This year's SENS rejuvenation research crowdfunding event puts the spotlight on the SENS Research Foundation's cancer program. So far more than 300 people have donated, and more than $26,000 has been raised; with ten days left to go, it won't take that much more of an effort to reach the same number of donors and the same level of support given to last year's fundraiser, and which led to the success in that research program. As for all of the SENS research initiatives in the science of aging, the SENS Research Foundation's work on cancer aims to support a big, bold goal in medicine: to build a single type of therapy that can be used to effectively treat all forms of cancer. When achieved, that will greatly increase the pace of progress towards control of cancer, the goal of finally ending cancer as a threat to health. At present the cancer research community spends much of its time and funding on approaches that are highly specific to only one or only a few of the hundred of subtypes of cancer. That is no way to win any time soon, as even with the vast funding devoted to cancer research, there are just too many forms of cancer and too few researchers. What is needed is to change the strategy, to focus on approaches to the treatment of cancer that are no more expensive to develop, but that far more patients can benefit from.

The most promising approach to a universal cancer therapy is to block telomere lengthening in cancerous tissues. Telomeres are a part of the mechanism that limits cell division in all human cells other than stem cells, repeating DNA sequences at the ends of chromosomes that shorten every time a cell divides. In order to achieve unfettered growth all cancers must bypass this limit by continually lengthening their telomeres, a goal that is achieved through mutations that allow cancer cells to use telomerase or the alternative lengthening of telomeres (ALT) processes. If both telomerase and ALT can be blocked in cancer tissue, then the cancer will wither; this is such a fundamental piece of cellular machinery that there is no expectation that cancer cells could find a way around it. Block only one of these two methods of telomere lengthening, however, and the cancer will probably switch to use the other. This has been observed in mice.

Thus it is very important that the research community deploy both telomerase and ALT blockades as a part of a prospective universal cancer therapy. Unfortunately while a number of groups are working on telomerase interdiction, and telomerase is very well studied these days, ALT is still poorly characterized, at the frontiers of what is known of cell biology. ALT doesn't occur in normal cells, and thus despite the fact that 10% of cancers make use of it, only recently have the necessary tools been developed to work towards understanding and intervention. The SENS Research Foundation is picking up the slack in this overlooked area of development, and with our support is working towards ensuring that the first universal cancer therapies can in fact target both telomerase and ALT, and therefore succeed.

The existence of cancer therapies that are both effective and cost-effective is going to become increasingly important as other rejuvenation therapies arrive in the clinic over the next few decades. Senescent cell clearance is under development in startup companies, for example, and a few other lines of research aimed at repairing the damage that causes aging are probably only a few years away from the same point. Certainly the 2020s are going to see multiple competing approaches to clearing out the damage of aging, and the first impact on age-related disease and mortality will occur in the public at large. None of these therapies are going to do much to reverse the random mutational damage in nuclear DNA that drives cancer, however, though they may well help to halt the decline of the immune system's ability to destroy cancerous cells before they become established. Fixing random DNA damage is a hard problem, and viable solutions will probably arrive very late in the progression of rejuvenation biotechnology. In the transitional world in which a lot of older people are living for longer and in better health, but with a high burden of mutational damage, it will be ever more necessary to control cancer through medicine.

Looking at the big picture, then, supporting the SENS approach to cancer makes sense: it is a great way for people like you and I to do our part to help build the sort of future that we want to live in.