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癌症为何难以治愈? – Kyuson Yun – 译学馆
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癌症为何难以治愈? - Kyuson Yun

Why is it so hard to cure cancer? - Kyuson Yun

癌症为何难以治愈?
Why is it so difficult to cure cancer?
我们已经利用了电力
We’ve harnessed electricity,
测序了人类基因组
sequenced the human genome,
并消灭了天花
and eradicated small pox.
但是在数十亿美元的研究之后
But after billions of dollars in research,
我们还没有找到一种能够在任何时候影响
we haven’t found a solution for a disease that affects more than 14 million people
1400多万人及其家人的疾病的解决方案
and their families at any given time.
癌症发生是由于正常细胞积累突变
Cancer arises as normal cells accumulate mutations.
大多数时间 细胞可以检测出突变和DNA损伤
Most of the time, cells can detect mutations or DNA damage
进行修复或者凋亡
and either fix them or self destruct.
然而 一些突变允许癌细胞无限增殖
However, some mutations allow cancerous cells to grow unchecked
侵入临近组织
and invade nearby tissues,
甚至转移到远处的器官
or even metastasize to distant organs.
癌症一旦转移将几乎无法治愈
Cancers become almost incurable once they metastasize.
癌症非常复杂
And cancer is incredibly complex.
它不仅仅是一种疾病
It’s not just one disease.
有多于100种不同类型
There are more than 100 different types
我们没有一种灵丹妙药来治疗所有癌症
and we don’t have a magic bullet that can cure all of them.
对于大多数癌症
For most cancers,
治疗通常包括手术切除肿瘤
treatments usually include a combination of surgery to remove tumors
结合放疗化疗杀死剩余癌细胞
and radiation and chemotherapy to kill any cancerous cells left behind.
激素疗法
Hormone therapies,
免疫疗法
immunotherapy,
和对特定类型的癌症的针对治疗
and targeted treatments tailored for a specific type of cancer
也经常使用
are sometimes used, too.
在许多情况下 这些治疗很有效
In many cases, these treatments are effective
患者就摆脱了癌症
and the patient becomes cancer-free.
但是他们远非终生百分之百有效
But they’re very far from 100% effective 100% of the time.
所以为了找到所有不同形式的癌症治疗方法我们要做什么?
So what would we have to do to find cures for all the different forms of cancer?
我们从理解一些科学家
We’re beginning to understand a few of the problems
需要解决的问题开始
scientists would have to solve.
首先 我们需要新的 更好的方法研究癌症
First of all, we need new, better ways of studying cancer.
大多数癌症治疗都是用实验室里生长的
Most cancer treatments are developed using cell lines grown in labs
从人类肿瘤中培养出的细胞株来进行的
from cultures of human tumors.
这些人工培养的细胞给我们提供关键的
These cultured cells have given us critical insights
关于癌症的遗传学和生物学信息
about cancer genetics and biology,
但是它们缺乏在实际的生物体中肿瘤的复杂性
but they lack much of the complexity of a tumor in an actual living organism.
经常发生的情况是对实验室培养的细胞起作用的新药
It’s frequently the case that new drugs, which work on these lab-grown cells,
在临床试验中对患者失效
will fail in clinical trials with real patients.
恶性肿瘤的复杂性之一
One of the complexities of aggressive tumors
是它们可以有多种不同的癌细胞
is that they can have multiple populations of slightly different cancerous cells.
随着时间的流逝 在肿瘤的不同部位中
Over time, distinct genetic mutations accumulate in cells
不同的基因突变在细胞中积累 产生独特的亚克隆
in different parts of the tumor, giving rise to unique subclones.
例如 叫成胶质细胞瘤的恶性脑肿瘤
For example, aggressive brain tumors called glioblastomas
在一名患者身体中可以产生六种不同亚克隆
can have as many as six different subclones in a single patient.
这叫做克隆的异质性
This is called clonal heterogeneity,
这使治疗变得困难因为一种药只对一种
and it makes treatment difficult because a drug that works on one subclone
亚克隆起作用可能对其他克隆没有效果
may have no effect on another.
还有另一个挑战
Here’s another challenge.
肿瘤是一个动态的相互联系的
A tumor is a dynamic interconnected ecosystem
癌细胞可以不断和彼此和邻近健康细胞
where cancer cells constantly communicate with each other
进行交流的生态系统
and with healthy cells nearby.
它们可以诱导正常细胞分化为血管为肿瘤
They can induce normal cells to form blood vessels that feed the tumor
提供营养排出代谢产物
and remove waste products.
它们还可以影响免疫系统
They can also interact with the immune system
抑制其功能
to actually suppress its function,
阻止识别和消灭癌细胞
keeping it from recognizing or destroying the cancer.
如果我们能研究出如何阻断这些信息交流通路
If we could learn how to shut down these lines of communication,
我们可以有更好的方法永久地击败肿瘤
we’d have a better shot at vanquishing a tumor permanently.
此外 越来越多的证据表明
Additionally, mounting evidence suggests
我们需要弄明白如何根除癌症干细胞
we’ll need to figure out how to eradicate cancer stem cells.
干细胞是很少的但似乎有特殊性质
These are rare but seem to have special properties
使它们对化疗和放疗有耐受性
that make them resistant to chemotherapy and radiation.
理论上 即使肿瘤的其余部分检测出在治疗中缩小
In theory, even if the rest of the tumor shrinks beyond detection during treatment,
一个剩余的癌症干细胞仍可以长出新肿瘤
a single residual cancer stem cell could seed the growth of a new tumor.
弄明白如何瞄准这些顽固细胞
Figuring out how to target these stubborn cells
可能有助于防止癌症复发
might help prevent cancers from coming back.
即使我们解决了这些问题 我们可能还会面临新的
Even if we solved those problems, we might face new ones.
癌细胞是适应的大师
Cancer cells are masters of adaptation,
调整它们的分子和细胞特性以适应压力
adjusting their molecular and cellular characteristics to survive under stress.
当它们被放疗和化疗攻击时
When they’re bombarded by radiation or chemotherapy,
一些癌细胞能有效开启保护盾
some cancer cells can effectively switch on protective shields
通过改变它们的基因表达抵抗攻击
against whatever’s attacking them by changing their gene expression.
恶性癌症是一种不断进化和适应的复杂系统
Malignant cancers are complex systems that constantly evolve and adapt.
为了打败它们 我们需要找到与它们
To defeat them, we need to find experimental systems
复杂性相配的实验体系
that match their complexity,
和可以随着癌症的变化而调整的监视和治疗方案
and monitoring and treatment options that can adjust as the cancer changes.
但是好消息是我们在进步
But the good news is we’re making progress.
即使我们不是全部了解
Even with all we don’t know,
大多数癌症的平均死亡率
the average mortality rate for most kinds of cancer
自从二十世纪七十年代显著下降并仍在下降
has dropped significantly since the 1970s and is still falling.
每天我们都了解的更多
We’re learning more every day,
每一份新的信息都给我们提供了一个增加我们武器的工具
and each new piece of information gives us one more tool to add to our arsenal.
历史会重演 但科学会产生影响
“History repeats, but science reverberates.”
这是普利策奖获奖作品《the Emperor of All Maladies
That’s a quote from the Pulitzer Prize winning book, the Emperor of All Maladies
a Biography of Cancer》的一段话
a Biography of Cancer.
我们强烈建议你读或听这本不同寻常的书
We highly recommend you read or listen to the extraordinary book.
如果你浏览Audible.com/Teded
If you visit Audible.com/Teded,
你可以免费下载这本书的音频版
you can download an audio version of this book for free.
Teded是非盈利组织
Teded is an non-profit
使用这两种方法来选择下一本好书
and using either of these methods to select your next great book
帮助我们继续为每个人创造免费的教育视频
helps us continue to create free educational videos for everyone.

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视频概述

我们已经利用了电力,测序了人类基因组,并消灭了天花。但是,在数十亿美元的研究之后,我们还没有找到一种能够在任何时候影响1400多万人及其家人的疾病的解决方案。为什么治疗癌症如此困难?Kyuson Yun解释了这些挑战。

听录译者

收集自网络

翻译译者

【MED】恩来

审核员

审核团GK

视频来源

https://www.youtube.com/watch?v=h2rR77VsF5c

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