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Changes in DNA can increase the risk of cancer. Such genetic changes, or mutations, in genes can lead to uncontrolled cell growth. Genetic changes that cause cancer can be inherited, arise spontaneously during our lifetime, or arise from certain environmental exposures. Most cancers are believed to occur by chance as a result of genetic changes throughout our lives. Cancer itself and genetic changes from cancer cells cannot be passed from parents to children. However, a genetic change can be inherited by a child if it is present in the parent’s germline DNA (egg or sperm cells). It is considered that up to 10% of cancers may be caused by such inherited genetic changes and may help explain why family members may be at higher risk of developing cancer. Shared environmental exposures can also increase the risk of developing cancer in families. This can include exposure to tobacco smoke, other types of pollution, or exposure to too much ultraviolet sunlight. These environmental factors can cause the DNA mutations or changes in gene activity that increase cancer risk.

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There are several things you can do to prevent cancer. Start with making healthy choices such as eating properly, reduce consumption of saturated fat and red meat, and increase consumption of fruits, vegetables, and whole grains, keep a healthy weight, exercise regularly, don’t smoke, and protect yourself from the sun. In addition, it is highly recommended to get regular screening tests for cancer.

If you have cancer, a different type of genetic tests can identify genetic changes that may be driving the growth of your cancer. This information can help your doctors decide which therapy might work best for you or if you may be able to enroll in a particular clinical trial. It will be more personalized type of treatment.

Cancer drugs can work in many ways. Most chemotherapies act by killing rapidly dividing cells with the hope that more cancer cells than normal cells are eliminated. They do this by targeting DNA itself, DNA synthesis or proteins such as tubulin that are required for cell division. Immunotherapies work by activating your immune system to destroy the cancer cells and overcome a process called cancer immune escape. Targeted therapies act on processes in cancer cells that are different than in normal cells. For example, the drug Herceptin binds to a protein that is upregulated in many breast cancer cells and selectively targets those cells. Similarly, drugs that reduce hormone levels (such as estrogen) can block the growth of cancers that require the hormones to grow. There are a growing number of targeted therapies which provide improved outcomes based upon the specific genetic and protein mutations of a cancer. These can lead to personalized treatments.

The is an excellent source of information to find out more about how cancer drugs work and the types of therapies available.

The two factors that are most widely discussed to reduce cancer risk are not smoking and moderate consumption of alcohol. In addition, adhering to the Mediterranean diet is viewed to reduce cancer incidence. Also recommended is exercising at least three times per week.

There are two recent findings that have made me optimistic about treating cancers that presently have low survival rates. The first is the use of MR-guided focused ultrasound (MRgFUS) to improve delivery of drugs across the blood-brain barrier. Recent studies have shown that using MRgFUS has allowed for efficient delivery of antibodies against cancer that has metastasized from the breast to the brain and that these antibodies are effective in reducing tumor size (as published in Science Translational Medicine 13, eabj4001 (2021)). The second is the further development of chimeric antigen receptor (CAR) T-cell therapy for treating solid tumors. CAR T-cell therapy had previously shown great promise for treating blood cancers, but recently was applied for immunotherapy of glioblastoma (brain cancer) (as published in Science Translational Medicine 14, eabn1128 (2022)).