The difficult challenges of beating Cancer

A city of the undead besieged by soldiers and police, ruthlessly gunning down waves of zombies that pour out from infected streets, attempting to escape and spread the infection to other cities. This situation is akin to what occurs when your body combats cancer, an experience more gripping than any movie. How does this life-and-death struggle unfold?

1. The Initial Phase of Elimination

It all starts with a single corrupted cell that can no longer repair its genetic code. Unable to undergo self-destruction, it begins to multiply rapidly. At this stage, the situation isn't critical yet, but without intervention, it will become dangerous.

Over a few weeks, the corrupted cell continues to replicate, giving rise to dozens, hundreds, and thousands of copies. As these copies inherit the original cell's defects, they further mutate, forming various genetic lineages. Some mutations weaken the cells, some have no significant impact, while a few become more robust and better adapted for survival. Together, they form a tiny tumor, not cancerous yet, but heading in that direction.

The growing tumor requires substantial resources. If these cells don't receive enough nutrients and oxygen, they will perish, resolving the issue. Unfortunately, some corrupted cells acquire a new mutation that enables them to command the growth of new blood vessels, ensuring a steady supply. However, as the tumor continues to grow, it starts causing damage, starving and killing neighboring healthy cells, which draws attention to the problem. In a way, this tiny tumor behaves like a rogue settlement.

Imagine a group of rebels in Brooklyn declaring independence from New York and forming a new settlement called Tumor Town in the same space. The new city strives to expand, ordering construction materials recklessly, resulting in poorly planned, ugly, and dangerous buildings scattered across streets, playgrounds, and existing infrastructure. Many former residents are trapped in this mess and begin to starve.

This continues until the smell of death attracts attention. Building inspectors and police show up. In your body, the immune system is activated, with first-responder immune cells, such as Macrophages and Natural Killer Cells, invading the tumor. These "police forces" get to work, killing and consuming tumor cells, while releasing chemical signals to alert the entire immune system about the presence of cancer.

Dendritic Cells, acting as the intelligence officers of the immune system, collect samples of dead tumor cells and activate specialized "heavy weapons," the Helper and Killer T Cells, which are your deadliest cancer killers. These T Cells recognize the genetic corruptions unique to the cancer cells, making them effective assassins against the tumor.

When the T Cells arrive, the tumor has grown to hundreds of thousands of cells, but the T Cells step in and block the growth of new blood vessels, starving thousands of tumor cells and halting their expansion. The tumor collapses as hundreds of thousands of cells are massacred, and their remnants are cleaned up and consumed by Macrophages, which then signal healthy tissue regeneration. Your body has mercilessly crushed the illegal Tumor Town.

You would never know about this internal battle or how many times it has occurred in your body. However, in this case, something unexpected happens.

2. The Phase of Equilibrium

Unfortunately, natural selection intervenes and spoils your victory. While your immune system does its best to destroy the tumor, it inadvertently selects the fittest tumor cells. The tumor comprises different lineages that grow and mutate. Most of these lineages are wiped out, but a few more resilient ones survive. One cell, coming from the fittest lineage, proves to be slightly better at surviving the massacre. It decides to start the process all over again, but this time with improvements.

This tumor cell is far stronger than the thousands that were killed. It may be better at evading detection or mounting a counterattack, growing faster, or stealing resources more efficiently. The cycle begins anew as the surviving tumor cell multiplies into thousands, mutating and forming new lineages, creating another tumor composed of more robust cells. However, the immune system remains relentless and even more experienced, sending in swat teams instead of starting with police, to tear down Tumor Town and exterminate its inhabitants mercilessly.

Despite their best efforts, the immune system still doesn't get rid of all the tumor cells. One of them survives: a fitter tumor cell from an already more resilient lineage. This time, it assumes a deceptive guise, imitating a lawyer, using court documents to create a facade of legitimacy and restart Tumor Town's growth. This cycle of struggle repeats several times, with the rebels (cancer cells) learning how to evade the law (immune system) more effectively. If the immune system eliminates all tumor cells at any point, the story ends. However, this is not the case here.

Finally, a tumor cell undergoes a change that makes it genuinely dangerous – it becomes cancerous. This type of cancer is deadly and lethal. How does it happen? Immune cells possess an "off switch" that deactivates them before they can attack, which is a protective mechanism. However, this off switch can be exploited. The mutated tumor cell finds a way to switch off the immune system by targeting inhibitor receptors on anti-cancer cells. These inhibitor receptors prevent immune cells from attacking. This cell becomes the powerful founder of a new lineage of cancer cells, mass-producing thousands of copies that continue to mutate and form yet another Tumor Town.

3. The Escape Phase

The new cancer cells become immune to the immune system, and everything changes this time. Tumor Town is rebuilt, even more bizarre and difficult to understand, but the cancer city council has forged various permits. When building inspectors arrive to shut down construction, they become confused and fail to order the destruction of the sprawling buildings.

The police attempt to enter the illegal city to apprehend the builders and eliminate the inhabitants, but Tumor Town has set up its own roadblocks, preventing law enforcement from entering. Confused officers find themselves unable to act effectively. As Tumor Town expands and claims more territory, causing more civilian casualties, T Cell swat teams arrive to put an end to this travesty. However, things take a turn for the worse – new lineages of Tumor Town officials begin to forge court documents, ordering the police to shoot at the swat teams.

At this point, the cancer cells actively shut down immune defenses by sending corrupt signals. The now malignant tumor is no longer easily defeated and begins creating the Cancer Microenvironment, a challenging borderland that is hard for immune cells to traverse. All avenues of attack are closed, and uncontrollable growth ensues. This becomes a dangerous tumor, with strong cells pushing the immune system back and expanding further. If additional mutations occur, some of the cancer cells may explore the body and spread to other tissues, establishing new Tumor Towns.

This is precisely what makes cancer so harmful – it occupies space and consumes so many nutrients that your body's normal functions are hindered. If this continues for too long, organs will eventually fail. However, this tactic is a dead end. The more successful the cancer becomes, the more it damages its own world. When the body dies, the cancer dies with it. It truly is a game without winners.

Yet, humanity is determined to win this game. Hundreds of thousands of scientists are currently working on new and improved methods to combat cancer, aiming to destroy and eradicate Tumor Towns once and for all. Immunotherapy, a recent therapy where one's immune cells are modified to combat cancer more effectively than any medicine,