"There may not be a cure for cancer, but there may be a strategy, a set of principles that can lead to the eradication of cancer," says Dr. Robert A Gatenby of the Moffitt Cancer Center. He is working on a novel approach to the treatment of metastatic prostate cancer that could one day prove effective for many other types of cancers as well.

Press play to discover:

• What the evolutionary dynamics of Anthropocene extinction can tell us about the potential eradication of cancer
• How mathematical models can be used to better understand cancer as a complex, nonlinear system, and predict the success of certain therapies
• How to avoid selecting for chemo-resistant cancer cells with the use of chemotherapy

Dr. Gatenby's background in physics led him to a key insight: cancer is a complex dynamic system with nonlinear interactions, and to understand such systems, mathematical models are necessary. This insight underlies his most recent work, which involves a novel approach to the treatment of metastatic prostate cancer.

Unintuitively, this approach requires that chemotherapy be used to knock down the number of cancer cells a bit, but not with the goal of wiping all of them out completely. The tumor is then allowed to grow back within certain biomarker parameters before another cycle of therapy is delivered. This is continued indefinitely, driving the cancer system into a near steady state that is oscillating. In other words, the tumor is still there, but it doesn't change significantly over the course of months or even years.

Why not just try to kill all of the cancer cells using massive doses of chemotherapy? Dr. Gatenby explains that this approach is only recommended when chemotherapy has a high likelihood of being curative, which is rarely the case when it comes to metastatic cancer. When treating metastatic cancer, the "try to kill as many cancer cells as possible" approach only leads to greater toxicity, higher costs, and lower quality of life for the patient. Perhaps even more importantly, this approach actually selects for chemo-resistant cells, allowing them to proliferate rapidly with no constraints, leading to a worsening state of metastasis.

Among many compelling topics, Dr. Gatenby explains the use of mathematical models and principles of evolutionary biology in taking this approach to the treatment of metastatic prostate cancer, extinction therapy,  induction therapy for pediatric leukemia, how and when to integrate immunotherapy in the treatment of cancer, and more.  

Available on Apple Podcasts: apple.co/2Os0myK