Chemoprevention backgrounder: Working for a future of cancer chemoprevention

, or blast it from the inside (chemotherapy).

But Hong worked in the field of head and neck cancers, which, along with lung cancers, are among the most common and most difficult to treat. Many of these cancers are associated with smoking, so Hong reasoned that if he could find genetic changes in cells lining the airways that are exposed to carcinogens, then targeting these "precancer" cells for treatment could delay the onset of cancer in some people.

Hong did find an "initiation phase" in which genetic changes produce premalignant lesions, which then can morph into full-blown cancer cells. He then collaborated with Reuben Lotan, Ph.D., now a professor in the Department of Thoracic/Head and Neck Medical Oncology, who had been studying the role of vitamin A (retinol) and its chemical cousins, known as retinoids, in cancer cell growth and death. Lotan suspected, and later proved, that tobacco smoke hampered efficient functioning of retinoids, and after a series of experiments, Lotan and Hong began to study whether retinoids could reverse precancerous changes in the lungs of former smokers.

Thus, the first such chemoprevention trial of its kind was launched. In the early 1990s, they demonstrated that high dose retinoids could, indeed, stop precancerous growths in the mouth and oral cavity from turning into cancer, allowing them to return to a normal state. The pioneering work provided the first proof that cancer could be reversed.

That effort continued. A different formulation of retinoid, known as 13-cis retinoic acid, has been found to prevent the development of second primary tumors in patients who have successfully completed treatment for head and neck cancers. Scott Lippman, M.D., professor and chair of M. D. Anderson's Department of Clinical Cancer Prevention, led the phase III trial, testing 13-cis retinoic acid in 1,265 patients with early stage lung cancer.

Yet another chemical cousin has shown itself to be a chemopreven

Contact: Nancy Jensen
University of Texas M. D. Anderson Cancer Center

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