced diet. But even if you are a paragon of healthy living, a random mutation in some cell in your body can lead to cancer.
Four paragraphs can hardly do justice to the mountains of published scientific research data related to cancer. PubMed list nearly 4 million (yes, million) articles on cancer. I admit to not reading all 4 million, though I have read a few hundred, especially on HPV and current cancer treatments.
Why we don’t have a cancer vaccine
We have been researching cancer causes and treatments for decades, probably as early as the late 1800s. You’d think we would certainly have a cancer vaccine by that time, but there reasons why we will probably never have one vaccine to stop all cancer.
Let’s go through the reasons one by one:
Cancer probably cannot be prevented
Many researchers accept that most genetic mutations which lead to cancer are more or less random, just bad luck. In this 2017 study, the authors analyzed data for 32 cancer types and found that approximately two-thirds of the mutations found in these cancers resulted from random or spontaneous errors in the DNA. This data came from 69 countries on six continents, in which the researchers found a statistically significant correlation between the incidence of cancer and the total number of stem cell divisions. Moreover, this correlation held up globally, irrespective of the environment encountered.
The original 2015 study, authored by Cristian Tomasetti, a biostatistician interested in cancer evolution, genomics, and stem cell dynamics, and Bert Vogelstein, who is one of the preeminent leaders in cancer research, first proposed the hypothesis that cancer was mostly “bad luck.” That article generated dozens of published comments (no, not like what you find on Facebook, but actually published by the journal Science in subsequent issues).
David Gorski, a surgical oncologist, wrote about this study back in 2015 in Science-Based Medicine. Although Dr. Gorski does criticize some parts of the paper by Tomasetti and Vogelstein, overall he does indicate that random mutations are responsible for a large majority of cancers:
Given the level of uncertainty inherent in such estimates, even if you interpret Vogelstein and Tomasetti’s conclusion that two thirds of cancers are due to “bad luck,” their estimate of the percentage of cancers that are probably not preventable is definitely in the ballpark of commonly-accepted estimates, albeit at the lower end.
Does that mean they’re on to something in concluding that stem cell replication over one’s lifetime primarily determines the “stochastic” component of cancer risk for each organ? That remains to be seen, but their preliminary finding makes sense, both from the perspective of producing a result that’s in the ballpark of what we already know based on epidemiology and being biologically plausible based on basic cancer biology.
Let’s look at it another way. The average body has around 50 trillion cells each of which contains over 3 billion DNA base pairs. That’s 150,000,000,000,000,000,000,000 base pairs in each person. Even though people believe that their cells are “perfect” in replicating themselves, that’s not true. Errors may occur in human cells anywhere from 0.0001% to as high as 1% of base pairs. That could mean billions of mutations, although most are corrected by cellular machinery, it still means millions of mutations that could lead to cancer.
Cancer is not one disease
I have no clue why this continues to be misunderstood by everyone, but it’s quite possible that internet scam artists pushing their miracle cures make it seem like all cancers are the same.
In fact, cancer is a generic word – it’s a cell or group of cells that undergo uncontrolled cellular growth and metastasize into other cells and organs. However, cancer is not one disease.
The National Cancer Institute states that there are over 100 types of cancer. Cancer Research UK states that there are over 200 types of cancer. The American Cancer Society lists over 70 types of cancer (although some are more classes of cancer rather than a single type). Wikipedia lists over 180 different cancers.
Because different cancers are not precisely defined, there is some variance over the actual number. In fact, it’s possible to argue that there are orders of magnitude more cancers because cancer in one person may have different characteristics and cellular mutations than cancer in another.
Nevertheless, each of these cancers has different etiologies (causes), pathophysiologies (development), prognosis, and treatment.
Cancer is self
Cancer is generally not a pathogenic disease (with a few exceptions). It’s mutations in one’s own cells, so it becomes almost impossible to create a vaccine that targets cancer cells but ignores one’s own cells.
Wait, we do have a cancer vaccine. Actually 2!
HPV-related cancers are caused by the human papillomavirus, which can be stopped with the HPV vaccine. Cervical, anal, vaginal, penile, oropharyngeal, and potentially a few others, are caused by this virus. And we have a safe and effective vaccine to prevent it. So, there’s one.
And some types of liver cancer are caused by hepatitis B, and, wait for it, we have a vaccine for that.
In other words, we have two very good vaccines that prevent many types of cancer, some of which are deadly.
But most cancers are not related to pathogens, like bacteria or viruses, that can be easily stopped with an effective vaccine.
Cancer is not an infectious disease, the target of most vaccines, so it’s really hard to block causal factors of cancer. We don’t have the ability to create a vaccine that destroys the hundreds of cancer-causing compounds in cigarette smoke, for example.
So that’s it, that’s why we don’t have one cancer vaccine to prevent all cancers. Vaccines can only cause the immune system to target things that shouldn’t be in the body like infectious diseases.
So we do have a couple of cancer-preventing vaccines, for HPV and hepatitis B. Maybe in the future we’ll discover that a whole bunch of cancers are caused by some pathogen, but that’s not likely, so pretending that there is one vaccine to prevent all cancers is out there but only for the incompetence of scientists is patently ridiculous.
And inferring that if we have spent all this time looking for cancer vaccines and haven’t found it must mean that the COVID-19 vaccines don’t really work is ridiculous.
Other than the HPV and hepatitis B vaccines, you might occasionally hear of other “cancer vaccines.” These are not traditional vaccines that train the immune system to recognize and destroy a pathogen.
In most cases, other than the HPV and hepatitis B vaccines, the cancer vaccines are actually therapeutic, meaning they are used to treat cancer. They are difficult to produce and sometimes are produced from the patient’s own immune system, so they can only be used on that patient.
In addition, there is one vaccine that treats one cancer in a non-specific manner. The BCG vaccine, to prevent tuberculosis, is used to treat bladder cancer. However, it mediates the immune system to attack bladder cancer cells, but it does not prevent or cure bladder cancer directly.
Again, there are two cancer prevention vaccines, but most of the others do not actually prevent cancer.
My spine tingles whenever I hear “cancer vaccine,” because journalists keep using that word, and I don’t think it means what they think it means.
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