Opinion: Lessons of a Nobel Prize – By MINABERE IBELEMA

Nobel

This year’s Nobel Prize in Physiology or Medicine went to two immunologists for their revolutionary contribution to the treatment of cancer. They are the brains behind immunotherapy.

For long, the primary treatments of cancer were surgery, radiation and chemotherapy. Though they are considerably effective, they often can’t get to all cancer cells. They are analogous to surgical strikes and aerial bombardments in combating guerilla incursions. It is rare that a guerrilla war is won that way.

Immunotherapy, in contrast, is like dispatching ground troops to ferret out the guerrillas from all their hideouts. Ultimately, that’s the way to win the war.

What James P. Allison, of the University of the Texas, and Tasuku Honjo, of Kyoto University, separately discovered is that certain cancers can be cured more effectively by aiding the body’s immune system. Their breakthrough is a reminder that the logic of science is fundamentally simple. It is through that logic that society largely took control of its destiny rather than grope around in mysticism.

Through all of human history, people have grappled with the question of why things are. Cultures have evolved largely in response to a given people’s answer to that question. And for much of human history, people have turned to supernatural forces for explanations. Earthquakes, hurricanes, and plagues were all manifestations of God’s or gods’ wrath.

When people got ill, it was because they offended a deity, witch or wizard. And the only recourse was to repent or appease the offended, perhaps through sacrifices and other rituals. These beliefs and practices sadly remain the norm in much of Africa.

All the while those who thought in scientific terms were busy searching for real answers. A major breakthrough with regard to diseases came in the 1860s when the French biologist Louis Pasteur discovered that the human habitat is also occupied by billions of microbes that crawl all over the skin, tables, foods, drinks — all over.  Pasteur also found that these microbes were responsible for various afflictions.

It took subsequent research to determine which particular microbes caused particular afflictions. And so came the germ theory of illnesses, which led to rapid advancement in the cure of various diseases.

But not all. Cancer, for example, has proven incredibly resistant to cure. And that’s because it develops from abnormalities in what otherwise is routine replication of cells in the human body. Ordinarily, the replication of cells is a necessary process that keeps us vital. But on occasion it goes haywire, creating a mass that chokes off normal functions of the affected organ.

Until recently, the approaches to curing cancer were limited to surgically removing the affected tissues or organs and/or killing the cancer cells with radiation or chemotherapy. The advancement that earned Allison and Honjo the Nobel Prize is demonstrating that the immune system can be effectively unleashed to destroy cancer cells with greater precision and in every nuke of the human body.

The immune system is, of course, the body’s own powerful defence force that routinely routs invaders. It is to its credit that recourse to myths and superstition in treating illnesses often “worked.”

In giving credit to the immune system, medical science has since developed various ways of helping it do its work. When, for example, a wound is treated with antibiotics and bandaged, the purpose is not to directly heal the wound. It is to keep invading microbes out and so reduce the number of them the immune system would have to fight off to heal the wound.

Medical science has also dealt with the fact that the immune system can overreact or underreact. Overreaction is evident in people who suffer from allergies. In essence, the immune system sickens people by reacting to allergens with much greater force than is warranted by the danger. It is the equivalent of a barrage of artilleries just to dislodge a rat.

Most people don’t experience such overreaction because the immune system has checks on its own warriors. It is much like what responsible governments do to restrain their soldiers from excesses during wars.

Allison and Honjo theorized that the inbuilt checks on the body’s immune warriors were keeping them from effectively attacking cancer cells, which, for practical purposes, are invaders. It took subsequent research to identify the particular proteins that serve as restraining agents. Allison and Honjo then developed what they call checkpoint inhibitors to keep those proteins from restraining the immune warriors. It has worked.

What is now known as immunotherapy has become standard treatment for several major cancers, among them lung, kidney, bladder and skin cancers. Like existing treatments, immunotherapy has severe side effects and has not been approved for all cancers. But it has proven successful in instances in which the other therapies have failed.

Allison and Honjo — both in their 70s — are still working to perfect the treatment they developed. “It’s a big challenge,” Allison told the New York Times. “But we know the basic rules now. It’s just a matter of more hard work to put things together based on science.”

Honjo is similarly enthused about current efficacy and future prospects. “When I’m thanked by patients who recover, I truly feel the significance of our research,” he has been quoted as saying. “I’d like to continue researching cancer for a while so that this immunotherapy will help save more cancer patients than ever before.”

The implicit point the septuagenarians have made both by what they have accomplished and how they characterize it is this: The logic of science may be simple, but it takes hard work and perseverance to arrive at the desired end. Myths and superstitions require no effort or serious reflections. Science does.punch

 

 

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