A new study published in the journal Nature Communications by scientists from Garvan Institute of Medical Research in Australia has revealed that cancer cells could sometimes lie sleeping in the bones for months or years, until woken up to start dividing and causing serious cancer disease by some medical influences.
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The importance of this research lies in the fact that it is necessary for understanding new bone cancer treatments, or metastatic cancer in patients.
Using the latest state-of-the-art microscopy techniques, the scientists observed cancer cells snoozing and then woken up when surrounding tissues in the bone hosting them change. The researchers prove that breast and prostate cancers among others often start off in the bones before spreading out to their eventual sites.
Professor Peter Croucher, Head of Garvan's Bone Biology Division and the study's lead investigator noted that "Once a cancer spreads to bone, it becomes notoriously difficult to treat. So, it's important to establish exactly what wakes those cells in bone. Is it some signal within the cells themselves, or is it a change in their environment?”
And then he added that the wake-up phenomenon occurring to cancer cells can be likened to what happen to people in the morning: some wake up naturally without anyone or anything waking them up, others need an alarm clock, some other person, or streaming sunshine to wake them up.
Employing the intravital two-photon microscopy, scientists monitored multiple myeloma cells injected into the tibia or longer bone of the leg – but that of a lab mouse in this instance. Most of the cells immediately became inactive and went into sleep, and funny enough their fluorescent dye became dimmed by wakeful cells which were dividing.
"Because we were looking at a long bone like a tibia (rather than the skull, which is more commonly studied), we could watch the same sleeping cancer cells, in the same bone, in the same mouse, over a long period of time - and this is something that hasn't been done before," said Dr. Tri Phan.
And then Prof. Croucher added that "Because we've done it this way, we can show that there are a great many dormant cells - yet only some of them get woken up, and those that do wake, wake at different times. We even saw some cells that woke then went back to sleep again.”
Croucher stated that since the myeloma cells behave differently even though they come from the same source indicates that an influence from outside the cells is signaling when they wake up for work.
Dr. Michelle McDonald, a bone biologist volunteered that cells known as osteoblasts build new bones and those known as osteoclast break bones down. She revealed that bone-lining cells are usually inactive and provide the environment that makes myeloma cells go to sleep, but activating osteoclasts change the peaceful environment and makes myeloma cells to wake up into action.
Having understood that cancer cells are woken up when osteoclasts create changes in the surrounding bone hosting the sleeping cancer cells, the research team now think two prospects arise for treating bone metastasis.
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The first treatment option is to hinder the action of osteoclasts in breaking down bone structures via the use of osteoporosis drugs – this will keep cancer cells in perpetual sleep; and the second option is to activate osteoclasts and wake up sleeping cells so that cancer treatments could target them for total destruction.