Abstract
Everybody is at risk for cancer yet environmental factors, life style and diet as well as genetic factors influence the individual cancer risk. Targeted or personalized cancer prevention is based on the knowledge of the molecular characteristics of the tumor to be prevented, the molecular mechanisms of action of the compounds to be used and the genetic make-up of the person who opts for prevention medicine.
Genetic factors are to a certain extent specific for cancer types or even subtypes as it has been shown for breast cancer. The growing knowledge of such genotype cancer risk associations will allow for the definition of personalized prevention strategies. Prevention in intermediate risk populations requires non-toxic, well tolerated and cheap compounds, such as Curcumin.
Its main activity is the inhibition of nuclear factor kappa B (NFkB) activation. NFkB is involved in many cancers where it acts through the generation of chronic inflammation that can be contrasted with anti-inflammatory drugs such as Curcumin. Targeted prevention of cancer also increases the possibility to conduct serious clinical experimentation with target based patient selection.
Focal points:
Bedside
Prevention might retard cancer development for years if specifically targeted. Growing knowledge of genetic determinants of cancer risk allows for the selection of individuals for targeted prevention.
Benchside
Genetic variants associated with the risk for specific cancer (sub-)types have been identified and additional research is needed in this promising field. The molecular mechanisms of cancer development and their relation with risk variants must be investigated and compounds that can interfere with these mechanisms must be identified.
Industry
A major effort in cancer prevention is needed and justified by a large potential market. The major challenge is the design of non-toxic compounds suitable for preventive treatments of healthy people who are at risk of developing cancer
Community
Active cancer prevention as opposed to early detection of cancer must become a focus of communication.
Governments
More effort in preventive cancer medicine is needed and justified by accumulating evidence for targeted prevention. Cancer prevention can add years of healthy life and can reduce cancer therapy associated costs.
